Objective: The present study was planned to evaluate the safety and efficacy of immediate postpartum
IUCD insertion in women delivering vaginally or by caesarean section.
Method: This prospective study was carried out at Sobhraj Maternity Hospital from 1st July 2012 to
30th June 2013. Women delivering in the hospital fulfilling inclusion criteria were included in the
study. Women with prelabour rupture of membranes for >18 hours, chorioamnionitis, temperature
>380
C during or after labour, continued excessive postpartum bleeding were excluded from the study.
The women included in the study underwent immediate postpartum insertion of Copper T 380A after
delivery of placenta in vaginal or caesarean delivery. These women were followed up at 6 weeks and
6 months after delivery.
Results: A total of 1238 women were included in the study who underwent immediate postpartum
IUCD insertion. 56% of insertions were performed after vaginal delivery and 44% insertions were
done at caesarean sections. The follow up rate at 6 weeks was 51% and 14% at 6 months. There
were no serious complications associated with immediate postpartum IUCD insertion. The expulsion
rate at 6 weeks and 6 months were 5% and 6%. The removal rate was 5% at 6 weeks and 10% at 6
months. The continuation rates were 90% at 6 weeks and 84% at 6 months respectively.
Conclusion: This study indicates that immediate PPIUCD insertion is safe and effective. However, the
expulsion rate for immediate postpartum IUCD insertions are higher than for interval insertions, but
the benefits of providing highly effective contraception immediately after delivery outweigh this disadvantage,
particularly in country like ours where women have limited access to healthcare.