We supply high-quality, low-cost intra-uterine devices (IUDs) and train providers to insert them right after delivery, so that the family planning needs of women and couples are met. The postpartum IUDs (PPIUDs) are offered among a full range of contraceptive choices.
Reaching postpartum women with family planning is a critical component to decreasing unmet need among women who want to limit or space their births. Over 90 percent of women do not want to have another child within their first year postpartum. Additionally, it is recommended that women wait 2-3 years between births in order to decrease the risk of adverse maternal and child health outcomes.
Reaching postpartum women with family planning is a critical component to decreasing unmet need among women who want to limit or space their births. Waiting at least 3 years following a delivery to get pregnant again can significantly decrease the risk of adverse maternal and child health outcomes.
In developing countries, the large majority of women do not want to have another child within their first year postpartum, yet less than 37 percent are using a family planning method. Postpartum IUD insertion (PPIUD), or the insertion of an IUD within 48 hours following childbirth, can help address the unmet need for family planning in the postpartum period.
Dedicated PPIUD inserter: a solution for postpartum women
Despite the benefits of the PPIUD it is not frequently used, mainly because there had not been a standard way to insert the IUD in postpartum women, most providers had not been trained to insert the IUDs immediately postpartum and expulsion rates can be slightly higher for IUDs inserted immediately postpartum.
Postpartum IUD insertion is a safe and effective contraceptive option that is highly convenient for women seeking non-hormonal protection immediately following delivery. Rather than depending on the woman to return to a health facility to receive the IUD at a later date – an impediment for many from resource-poor communities – PPIUD takes advantage of the woman and provider already being in the hospital where the procedure can be quickly performed. PSI integrates PPIUD programs into maternal, newborn and child health programs.
Although PPIUD insertion has several benefits to clients and providers, it also comes with certain challenges due to the shape and size of the uterus postpartum:
- Conventional IUD inserters are neither long nor firm enough to reach the postpartum uterine fundus. As a workaround, providers have used forceps, which requires them to remove the IUD from the inserter sleeve, place it at the tip of the forceps, and then insert it into the uterus.
- The string in conventional copper IUDs is too short to be visible after PPIUD insertion. Visibility of the string ensures that an IUD is in place. PSI partnered with the Stanford Program for International Reproductive Education and Services (SPIRES) and Pregna International Ltd., to create a low-cost inserter designed specifically for PPIUD insertion. The dedicated PPIUD inserter addresses the particular insertion challenges during the immediate postpartum period. The new inserter eliminates the need to use forceps for insertion, making the PPIUD insertion technique easier and more similar to interval insertion. Its firm consistency still allows it to bend to accommodate the shape of the postpartum uterus and its longer string is visible after PPIUD insertion. The PPIUD inserter has the potential to improve providers’ acceptability of PPIUD services.