Re: Difficult IUD insertions [letter]

I read Dr Drapers letter in the January 2008 issue of the Journal with great interest. May I suggest that another factor may be the increased intensity of counselling these days? This is of course necessary as patients have a right to information and documented counselling is our only defence if complications occur. Nevertheless we need to acknowledge that it increases anxiety for both patient and clinician and this in itself may make fitting harder. It is matter of national concern that in some areas access to intrauterine device fitting is limited and we need to encourage the acquisition of a skill that can give a great deal of satisfaction and pride in a service that means a great deal to many of our patients. It would be a shame if medico-legal anxieties took the joy out of performing this and other practical procedures. (full-text)