Acceptability, continuation and satisfaction of postpartum intrauterine contraceptive device (PPIUCD) and delayed insertion: a comparative study

Neha Jain, Nishat Akhtar


Background: Postpartum period is an ideal time to counsel and begin contraception as women are strongly motivated at this time, also being convenient for both patients and health-care providers. Copper T 380A is a safe, highly effective method of contraception and has become the method of choice of many women for attaining their reproductive goals.

Methods: It was a prospective study conducted from February 2012 and November 2013 in the Department of Obstetrics and Gynecology, JNMCH, AMU, Aligarh, U.P.

Results: 386 clients were counseled for immediate postpartum IUCD insertion (GROUP-I), out of which 34.2% clients accepted for insertion but 24.3% actually got it inserted. 337 clients were counseled for extended IUCD insertion (GROUP-II) out of these 61.1% clients accepted but only 16.5% actually got it inserted. 10.63%, 6.02% and 5.19% clients in GROUP-I and 16.22%, 13.11%, 11.54% GROUP-II went lost to follow up at 6 weeks, 3 months and 6 months respectively. Continuation rates in GROUP-I after 6 months was 73.4% in GROUP-I and 59.5% in GROUP-II. Among the clients who continued, 92.7% were satisfied in GROUP-I and 81.8% in GROUP-II.

Conclusions: Immediate postpartum IUCD has better acceptability, continuation and satisfaction profile when compared to extended insertion.



Contraception, Extended insertion, Immediate PPIUCD, Postpartum

Full Text:



Safwat A. Mohamed, Momen A. Kamel, Omar M. Shaaban, Hossam T. Salem. Acceptability for the Use of Postpartum Intrauterine Contraceptive Devices: Assiut Experience. Med Principles Pract. 2003;12:170-5.

Long Term Safety and Effectiveness of Copper-Releasing Intrauterine Devices; HRP External Evaluation 2003-2007; Outcome, Impact;6,7.

United Nations Development Programme, United Nations Population Fund, World Health Organization. Long-term reversible contraception: Twelve years of experience with the TCu380A and TCu220C. Contraception. 1997;56:341-52.

Sivin I, Stern J, Diaz S, Pavéz M, Alvarez F, Brache V et al. Rates and outcomes of planned pregnancy after use of Norplant capsules, Norplant II rods, or levonorgestrel-releasing or copper TCu 380Ag intrauterine contraceptive devices. Am J Obstet Gynecol. 1992;166(4):1208-13.

Skjeldestad FE. The impact of intrauterine devices on subsequent fertility. Curr Opin Obstet Gynecol. 2008;20(3):275-80.

Gillian D, Bimla SE. Intrauterine contraceptives (IUCs). In Robert AH, James T, Anita NL, Willard C Jr, Deborah K, Michael PS. Contraceptive technology (20th revised ed.). New York: Ardent Media;2011:147-191.

Padubidri VG, Daftary SN. Howkins and Bourne Shaws Text Book of Gyanecology. 15th Edition; p-18,19.

Ogburn JA, Espey E, Stonehocker J, Barriers to intrauterine device insertion in post partum women. Contraception. 2005;72(6):426-9.

Chen BA, Hayes JL, Hohmann HL, Perriera LK, Reeves MF, Creinin MD. A randomized trial of post placental compared to delayed insertion of levonorgestrol releasing intrauterine device after vaginal delivery. Contraception. 2009;80(2):205.

Gujju RLB, Prasad U, Prasad U. Study on the acceptance, complications and continuation rate of post-partum family planning using the post placental intrauterine contraceptive device among women delivering at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2015;4(2):388-391.

Gupta A, Verma, Chauhan J. Evaluation of PPIUCD versus interval IUCD (380A) insertion in a teaching hospital of Western U. P. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):204-8.

Celen S, Moroy P, Sucak A, Aktulay A, Danisman N. Clinical outcomes of early post placental insertion of intrauterine contraceptive devices. Contraception. 2004;69:279-82.

Çelen Ş, Sucak A, Yıldız Y, Danışman N. Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section in Turkey. Contraception. 2011;84:240-3.

O’Henley K, Huber DH. Post Partum IUDs; Key for Success; Association for Voluntary Surgical Contraception, New York. Contraception. 1992;45(4):351-61.

Tatum HJ, Beltran RS, Ramos R, Van Kets H, Sivin I, Schmidt FH. Immediate postplacental insertion of GYNE-T 380 and GYNE-T 380 postpartum intrauterine contraceptive devices: Randomized study. Am J Obstet Gynecol. 1996;175:1231-5.