Intrauterine Contraceptive Device IUCD Imarisha Maisha 1 What

What it is § Small, flexible, plastic "T“ device wrapped in copper wire that

Mechanism of Action of Copper IUDs § Prevents sperm from meeting the egg by

Who Can Use Copper IUDs § Women of any age and parity § Women

Who Should Not Use Copper IUDs § High individual risk of STIs, AIDS §

Advantages § Highly effective and safe § Does not interfere with intercourse § Easy

Disadvantages § Side effects, including cramping and increased or prolonged bleeding in the first

Timing of IUD Insertion Interval insertion § Anytime during menstrual cycle if woman is

IUD Use and Follow-up § Schedule follow-up visit at: § 3 to 6 weeks

Dispelling IUD Myths § Are not abortificients § Do not cause infertility § Do

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Intrauterine Contraceptive Device (IUCD) Imarisha Maisha 1

What it is § Small, flexible, plastic "T“ device wrapped in copper wire that is placed in the uterus

Mechanism of Action of Copper IUDs § Prevents sperm from meeting the egg by changing the uterine environment § Impairing the viability of the sperm § IUCD does NOT cause abortion Source: Ortiz, 1996. 3

Who Can Use Copper IUDs § Women of any age and parity § Women with medical conditions eg hypertension, heart disease, diabetes, Deep Venous Thrombosis (DVT) § Immediately after a delivery

Who Should Not Use Copper IUDs § High individual risk of STIs, AIDS § pregnancy; § When there is infection at the time of initiation; § Puerperal sepsis § Post abortion sepsis; § Pelvic inflammatory disease § Cervicitis § Pelvic tuberculosis § Unexplained vaginal bleeding § Endometrial or cervical cancer or ovarian cancer

Advantages § Highly effective and safe § Does not interfere with intercourse § Easy to use § Long lasting (can be used for upto 12 years) § Easily reversible and quick return to fertility § No systemic effects § Can be removed any time if you want to get pregnant • Does not cause infertility Source: CCP and WHO, 2007.

Disadvantages § Side effects, including cramping and increased or prolonged bleeding in the first few months after insertion § Rare complications include perforation and pelvic inflammatory disease § Insertion and removal require trained provider § Does not protect against STI/HIV Source: CCP and WHO, 2007.

Timing of IUD Insertion Interval insertion § Anytime during menstrual cycle if woman is not pregnant Postpartum insertion § Immediately after vaginal or cesarean delivery if no infection or bleeding (within 48 hours) Insertions after abortion § Immediately if no infection

IUD Use and Follow-up § Schedule follow-up visit at: § 3 to 6 weeks (or during menses) § Counsel on side effects including signs of complications that require immediate return to the clinic)

Dispelling IUD Myths § Are not abortificients § Do not cause infertility § Do not cause discomfort for the male partner § Do not travel to distant parts of the body § Are not too large for small women 10