Insertion & Removal
Immediate Postpartum IUD insertion Videos
Click on the video clips below for instruction on immediate postpartum IUD insertion.
Postplacental IUD insertion
Insertion of IUDs immediately postpartum requires a different set of skills than for interval placement and varies by delivery method. Training is advised before provision of immediate postpartum IUD placement. No matter what insertion technique is used, it is key to ensure the IUD is placed at the fundus of the uterus to decrease chance of expulsion.
Implant insertion
The technique for implant placement immediately postpartum does not differ from that for interval insertion.
The FDA requires that all health care providers who perform implant insertions and removals receive training from Merck, the manufacturer of Nexplanon®. See the manufacturer’s website for more information about the implant insertion process and training.
Removal
Both the insertion and removal of a LARC device are reliant on a clinician, which can impact patient autonomy. A patient’s right of refusal for initiating or discontinuing a method should be addressed by obstetrician-gynecologists and other health care providers. At no time should a patient be forced to use a method chosen by someone other than themselves, including a parent, guardian, partner, or health care provider. Clinicians should be aware of changes to insurance coverage in the postpartum period and how that may affect coverage of device removal for patients, and should discuss options for low or no-cost removal services, including Title X or other clinics.
- Find more information on using shared medical decision making and a reproductive justice framework for contraceptive counseling here.
- ACOG guidance on the management of difficult IUD or contraceptive implant removals can be found here.
