Acceptability, safety, and clinical outcomes of postpartum intrauterine contraceptive device insertion: a prospective study at a tertiary care hospital

Shruthi K. R.; Ananda Kalgudi

doi:10.18203/2320-1770.ijrcog20252889

Authors

Shruthi K. R. Department of Obstetrics and Gynecology, JSS Medical College and Hospital, JSS AHER, Mysuru, Karnataka, India
Ananda Kalgudi Department of Neurosurgery, Mysore Medical College and Research Institute, Mysuru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252889

Keywords:

PPIUCD, Acceptability of PPIUCD, Postpartum contraception

Abstract

Background: Contraception is vital in improving the quality of life of women and reducing the maternal mortality and morbidity, occurring due to unplanned pregnancy. During the immediate post-delivery period, women are highly motivated and need an effective method of contraception. The benefits of the postpartum intrauterine contraceptive device (PPIUCD) have to be emphasized to the women

Methods: The present study was conducted in the department of obstetrics and gynecology, JSS hospital, Mysore, from June 2021 to June 2024, spanning a period of 3 years. After counseling and consent, Copper T 380A was inserted after delivery. Acceptability, safety, and clinical outcome were studied.

Results: Among a total of 14196 deliveries at JSS hospital during the study period, 3107 PPIUCDs were inserted (21.88%). The 2522 among 6258 antenatally counselled women accepted PPIUCD insertion (40.3%), and 2450 (97.14%) got PPIUCD inserted. The 585 (11.68%) out of 5006 women counseled on admission for delivery had PPIUCD inserted. The most common reason for denial of PPIUCD was a family member's objection, followed by the concern about side effects. The 718 (23.10%) women reported complications like excessive bleeding, white discharge per vagina, abdominal pain, and only 2 (0.075%) had spontaneous expulsion of PPIUCD.

Conclusions: PPIUCD appears to be a safe and effective method of contraception. All the institutions providing health care to women need to be trained in the correct insertion technique of PPIUCD, counselling of women and family members, to propagate this novel method of contraception, and to motivate the women for continuation of IUCD by providing effective follow-up service.

Metrics

Metrics Loading ...

References

Sara Hertog, Patrick Gerland, and John Wilmoth, UN DESA Population Division. UN DESA Policy Brief No. 153: India overtakes China as the world’s most populous country. April 2023 United Nations Department of Economic and Social Affairs. Available at: https://desapublications.un.org/policy-briefs. Accessed on 15 July 2025.

Devaraj K, Gausman J, Mishra R, Kumar A, Kim R, Subramanian S V. Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993-2021. Reprod Health. 2024;21(1):48. DOI: https://doi.org/10.1186/s12978-024-01781-6

Thota S, Nasreen MU, Ramadevi S, Himasree M. Study of acceptability for the use of postpartum intrauterine contraceptive device among women attending the government general hospital, Guntur. N Indian J OBGYN. 2023;9(2):349-53. DOI: https://doi.org/10.21276/obgyn.2023.9.2.31

Sharma M, Joshi S, Nagar O, Sharma A. Determinants of intrauterine contraceptive device discontinuation among Indian women. J Obstet Gynecol India. 2014;64(3):208-11. DOI: https://doi.org/10.1007/s13224-014-0516-5

Dorairajan G, Ashok VM, Veena P. Effect of the timing of insertion of postpartum intrauterine contraceptive device (PPIUCD) copper T380A on expulsion rates. Indian J Med Res. 2023;157(4):322-9. DOI: https://doi.org/10.4103/ijmr.IJMR_1485_19

Medical eligibility criteria for contraceptive use. 5th edition. Geneva: World Health Organization. World Health Organization. 2015;268.

Gupta S, Bansal R, Shergill HK, Sharma P, Garg P. Correlates of post-partum intra-uterine copper-T devices (PPIUCD) acceptance and retention: an observational study from North India. Contracept Reprod Med. 2023;8(1):25. DOI: https://doi.org/10.1186/s40834-023-00222-2

Radhika AG, Gupta R, Suneja A, Dorairajan G, Aggarwal P, Ashok V, et al. Evaluation of long-term clinical outcomes among PPIUCD users at six medical college hospitals. Int J Reprod Contracept Obstet Gynecol. 2024;13(11):3255-67. DOI: https://doi.org/10.18203/2320-1770.ijrcog20243187

Gudi SN, Jyoti S, Renu M, Mrinalini M, Shailja RRS, Sushma S, et al. A Prospective Multi-centric Study of Acceptance, Insertion and Follow-Up of Postpartum Insertions of IUCD. J Obstet Gynaecol India. 2023;73(3):254-261. DOI: https://doi.org/10.1007/s13224-022-01738-4

Dagar S, Kanishka, Pandey V, Deepanshu, Varsha, Sachin et al. Study to Assess Knowledge and Attitude Regarding PPIUCD among Antenatal Mothers at Selected Hospitals, Gurugram, Haryana. Int J Adv Multidiscipl Res Studies. 2024;4(6):1247-50. DOI: https://doi.org/10.62225/2583049X.2024.4.6.3592

Kumari M, Shukla DL. Study of immediate postpartum insertion of (cu-t 380a) to evaluate its acceptability and complications. Int J Acad Med Pharm. 2023;5(5):1742-6.

Bharia M, Jakhar R, Choudhary A, Vishnoi N. Comparison of satisfaction and outcome of PPIUCD and interval IUCD at a tertiary care center in western Rajasthan. Asian J Pharm Clin Res 2023;16(12):249-52. DOI: https://doi.org/10.22159/ajpcr.2023.v16i12.48597

Srivastava A, Sharma S, Lalchandani K, Mohanty N, Bhatt DC, Usmanova G, et al. One-year continuation of postpartum intrauterine contraceptive device: Findings from a prospective cohort study in India. PLoS One. 2024;19(6):e0304120. DOI: https://doi.org/10.1371/journal.pone.0304120

Sengar S, Ohary R, Rakhonde AK, Sengar JU. Clinical Outcome of Post-placental PPIUCD in a Primigravida Woman Delivering by Caesarean Section. Int J Heal Clin Re. 2021;4(17):155-8.