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Patients receive the full range of contraception options when providers are educated on the proper use and spectrum of contraceptive options. When an educational intervention was introduced in three countries (Democratic Republic of Congo, Somalia, and Pakistan), aimed at training providers on counseling and provision of immediate postpartum LARC, a significant number of women opted for LARC. This was in comparison to countries that did not implement this educational intervention (Rwanda, Syria, Yemen). The rate of LARC adoption was 10.01% versus 0.77%, respectively in countries providing the educational intervention versus those that did not.
The copper IUD has long been utilized for emergency contraception, providing nearly 100% efficacy in pregnancy prevention, as well as long-acting, reversible contraception. Recently, the levonorgestrel (LNG) IUD was considered for similar use as emergency contraception. Turok et al studied the pregnancy rate of the LNG IUD compared the copper IUD and found that the LNG IUD was noninferior to the copper IUD when used for emergency contraception, with pregnancy rates of 1 in 317 (LNG) compared to 0 in 321 (copper). LNG IUDs are often more readily available in OBGYN offices and could improve access to higher efficacy emergency contraception compared to traditional emergency contraceptive pills.
When placing IUDs, providers have a range of devices to measure the length of the uterus for correct IUD placement, including endometrial biopsy pipelles, uterine sounds, both plastic and metal, as well as the device inserters. In a biomechanical ex vivo analysis, Duncan et al examined the maximum force generated for IUD placement with the levonorgestrel placement instrument, the copper IUD placement instrument, and a metal sound. Using their model, the investigators found that the metal sound caused uterine perforation, but the plastic IUD placement device did not. Although the study authors utilized the device inserters themselves, we recommend the use of plastic uterine sounds or biopsy pipelles over the device inserters in accordance with IUD packaging instructions. IUD packaging should not be opened until both the ability to access the uterine cavity and appropriate uterine size are determined to avoid needing to discard the IUD.
Patients receive the full range of contraception options when providers are educated on the proper use and spectrum of contraceptive options. When an educational intervention was introduced in three countries (Democratic Republic of Congo, Somalia, and Pakistan), aimed at training providers on counseling and provision of immediate postpartum LARC, a significant number of women opted for LARC. This was in comparison to countries that did not implement this educational intervention (Rwanda, Syria, Yemen). The rate of LARC adoption was 10.01% versus 0.77%, respectively in countries providing the educational intervention versus those that did not.
The copper IUD has long been utilized for emergency contraception, providing nearly 100% efficacy in pregnancy prevention, as well as long-acting, reversible contraception. Recently, the levonorgestrel (LNG) IUD was considered for similar use as emergency contraception. Turok et al studied the pregnancy rate of the LNG IUD compared the copper IUD and found that the LNG IUD was noninferior to the copper IUD when used for emergency contraception, with pregnancy rates of 1 in 317 (LNG) compared to 0 in 321 (copper). LNG IUDs are often more readily available in OBGYN offices and could improve access to higher efficacy emergency contraception compared to traditional emergency contraceptive pills.
When placing IUDs, providers have a range of devices to measure the length of the uterus for correct IUD placement, including endometrial biopsy pipelles, uterine sounds, both plastic and metal, as well as the device inserters. In a biomechanical ex vivo analysis, Duncan et al examined the maximum force generated for IUD placement with the levonorgestrel placement instrument, the copper IUD placement instrument, and a metal sound. Using their model, the investigators found that the metal sound caused uterine perforation, but the plastic IUD placement device did not. Although the study authors utilized the device inserters themselves, we recommend the use of plastic uterine sounds or biopsy pipelles over the device inserters in accordance with IUD packaging instructions. IUD packaging should not be opened until both the ability to access the uterine cavity and appropriate uterine size are determined to avoid needing to discard the IUD.
Patients receive the full range of contraception options when providers are educated on the proper use and spectrum of contraceptive options. When an educational intervention was introduced in three countries (Democratic Republic of Congo, Somalia, and Pakistan), aimed at training providers on counseling and provision of immediate postpartum LARC, a significant number of women opted for LARC. This was in comparison to countries that did not implement this educational intervention (Rwanda, Syria, Yemen). The rate of LARC adoption was 10.01% versus 0.77%, respectively in countries providing the educational intervention versus those that did not.
The copper IUD has long been utilized for emergency contraception, providing nearly 100% efficacy in pregnancy prevention, as well as long-acting, reversible contraception. Recently, the levonorgestrel (LNG) IUD was considered for similar use as emergency contraception. Turok et al studied the pregnancy rate of the LNG IUD compared the copper IUD and found that the LNG IUD was noninferior to the copper IUD when used for emergency contraception, with pregnancy rates of 1 in 317 (LNG) compared to 0 in 321 (copper). LNG IUDs are often more readily available in OBGYN offices and could improve access to higher efficacy emergency contraception compared to traditional emergency contraceptive pills.
When placing IUDs, providers have a range of devices to measure the length of the uterus for correct IUD placement, including endometrial biopsy pipelles, uterine sounds, both plastic and metal, as well as the device inserters. In a biomechanical ex vivo analysis, Duncan et al examined the maximum force generated for IUD placement with the levonorgestrel placement instrument, the copper IUD placement instrument, and a metal sound. Using their model, the investigators found that the metal sound caused uterine perforation, but the plastic IUD placement device did not. Although the study authors utilized the device inserters themselves, we recommend the use of plastic uterine sounds or biopsy pipelles over the device inserters in accordance with IUD packaging instructions. IUD packaging should not be opened until both the ability to access the uterine cavity and appropriate uterine size are determined to avoid needing to discard the IUD.