Clinical availability of the copper IUD in rural versus urban settings: A simulated patient study

OBJECTIVE: To assess the proportion of Washington state clinics that offer the copper IUD in rural vs urban settings. STUDY DESIGN: We employed a simulated patient model to survey clinics in the Human Health Resources and Services Administration 340B database to primarily assess the availability of the copper IUD. RESULTS: We successfully surveyed 194/212 (92%) clinics. More urban than rural clinics reported copper IUD availability (76/97 [78%] vs 49/97 [51%]; p < 0.01). CONCLUSIONS: Rural clinics are less likely than urban clinics to have the copper IUD available. IMPLICATIONS: The frequency of unintended pregnancies is high in the United States. We should focus our attention on decreasing barriers to the copper IUD as a long-acting reversible contraceptive, particularly for women living in rural settings.