Healthcare Professionals' Self-Perceived Confidence in Contraceptive Implant Localisation and Removal Procedures in Catalonia: A Cross-Sectional Study.

Purpose: Removal of contraceptive implants can be technically challenging, particularly in complex cases such as deeply located or non-palpable implants. To evaluate healthcare professionals' (HCPs') self-perceived confidence in contraceptive implant procedures-including localization and removals of varying complexity-and to examine their opinions regarding access to specialized referral pathways for difficult cases. Patients and Methods: A cross-sectional study was conducted among 135 HCPs involved in contraceptive implant management. Participants completed a structured questionnaire assessing self-perceived confidence (5 point Likert scales), frequency of complex case encounters and views on referral systems. Analyses included descriptive statistics, Mann-Whitney Results: The sample included 68.1% midwives (n=92) and 20.0% gynaecologists (n=27), with a mean age of 39.7±10.8 years and 11.6±9.3 years of experience. Self-perceived confidence was high for localization (48.1% "much", 17.8% "very much") but markedly lower for complex removals: 40.7% reported "very little" confidence for deeply located palpable implants and 70.4% for nonpalpable implants (89.7% "little/very little"). Gynaecologists reported significantly higher confidence than midwives (p ≤ 0.002). Awareness of referral pathways was low (31.9%), although support for creating specialized circuits was nearly universal (98.5%). Conclusion: HCPs reported limited confidence in performing complex implant removals. These findings highlight perceived confidence gaps and support consideration of targeted training and clear referral pathways to support safe and equitable access to implant removal services.