An emerging study reveals that doctors are unclear about which women can safely and effectively receive intrauterine devices (IUD). The researchers surveyed health care providers at a variety of health clinics in Colorado and Iowa and found that only about half of them felt that the ParaGard® (intrauterine copper contraceptive) and Mirena® (levonorgestrel-releasing intrauterine system) IUDs were safe and reliable for women who had recently given birth, said My Health News Daily. About 30 percent of those surveyed said these IUDs were not safe for women who just underwent abortions. Both views are in conflict with recent American College of Obstetrics and Gynecology recommendations, which indicate that, as of 2011, just about every woman—including those who just gave birth or received an abortion—can be safely implanted with the devices. Of concern is that, typically, health care providers at family planning clinics are usually better informed about IUD use than typical physicians, noted My Health News Daily, which means that misconceptions about IUDs might be more widespread, said study researcher Claire Brindis, a director of the Bixby Center for Global Reproductive Health at the University of California, San Francisco. For their study, Brindis and colleagues reviewed data from 273 doctors, doctor’s assistants, nurse practitioners, certified nurse midwives, and registered nurses who completed surveys in 2010 and 2012, said My Health News Daily. During that time, IUD education was increased by family planning agencies at health care providers in Iowa and Colorado. IUDs may have greater efficacy in preventing pregnancy than birth control pills, skin patches, or vaginal rings, said My Health News Daily. A study published this May in the New England Journal of Medicine revealed that women using birth control pills, skin patches or vaginal rings were 20 times likelier to become pregnant over a three-year period versus women using IUDs or implants. But, IUDs carry risks. For instance, women diagnosed with a pelvic infection and women prone to these infections should not use IUDs. The ParaGard® IUD, a copper, hormone-free device, has been linked to heavy bleeding, severe cramping, and vaginal inflammation; the Mirena® IUD releases small amounts of a synthetic progestin hormone and has been linked to hormonal side effects that include acne, weight gain, or mood changes, My Health News Daily explained. Neither IUD protects against sexually transmitted infections. We’ve long written about some of the adverse effects women have experienced with IUDs. Specifically, uterine perforation or perforated uterus is a possible side effect of the Mirena® IUD. In fact, about 2 in 1,000 women who use the Mirena® device and other IUDs have reported cases of uterine perforation. The Mirena® IUD is inserted into the uterus, where it can remain for up to five years. A plastic string tied to the end of the Mirena® IUD hangs down through the cervix into the vagina. Women who have received the Mirena® IUD are instructed to check the string to ensure the device is in place. The U.S. Food & Drug Administration (FDA) says that Mirena® has been associated with a number of serious side effects, including perforation of the uterine wall or cervix, embedment of the device in the uterine wall, ectopic pregnancy, intrauterine pregnancy (a pregnancy with Mirena® in place), Group A streptococcal sepsis, and pelvic inflammatory disease (PID). Mirena® uterine perforation is a serious, life-threatening complication that often requires emergency surgery to correct. This potential Mirena® side effect can lead to other serious health consequences, including damage to other organs, infection, infertility, the need for a hysterectomy, adhesions and scarring, and intestinal obstruction Perforation of the uterus can occur when Mirena® is being implanted. Bayer has estimated that this occurs in approximately one per 1,000 – 10,000 insertions; however, Mirena® uterine perforations can also occur when the device migrates from its proper position. After the Mirena® IUD punctures the uterus, it can even migrate into the abdominal cavity and potentially puncture the bladder or intestines. Because the potential consequences of a Mirena® uterine perforation are so serious, it is important that women who have received this IUD be aware of possible symptoms, including abnormal bleeding (may be continuous), abdominal pain, fatigue, tiredness, pelvic infection, lost threads, and pregnancy.