Early vs. Interval Postpartum IUD Insertion

The purpose of this study is to determine the proportion of IUDs inserted in the Early
Postpartum (EPP) period that are expelled at 6 months postpartum. This prospective,
multi-site randomized trial will enroll approximately 424 women at three large academic
hospitals in the United States.

Women will be recruited who are interested in receiving a levonorgestrel-IUD or a copper-IUD
after delivery. Postpartum women who desire an IUD will be randomized to EPP IUD insertion
(between 14-28 days PP) or interval postpartum IUD insertion (42-56 days PP) and the
proportion of IUDs expelled will be compared between groups at 6 months postpartum. All women
will be seen in clinic at 6-8 weeks and 6 months postpartum. Women randomized to EPP IUD
placement will be seen at 2-3 weeks postpartum.

Provider perspectives of EPP IUD placement will also be evaluated, as will whether these
attitudes change after 6 to 9 months of providing early postpartum IUDs.

Inclusion Criteria:

- Gave birth less than or equal to 10 days ago

- Desires to use an IUD for Contraception (either copper or levonorgestrel)

- Willing and able to sign an informed consent

- Willing to comply with the study protocol

- Age greater than or equal to 18 years

- English or Spanish speaking

Exclusion Criteria:

- Uterine anomaly or leiomyomata which would not allow placement of an IUD

- Desire for repeat pregnancy in less than 6 months

- Evidence of intrauterine infection (chorioamnionitis or postpartum endometritis)
treated with antibiotics

- Ruptured uterus at the time of delivery

- Received a postpartum tubal ligation or immediate postpartum IUD or implant at
delivery

- Incarcerated women or women with significant cognitive impairment

- 4th degree perineal laceration sustained at delivery

- Any medical contraindication to IUD per the US CDC Medical Eligibility Criteria

- Suspicion for new pregnancy