Post-placental IUD insertion (PPIUD): what do women think?

Abstract

Women are highly vulnerable to unplanned pregnancy in the postnatal period, and can find it challenging to access contraceptive services with a newborn (Heller et al., 2016). Improving access to contraception in the postnatal period could reduce unintended pregnancies and resulting abortions, enable improvement of maternal health prior to future conceptions, and facilitate optimal birth spacing.

Post-placental intrauterine device insertion (PPIUD) – insertion of either an intrauterine device (copper coil) or intrauterine system (Mirena or Jaydess coil) immediately after either vaginal or caesarean birth - is safe and effective (Lopez et al., 2015). PPIUD is compatible with breastfeeding, associated with less pain and fewer side effects than later insertion, and provides long-acting yet reversible contraception (Whitaker & Chen, 2018). As a result, there have been calls for PPIUD to be routinely offered in the UK (Faculty of Sexual and Reproductive Healthcare, 2017).

In order to provide women-centred, high quality PPIUD services, including appropriate counselling, it is important to understand what factors affect women’s decisions to accept or decline PPIUD. A systematic review and metasynthesis of existing qualitative evidence was undertaken to answer the question: what are the views of childbearing women and their partners on immediate postpartum contraceptive services?