Use of Paracervical Blocks for Patients Who Undergo Intrauterine Device Insertion
Authors' conclusion
In this cross-sectional time series study of IUD insertion procedures in a large academic health system, Latine ethnicity, non-English language preference, no prior patient-clinician visit together, and shorter appointment length were associated with lower odds of receiving paracervical blocks.
Study context
- Population
- Individuals undergoing intrauterine device (IUD) insertion at the University of California, San Francisco (UCSF) academic health system, July 2, 2012 to August 16, 2024
- Participants
- 13,702 IUD insertions
- Exposure
- Clinic-, clinician- and patient-level variables and paracervical block receipt
- Outcome
- Paracervical block receipt (from clinical notes)
Methodological detailssingle academic health system, electronic health record data, multilevel models, causal mediation analysis, Data analysed from October 2023 to April 2025
- Single academic health system
- Electronic health record data
- Multilevel models
- Causal mediation analysis
- Data analysed from October 2023 to April 2025
Main finding
As reported in the abstract
Paracervical block receipt
Odds ratio (95% CI)
Non-OB-GYN specialties
0.01(0.001–0.07)
Appointments <30 minutes
0.77(0.66–0.90)
Prior patient-clinician visit together
1.27(1.09–1.48)
Latine patients vs Non-Hispanic White patients
0.77(0.64–0.94)
Preferred language besides English
0.63(0.41–0.96)
- Overall insertions including a paracervical block
- 5311 (38.8%)
Observational data: associations, not effects.
Further findings
Paracervical block receipt by age (<18 years vs adults), mediated by pediatrics/adolescent medicine clinic care
total effect RD −0.11 (−0.19 to −0.03)
| Outcome | Indirect effect RD (95% CI) |
|---|---|
| Paracervical block receipt by age (<18 years vs adults), mediated by pediatrics/adolescent medicine clinic careMediated by clinic specialty | −0.22 (−0.26 to −0.18) |
- Paracervical block receipt by age (<18 years vs adults), mediated by pediatrics/adolescent medicine clinic care: denominators as printed: 347 (<18 years) and 135 55 (adults)
Original publication
Use of Paracervical Blocks for Patients Who Undergo Intrauterine Device Insertion. JAMA Netw Open. Published 1 April 2026. doi:10.
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