Clinical Edge

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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.

Citation:

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.