Expanding Access to Postpartum Contraception

Stanford’s Family Planning researchers continue to investigate barriers to postpartum contraception access, and their discoveries have the potential to shift current best practice in post-delivery IUD insertion.

In a recent study published in the Internal Journal of Gynecology & Obstetrics, our researchers examined the expulsion rate and IUD-to-fundus distance of copper IUDs inserted within or outside of a 10-minute window following placental delivery. Current guidance indicates that postplacental (≤ 10 minutes of placental delivery) IUD placement should be prioritized due to increased expulsion risk of placement after that 10-minute window. However, the data influencing this recommendation are limited in scope and consistency. Our team sought to investigate this guidance.

In a sample of 560 women who had an IUD inserted after delivery with standardized insertion methods, our researchers did not find a statistically significant difference in expulsion rate or IUD-to-fundus distance between those who had immediate insertion and those who had the IUD inserted after the 10 -minute window. These findings indicate that expanding guidelines to prioritize IUD insertion while still in the delivery room or facility, even outside the 10-minute window, will expand access to desired contraception.