Copper intrauterine contraceptive device event rates following insertion 4 to 8 weeks post partum

There is a consensus in the literature that intrauterine contraceptive devices (IUDs) should not be inserted within 8 weeks post partum because of reported greater rates of pregnancy, expulsion, and perforation. This greater incidence of event rates was observed in certain clinics that used large plastic IUDs, mainly the loops. In an effort to determine whether the interval from delivery to insertion of a copper-bearing IUD caused altered event rates, an analysis of studies of parous women who were using five different copper-bearing IUDs was undertaken. During the time of these studies, 411 women had an IUD inserted between 4 and 8 weeks post partum, whereas 1,197 women had the IUD inserted more than 8 weeks after a term delivery. At the end of 1 and 2 years of use, there were 4,164 and 6,816 woman months of experience, respectively, in the women with postpartum insertion, and 11,647 and 19,733 woman months of experience with insertion more than 8 weeks post partum. There were no uterine perforations in this experience, and there were no significant differences in the termination rates of any event between the two groups. This retrospective analysis indicates that copper IUDs can be inserted at the time of the routine postpartum examination without concern that the rate of accidental pregnancy, expulsion, or removal for bleeding and/or pain will be increased in comparison with a later insertion.