Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

SFP Guideline on Postplacental Insertion of IUDs

Contraception; ePub 2017 Oct 5; Whitaker, et al

Postplacental intrauterine device (IUD) insertion is safe and does not have higher risks of complications than interval insertion, according to a recent review of Society of Family Planning (SFP) guidelines. The guidelines present an evidence-based assessment of postplacental IUD placement (placement within 10 minutes after delivery of the placenta) after vaginal and cesarean delivery. Other highlights and conclusions include:

  • Most studies found that the risk of IUD expulsion is higher after postplacental insertion than after interval insertion for both vaginal and cesarean deliveries.
  • Most studies found higher expulsion rates after vaginal delivery than after cesarean delivery; however, expulsion rates vary widely across studies with no clear evidence of factors influencing expulsion.
  • Patient populations with low rates of return for postpartum visits are most likely to benefit from postplacental IUD placement with appropriate counseling about risk and benefits.

Whitaker AK, Chen BA, Borgatta L. Society of Family Planning guidelines: Postplacental insertion of intrauterine devices. [Published online ahead of print October 5, 2017]. Contraception. doi:10.1016/j.contraception.2017.09.014.

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