Is lactation a risk factor of IUD- and sterilization-related uterine perforation? A hypothesis

A recent article reported a high risk of IUD-related uterine perforation in lactating women in the U.S. This article prompted the authors to examine the large international datasets on IUDs and tubal sterilizations collected by Family Health International. The findings are somewhat suggestive of such a positive association in IUD users as well as in women undergoing laparoscopic or minilaparotomy sterilization. More definitive studies are urged.