Clinical Edge

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Postpartum Levonorgestrel IUD Insertion & Breastfeeding

Am J Obstet Gynecol; ePub 2017 Aug 22; Turok, et al

Immediate postpartum intrauterine device (IUD) insertion is an acceptable option for women planning to breastfeed and use the levonorgestrel IUD despite higher expulsion rates, a recent study found. The study examined the effect of immediate vs delayed postpartum levonorgestrel IUD insertion on breastfeeding outcomes. Eligible women (aged 18-40 years) were pregnant, planned to breastfeed, and desired a levonorgestrel IUD. Enrolled women were randomized 1:1 to immediate postpartum insertion (immediate group, n=132) or insertion 4-12 weeks postpartum (delayed group, n=127). Researchers found:

  • Any breastfeeding at 8 weeks in the immediate group (79%) was noninferior to that of the delayed group (84%).
  • Time to lactogenesis in the immediate group was noninferior to that of the delayed group.
  • A total of 24 IUD expulsions occurred in the immediate group vs 2 in the delayed group.


Turok DK, Leeman L, Sanders JN, et al. Immediate postpartum levonorgestrel IUD insertion & breastfeeding outcomes: A noninferiority randomized controlled trial. [Published online ahead of print August 22, 2017]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2017.08.003.