Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences



Major Advisor

Dr. Ta'Neka Lindsay

Second Advisor

Dr. Kathy Hager

Third Advisor

Dr. Joy Monsma


Background and Purpose: Worldwide unintended pregnancy rates are reported at 40% of all pregnancies. The United States has an unintended pregnancy rate of 45%. Contraception is safe and available for most women. Many providers lack evidence-based tools and current information in assisting clients to choose a highly effective contraceptive method. Intrauterine devices (IUD) and implants are highly effective contraception. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend IUDs and implants as first tier contraception for most sexually active females.

Methods: Implementation of the World Health Organization Decision-Making Tool (WHO DMT) for contraceptive counseling guidance for clients and providers. The tool consists of a training manual for providers, exam room posters, flipcharts, and printed patient education materials. Pre and post intervention surveys were collected and analysis conducted.

Hypothesis 1: The WHO DMT will increase client selection of intrauterine devices as the preferred contraceptive method. Hypothesis 2: There will be an increased IUD selection by clients seen by providers using the WHO DMT for counseling. Hypothesis 3: Patients counseled with WHO DMT will be more satisfied with contraceptive method chosen.

Implications for practice: Use of WHO DMT can impact unintended pregnancy rate by educating women on the highly effective contraceptive methods, focusing on IUDs, to all populations, especially the underserved and vulnerable.

Keywords: Contraception, family planning, WHO DMT, intrauterine devices, shared decision- making, provider training