Postpartum intrauterine devices: clinical and programmatic review

Am J Obstet Gynecol. 2018 Sep;219(3):235-241. doi: 10.1016/j.ajog.2018.07.013. Epub 2018 Jul 19.


The immediate postpartum period is a critical moment for contraceptive access and an opportunity to initiate long-acting reversible contraception, which includes the insertion of an intrauterine device. The use of the intrauterine device in the postpartum period is a safe practice with few contraindications and many benefits. Although an intrauterine device placed during the postpartum period is more likely to expel compared with one placed at the postpartum visit, women who initiate intrauterine devices at the time of delivery are also more likely to continue to use an intrauterine device compared with women who plan to follow up for an interval intrauterine device insertion. This review will focus on the most recent clinical and programmatic updates on postpartum intrauterine device practice. We discuss postpartum intrauterine device expulsion and continuation, eligibility criteria and contraindications, safety in regards to breastfeeding, and barriers to access. Our aim is to summarize evidence related to postpartum intrauterine devices and encourage those involved in the healthcare system to remove barriers to this worthwhile practice.

Keywords: contraception; intrauterine device; postpartum.

Publication types

  • Review

MeSH terms

  • Breast Feeding
  • Cesarean Section
  • Clinical Competence
  • Contraceptive Agents, Female / administration & dosage
  • Contraindications, Procedure
  • Delivery, Obstetric
  • Female
  • Health Care Costs
  • Health Services Accessibility
  • Humans
  • Insurance, Health
  • Intrauterine Device Expulsion
  • Intrauterine Devices*
  • Intrauterine Devices, Copper
  • Intrauterine Devices, Medicated
  • Levonorgestrel / administration & dosage
  • Long-Acting Reversible Contraception
  • Postnatal Care / methods*
  • Pregnancy
  • Time Factors
  • Ultrasonography
  • Uterus


  • Contraceptive Agents, Female
  • Levonorgestrel