6 steps for IUD placement at the time of a cesarean delivery

October 17, 2019

Charisse Loder, MD, MSc, Kirsten Bonawitz, BS

Immediate postplacental insertion of an IUD is not only convenient for the patient, but also safe and effective for postpartum contraception. Here's what to be mindful of when performing the procedure following cesarean delivery.

For more information: Counseling on complex contraception dilemmas: Case 2

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Step 1

Perform time out and verify that there are no contraindications to placement: hemorrhage or intrauterine infection.

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Step 2

Remove IUD from packaging and trim IUD strings to 12 cm.

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Step 3

Grasp the IUD firml along the stem of the device.

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Step 4

Stabilize the uterus using the non-dominant hand or with the aid of an assistant and advance the IUD through the hysterotomy to the fundus.

Step 5

Remove hand and ensure that the strings are in the lower uterine segment.

Step 7

Close the hysterectomy, taking care not to incorporate the IUD strings.