Best Practices for IUD • Provide IUD the same day as requested, whenever possible, if pregnancy can reasonably be excluded. • Offer IUD at the time of natural vaginal delivery, abortion, or dilation and curettage for miscarriage. (Insertion of an IUD immediately after abortion or immediate post-partum is both safe and practical. IUD expulsion rates appear higher than after interval insertions) • Screen for sexually transmitted infections at the time of intrauterine device (IUD) insertion; if screening test result is positive, treat infection without removal of IUD. • Offer the copper IUD as the most effective method of emergency contraception. When inserted within five days( 120 hours) of unprotected intercourse, a copper-bearing IUD is the most effective form of emergency contraception available.
LARC (Long-Acting Reversible Contraception) Intrauterine devices (IUDs) are long-acting reversible contraception. ACOG’s LARC Program works to reduce unintended pregnancy. Ob-gyns, physicians whose primary responsibility is women’s health, play a leading role in providing scientific information and access to birth spacing methods, including IUDs for their patients.
LARC methods, such as IUDs, were 20 times more effective at preventing pregnancy among CHOICE Project participants than oral contraceptive pills, patches or rings. Despite potentially high costs and need for office visits and trained gynecologists and obstetric care providers for insertion and removal, LARC methods have advantages over other methods Advantages: • Effectiveness independent from coitus, user motivation, and adherence • Highest effectiveness, continuation rates, and user satisfaction of all reversible methods • No requirement for frequent visits for resupply • No requirement for additional funding for consistent use once placed
• Highly cost-effective • Reversible, with a rapid return to fertility after removal • Few contraindications The FDA has approved use of the copper IUD for up to 10 continuous years, during which it remains highly effective. It has a reported failure rate at 1 year of 0.8 per 100 women, and a 10-year failure rate comparable with that of female sterilization (1.9 per 100 women over 10 years). The most common adverse effects reported are abnormal bleeding and pain.
ACOG Strengthens LARC Recommendations “ACOG has long recommended LARC as the most effective reversible contraceptive option for most women, including those who have not given birth and adolescents.” Access to and knowledge about LARC methods increases use and may decrease unintended pregnancies, abortions, repeat abortions and adolescent birth rates. Additionally, A woman’s ability to choose if and when to become pregnant has a direct impact on her health and well-being and spacing between pregnancies can have important health implications for a mother and her baby. Research has shown that there are a number of issues which are more likely to occur when a woman is pregnant again within a year of giving birth. These issues include an increased risk of:
– Low Birth Weight – Small Gestational Size – Preterm Birth – Infant Death – Labor issues such as uterine rupture These conditions can threaten the health of the child and the mother and are associated with infant mortality and other short-term and long-term health complications. Birth spacing can prevent closely spaced and ill-timed pregnancies and births, which contribute to some of the world’s highest infant mortality rates