Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre

Kanchan Rani, Nirmal Kumar Pangtey, Garima Khanna, Mahima Rani


Background: According to USAID/ ACCESS 2009 survey, in India, 65% of women in first year postpartum have an unmet need for family planning. Recommended spacing between birth to next pregnancy is at least 24 months and between abortion to next pregnancy is at least six months (WHO Technical Committee,2006). Pregnancy before 24 months of previous birth increase maternal and perinatal morbidity and mortality. So, during this postnatal period woman must be offered any form of reversible contraceptive. IUCD is most frequently use reversible method of family planning in the world. The aim of present study is to evaluate acceptability safety efficacy and complication of PPIUCD in tertiary care center.

Methods: This is a retrospective study conducted at Government Medical College and Hospital in northern India over a period of 1 year from January 2016 to December 2016. Patients were followed up to 6 months period and their complaints and various parameters were analyzed.

Results: 219 patients were inserted PPIUCD during 1-year period. Acceptance rate was higher in P2 (51.6%), between 20 to 25 years of age (47.49%) followed by 26 – 30 years of age (38.8%). On follow up 44.3% had no complaints. Most common complaints were lower abdominal pain (15%), missing thread (14.6%) and vaginal discharge (8.2%). 5.48% women came for removal of IUCD. Main cause of removal was pressure from family and lower abdominal pain. Expulsion rate was low (2.74%). There was no case of perforation or failure (pregnancy).

Conclusions: During present study authors found that PPIUCD is highly effective, acceptable, safe and with fewer side effects. PPIUCD is especially beneficial in Indian population where accessibility for contraception is lower during interval period and women do not come for contraception during postpartum period.


Complications, Intra caesearean, Post placental, PPIUCD

Full Text:



WHO (1970). Techn. Rep. Ser. No. 442. Available at:

WHO (1975). Techn. Rep. Ser. No. 569. Available at:

United Nations (1975) World Conference of the International Women’s Year: World Plan of Action, Document E/C of .66/5, 1975, UN Secretariat. Available at:

Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet. 2006;368:1810-27.

Akkuzu G, Vural G, Eroglu K, Dilbaz B, Taskin L, Akin A, et al. Reason for continuation or discontinuation of IUD in post placental/early post-partum periods and post puerperal/interval periods. One year follow up. Turkiye Klinikleri J Med Sci. 2009;29:353-60.

Lim SS, Dandona L, Hoisington JA, James SL, Hogan MC, Gakidou E. India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. Lancet. 2010 ;375(9730):2009-23.

Government of India: All India Summary of National Rural Health Mission Program, 2012. Available at:

Katheit G, Agarwal J. Evaluation of post placental intrauterine contraceptive device (PPIUCD) in terms of awareness, acceptance and expulsion in a tertiary care centre. Int J Reprod Contracept Obstet Gynaecol. 2013;2:539-43.

Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD). J Obstet Gynaecol India. 2014;64:337-43.

Bhalerao AR, Purandare MC. Post-puerperal Cu-T insertion. A prospective study. J Prostgrad Med. 1989;35:70.

Malchuru S, Arun V, Prabhavathi N. Postpartum intrauterine device insertion- 2 years’ experience at tertiary care centre in Gunture Medical College/Govt general hospital, Guntur. J Dent Med Sci. 2015;14:56-61.

Gautam R, Arya KN, Kharakwal S, Singh S, Trivedi M. Overview of immediate PPIUCD application in Bundelk hand region. J Evol Med Dent Sci. 2014;3:9518-26.

Vidyarama R, Nagamani T, Prasad U. PPIUCD as a long acting reversible contraceptive (Larc)-an experience at a tertiary care centre. IJSR. 2012;4:5-7.

Chen BA, Hayes JL, Hohmann HL, Perriera LK, Reeves MF, Creinin MD. A randomized trial of post-placental compared to delayed insertion of the levonorgestrel releasing intrauterine device after vaginal delivery. Obstet Gynecol. 2010;116(5):1079-87.

Nayak AK, Jain MK. Experience on awareness, acceptability, safety, efficacy, complications and expulsion of postpartum intrauterine contraceptive device insertion. Int J Sci Stud. 2017;5(1):207-12.

Eroglu K, Akkuzu G, Vural G, Dilbaz B, Akın A, Taşkın L, et al. Comparison of efficacy and complications of IUD insertions in immediate post-placental/early postpartum period with interval period: 1-year followup. Contracept. 2006;74(5):376-81.

Kittur S, Kabadi YM. Enhancing contraceptive usage by PPIUCD insertion with evaluation of safety, efficacy and expulsion. Int J Reprod Contracept Obstet Gynaecol. 2012;1(1);26-32.

Celen S, Moroy P, Sucak A, Aktulay A, Danışman N. Clinical outcomes of early post-placental insertion of intrauterine contraceptive devices. Contracept. 2004;69(4):279-82.

Beltagy NS, Darwish EA, Kasem MS, Hefila NM. Comparison between cupper T 380 IUD and multiload 375 IUD in early postpartum insertion. Middle East Fert Soc J. 2011;16(2):143-8.

Bluementhal P, Shiliya N, Nenkom J. Expulsion rates and satisfaction levels among immediate postpartum IUD users in periurban Lusaka, Zambia. Contracept. 2011;84:320.

Shobhasmita B, Anupal S, Alakananda D, Bhattacharjee A, Nabnita D. Acceptance of postpartum intrauterine contraceptive device among women attending Gauhati Medical College and Hospital for delivery between January 2011 to December 2014 and their follow up. J Evol Med Dent Sci. 2015;4:15756-8.

Runjun D, Bornali P. A retrospective study on acceptability and complications of PPIUCD insertion. J Evol Med Dent Sci. 2016;5:1631-4.