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Re: IUD and PID From: Betsy Hyde (elishyde@connix.com) Fri May 28 20:19:47 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Betsy Hyde: "Re: OB: new cases" Previous message: Steven Crawford: "Re: IUD and PID" Maybe in reply to: Deborah J. Wage FNP, CNM: "IUD and PID" Next in thread: Karen J. Bacon, RNC, WHNP: "Re: IUD and PID" At 7:57 PM 5/28/99, Steven Crawford wrote: >In all due respect, IUD placement, in my opinion only, should occur in >collaboration >with a physician. I realize this may cause some painful rebuttal, but I am >seriously only stating this fact for the patient's best overall interest. > >Patients are the focus of our existence. We are here for them to be >treated in a >professional, non biased manner. CNMs and APRNs and FNPs all are educated in evaluation of the patient and the suitability/non-suitability for an IUD. During this thread, there has been disagreement as to use of IUD in a woman with prior PID.....it has not been along professional lines. MDs and CNMs have said they would not use an IUD with prior history of PID. MDs and CNMs have said they would insert an IUD. Both sets of professionals are able to assess the suitability for IUD insertion, and there has been honest disagreement. > >Obviously, one should understand, fully, that an IUD does not cause PID. A >physician would know this simple fact, in all due respect to you. The >history of PID is an indicator that the patient has exhibited behavior, >albeit maybe in the past, that may clue the physician in as to the type of >activity >the patient may engage in or has engaged in somewhere in their past. Eliciting a history of sexual risk-taking behavior is standard in the teaching CNMs get in our programs. We are fully capable of taking a complete sexual history. IMO the issue is not history of PID, but type of sexual behavior the woman participates in at the present time. I have had clients w/ hx PID at a time in their lives when they had multiple sexual partners, and did not use contraception that would have prevented transmission of STDs. Now they are in monagamous relationships, have negative cultures, and, IMO are good candidates for IUDS. As you stated, an IUD does not cause PID (except, perhaps, the Dalkon shield because of the wicking action of their tails). I don't think this is a professional issue (MD vs CNM), rather one of adequate history taking and assessment of current risk. One does not need to be a physician to do this. -- Betsy Hyde CNM Branford, CT Next message: Betsy Hyde: "Re: OB: new cases" Previous message: Steven Crawford: "Re: IUD and PID" Maybe in reply to: Deborah J. Wage FNP, CNM: "IUD and PID" Next in thread: Karen J. Bacon, RNC, WHNP: "Re: IUD and PID"

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