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Pain With Early Postpartum Intrauterine Device Placement.

Holly H Berkley1, Monica A Lutgendorf1, Gennifer Kully1

  • 1Department of Gynecologic Surgery and Obstetrics, Naval Medical Center San Diego, San Diego, and the Division of Complex Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California; the Division of Maternal Fetal Medicine, Department of Gynecologic Surgery and Obstetrics, and the Department of Preventative Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland; the Division of Complex Family Planning, Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois; and the Division of Complex Family Planning, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico.

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Summary
This summary is machine-generated.

Postpartum intrauterine device (IUD) placement pain is similar whether done early or later. This finding helps clinicians and patients make informed decisions about IUD timing.

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Area of Science:

  • Reproductive Health
  • Contraception
  • Clinical Trials

Background:

  • Postpartum intrauterine device (IUD) insertion is a common contraceptive method.
  • The timing of IUD placement (early vs. interval postpartum) may influence patient experience, particularly pain.
  • Understanding pain associated with different IUD placement timings is crucial for patient counseling.

Purpose of the Study:

  • To compare the pain experienced during early postpartum versus interval postpartum intrauterine device (IUD) placement.
  • To provide data to inform clinical practice and patient choice regarding IUD insertion timing.

Main Methods:

  • A secondary outcome analysis of a randomized trial involving 404 participants.
  • Participants were randomized to early (14-28 days) or interval (42-56 days) postpartum IUD placement.
  • Pain was assessed using a 100-mm visual analog scale during bimanual examination, speculum placement, and IUD insertion; linear mixed models were used for analysis.

Main Results:

  • No significant difference in mean pain scores was observed between the early and interval IUD placement groups for bimanual examination (P=.37), speculum placement (P=.66), or IUD placement (P=.32).
  • Per-protocol sensitivity analyses confirmed that pain scores were not meaningfully different from the primary intention-to-treat analysis.
  • A total of 325 participants who received IUDs were included in the pain analysis.

Conclusions:

  • Pain experienced during postpartum intrauterine device (IUD) placement does not differ significantly based on whether the IUD is inserted early or at an interval postpartum.
  • These findings can empower clinicians to better support patients in making informed decisions about the optimal timing for IUD insertion.
  • Further research may explore other factors influencing patient satisfaction with postpartum IUD placement.