Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study


  • Ritu Goyal Department of Obstetrics and Gynecology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
  • Mini Bedi Department of Obstetrics and Gynecology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India



Lower segment caesarean sections, Non-steroidal anti-inflammatory drugs, Postpartum intrauterine contraceptive device


Background: Post-partum family planning is prevention of unintended and closely spaced pregnancies during first 12 months following childbirth. Postpartum IUCD is the best method of all as it is the safest, most effective, has no effect on breast feeding, reliable and with minimum complications.

Methods: The cross-sectional study was conducted in AIMSR Bathinda on 400 postpartum patients. It was a prospective, observational study of women who received PPIUCD in our region.

Results: Out of total 400, 58% had normal vaginal delivery and 42% had cesarean section. PPIUCD was done in all cases after applying exclusion criteria and the females were called for follow up.  53% cases who had cesarean and 47% of normal vaginal delivery turned up for follow up. Acceptance is more in multipara (20.7%) than in primi patients (13.7%). Almost 90% patients had good continuation rate. There were few problems faced by patients like irregular bleeding for first few months, pain lower abdomen, leucorrhea etc. which were removed by good counseling and some treatment like NSAIDs for bleeding.

Conclusions: The acceptance of PPIUCD was high in present study in both types of females delivered by normal vaginal delivery or post LSCS but with good counseling efforts. It was safe and effective and had high retention rate when done at good timing by trained service provider that is within 10 minutes of placental delivery. So the need of time is creating awareness of public towards it and removing fear from minds, breaking taboos and myths.



Novodani KT, Foneska P, Goonewardena CS. Postpartum family planning: missed oppurtunities across the continuum of care. Ceylon Med J. 2017;2:87-91.

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

Rutstein SO. Effects of preceding birth intervals on neonatal, infant and under‐five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. International J Gynecol Obstet. 2005;89:S7-24.

International Institute for Population Sciences (IIPS) and Macro International: National Family Health Survey (NFHS-3). 2015-16. Available at:

Mishra S. Evaluation of safety, efficacy and expulsion of post-placental insertion of intra-cesarean insertion of intauterine contraceptive device (PPIUCD). J Obstet Gynecol India. 2014;64(5):337-43.

World Health Organization: Medical Eligibility Criteria for Contraceptive Use. 4th edition. Geneva: World Health Organization; 2010. Available at:

Government of India: All India Summary of National Rural Health Mission Program. 2012. In Available at: Accessed on 8 March 2013.

WHO. Medical Eligibility Criteria for Contraceptive use. 5th ed. Geneva WHO; 2015. Available from:

International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3) India. 2005-2006. Key Findings. Mumbai, IIPS, 2007. Available at: Accessed on 14 March 2013.

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 intra-uterine contraceptive devices: randomized study. Am J Obstet Gynecol. 1996;175:1231-5.

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

Araujo VB, Ortiz L, Smith J. Postpartum IUD in Paraguay: a case series of 3000 cases. Contraception. 2012;86:173-86.

Blumenthal P, Shiliya N, Neukom J, Chilambwe J, Vwalika B, Prager B, et al. Expulsion rates and satisfaction levels among immediate postpartum IUD users in peri-urban Lusaka, Zambia. Contraception. 2011;84:320.

Mohamed SA, Kamel MA, Shaaban OM, Salem HT. Acceptability for the use of postpartum intrauterine contraceptive devices: Assiut experience. Med Principle Pract. 2003;12(3):170-5.

Grimes D, Schulz K, van Vliet H. Immediate post-partum insertion of intrauterine devices: a Cochrane review. Hum Reprod. 2002;17(3):549-54.

Shukla M, Qureshi S, Chandrawati. Post-placental intrauterine device insertion- a five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136:432-5.

Hooda R, Mann S, Nanda S, Gupta A. Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study of follow-up outcomes. Int J Reprod Med. 2016;2016:1-5.

Sood B, Asif R, Charurat E, Das S, Kumar S, McKaig C, et al. Revitalization of postpartum IUCD (PPIUCD) services: experience from India. Contraception. 2012;86(2):184-5.

Welkovic JS, Costa F, Faundes A. Post-partum bleeding and infection after post-placental IUD insertion. Contraception. 2001;63(3):155-8.

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

Iftikhar PM, Shaheen N, Arora E. Efficacy and satisfaction rate in postpartum intrauterine contraceptive device insertion: a prospective study. Cureus. 2019;11(9).

Çelen S, Sucak A, Yildiz Y, Danis N. Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section. Contraception. 2011;84(3):240-3.

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

Muller ALL, Ramos JGL. Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study. Contraception. 2015;72(3):192-5.

United Nations Population Information Network (POPIN) UN Population division. Department of Economic and Social Affairs with support from UN Population Fund. Network Intrauterine devices Family Health International. 1996;16 (2).






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