Like millions of other users, Jenny Wu, a current medical resident in the department of obstetrics and gynecology at Duke's School of Medicine, joined TikTok at the start of the pandemic. Unlike millions of other users, Wu took the content TikTok’s algorithm recommended to her and turned it into a study.
Wu, School of Medicine ‘21, said that as a millennial, she got videos targeted at reproductive-aged women. In these videos, users described painful experiences with IUDs, or intrauterine devices, a type of birth control.
Now at over 1.4 billion views in the last several months, the trending hashtag #IUD has allowed TikTok to rise as a platform for women to share their experiences with IUD insertion, removal and general usage.
But when Wu read the comments on these videos, she found “a lot of distrust that people feel toward their health care professionals.”
“I'm an OB-GYN resident, and I do place a lot of IUDs for patients. And I think it's a really great form of birth control,” Wu said. “There was this big disconnect between what I recommend to a patient coming in who is not interested in having a pregnancy in the next few years, who wants a form of long acting, reversible birth control, and what I was seeing on TikTok of patients who really expressed a lot of pain, a lot of distrust, a lot of misinformation about it.”
So Wu decided to take a deeper look at these videos.
The study, recently published in “Obstetrics and Gynecology,” used a web-scraping application to compile the top 100 most viewed TikToks that had the hashtag #IUD. The top videos were then coded by Megan Happ, School of Medicine ‘25, according to a predetermined scoring system. The parameters considered the number of views, if the creator was a healthcare professional, the accuracy of the information and the tone as either “positive, negative, neutral or ambiguous.”
Happ said another focus was whether or not the video had an “explicit mention of distrust.”
Wu, Happ and the research team found that an overwhelming amount of the videos portrayed a negative experience with IUDs. The results showed that over one third of the top videos had a general negative tone, over one fourth contained mistrust of healthcare professionals and nearly one fourth of all analyzed videos contained inaccurate scientific claims.
“I think that this study on a larger scale quantifies the number of people that have feelings of distrust, or that they did not get the information that they needed to feel like they made an informed choice for their health and their body,” Happ said.
“With respect to IUDs in general, and contraceptive education in reproductive health, we are not meeting the needs right now of a significant portion of patients and adequately educating and preparing them for the experience,” Happ continued.
Happ said she feels that it is unsurprising that patients will question their doctors’ claims if they are seeing contradictory information on the internet.
“As health care providers … we have a responsibility to listen to that and to know that our patients are coming in with those concerns,” Happ said.
Although many reproductive healthcare advocates speak highly of IUDs, and Planned Parenthood says it is “one of the best birth control methods out there,” the videos with negative tones attract the most viewership.
“There aren't a lot of people who talk about how great their IUD is,” Wu said.
As a result of being presented with only the worst experiences with IUD insertion and removal, many patients may be fearful and lack the understanding that the experience may not be the same for everyone.
Wu found that many users’ videos had an underlying theme that “their pain was not adequately controlled.”
The study and its findings have changed the way Wu practices. She now preemptively offers patients pain management and explains that an IUD can be painful for some people.
“Getting seen by your OB-GYN shouldn't be a traumatic experience,” Wu said.
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Audrey Patterson is a Trinity first-year and a staff reporter of The Chronicle's 118th volume.