A prospective study of immediate postpartum intra uterine device insertion in a tertiary level hospital

Arti Sharma, Vineeta Gupta, Neeta Bansal, Utkarsh Sharma, Archna Tandon


Background:In India there is an unmet need for contraception. Intrauterine device is a long acting reversible method. This study was done to determine the efficacy and safety of immediate Post-Partum Intrauterine Device (PPIUD) and to compare the outcome of PPIUD insertion after vaginal delivery and caesarean section.  

Methods:A total of 113 women who underwent PPIUD insertion were followed up at 6 weeks and 6 months post-partum. Outcome in term of side effects, removal and expulsion was compared in vaginal delivery and caesarean section insertions.

Results:In 61.45% women there was no complaint. Menstrual disturbances were found in 16.66% women and pelvic pain in 13.54% women. The expulsion rate was 5.20% and IUD removal was done in 13.54% women. Incidence of removal was more in vaginal insertions than in caesarean insertions and this difference was statistically significant. Continuation rate at 6 months was 81.25%.  

Conclusion:Immediate postpartum IUD insertion is a safe, convenient and effective method.


Immediate postpartum, Intrauterine device, Caesarean section, Expulsion rate

Full Text:



Post-partum IUCD reference manual. New Delhi: Family Planning Division, Ministry of Health and Family Welfare, Government of India, 2010. Available at: www.nrhmtn.gov.in.

Kulier R, O’Brien PA, Helmerhorst FM, Usher-Patel M, D’Areangues C. Copper containing, framed intra-uterine devices for contraception. Cochrane Database Syst Rev. 2007;(4):CD005347.

Shukla M, Qureshi S, Chandravati. Post-placental intrauterine device insertion: a five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136:432-5.

Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009;80:327-36.

Stefan Welkovic, Costa L, Faundes A, Ximenes R, Costa C. Postpartum bleeding and infection after postplacental IUD insertion. Contraception. 2011;63:155-8.

Anita L. Nelson. Safety, efficacy and patient acceptability of the copper T-380 A intrauterine contraceptive device. Clinical Medicine Insights. Women’s Health. 2011;4:35-40.

Fernandes JHA, Lippi UG. A clinical and ultrasound study on the use of post placental intrauterine device. Einstein. 2004;2(2):110-4.

Celen S, Sucak A, Yildiz Y, Danisman N. Immediate postplacental insertion of an intrauterine contraceptive device during caesarean section. Contraception. 2011;84:240-3.

Jose A. Lopez-Farhan, Alicia Hernandez-Gonzalez, Irvin J. Velez-Machorro, Leopoldo A. Vazquez- Estrada. A comparative, randomized study of levonorgestrel intrauterine system (LNG-IUS) vs. copper T 380 A intrauterine device applied during caesarean section. Open J Obstet Gynaecol. 2012;2(2):151-5.

Shereen Z. Butta, Iffat Javed Butt, Khadeja Bano. Insertion of intrauterine contraceptive device at caesarean section. J Coll Physicians Surg Pak. 2011;21(9):527-30.

Xu J, Yang X, Gu X, Xu S, Zhou X, Chen Y, et al. Comparison between two techniques use in immediate postplacental insertion of Cu T 380 A IUD. Reprod Contracept. 1999;10(3):156-62.