Although the IUD (intrauterine device) has been around since the 1970’s it has gained renewed popularity and it seems to be safe. The IUD is a small plastic device that’s inserted into the uterus to prevent unplanned pregnancies and comes in two types: one that has copper and the other that releases a hormone. A previous type called the Dalkon Shield was removed from the market about 20 years ago based on its association with infection, increased pregnancy and sometimes death. However, the introduction of the copper and hormone-released IUD to the market has resurrected interest and use of these devices.

Traditionally, the IUD is inserted in a provider’s office after the last menstrual period has been documented and the vaginal cultures are negative for disease or cancer. The copper IUD can remain for up to 10 years while the hormone-releasing IUD must be removed after 5 years. Recently, some hospitals have adopted a policy of inserting the IUDs immediately after the patient delivers in order to reduce future unplanned pregnancies, especially if they are noncompliant or had no previous prenatal care prior to delivering their baby. This procedure is also targeted to poor women who have a significant number of children or women whose future pregnancy might place their life at risk. While some might applaud this policy, a word of caution is advised. A recent medical study suggests that women, who have IUDs inserted immediately after having a baby, are at an increased risk of IUD explusion, meaning, the device falls out of the body, sometimes without the patient’s knowledge.

The study states that an ultrasound was done right after the procedure to document proper placement but when another ultrasound was done at 6 months after delivery, 50% of the IUDs were missing as compared to only 5% for women who had their IUDs inserted during their routine 6-week post partum exam.

So, what’s the take home message? If you decide to use the IUD as a birth control method, do not have it inserted immediately after you have a baby if at all possible. This will eliminate future surprises and an unplanned pregnancy.

Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.