The intrauterine device (IUD) is an excellent postpartum contraceptive method. Right after childbirth, women are certain that they are not pregnant, they are highly motivated to use contraception and they appreciate avoiding extra visits to the pharmacy or clinician’s office.

According to the U.S Medical Eligibility Criteria for Contraceptive Use:

• Immediate postpartum insertion, which refers to inserting the IUD within 10 minutes of delivery of the placenta, is safe and effective. Immediate insertion of a copper IUD in postpartum women can be used without restrictions (1), but immediate insertion of a levonorgestrel (LGN) IUD in both breastfeeding and non-breastfeeding women should be used with mild caution (2).
• Insertion of both the copper IUD and levonorgestrel IUD after 10 minutes postpartum, but before 4 weeks postpartum should be done with mild caution (2).
• Insertion of either IUD at or after 4 weeks postpartum can be used without restrictions (1).

IUD expulsion risk is somewhat higher in women who opt for immediate insertion. However, immediate insertion of an IUD provides a highly effective contraceptive method even for women who miss their postpartum visit.

Take home lesson: Whether the benefits of immediate insertion outweigh the increased risk of expulsion is a decision for patients to make with the help of their clinicians.

Helpful Resources

Medical Eligibility for Initiating Contraception

IUD Fact Sheet

Sources

Grimes DA, Lopez LM, Schulz KF, et al. Immediate post-partum insertion of intrauterine devices. The Cochrane Database of Systemic Reviews. May 2010, (5); 1-26.  

Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Mar 2009, 80(20090; 327-336. 

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The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.