Learn about PPIUCD, its benefits, and how it works for postpartum contraception on Meri Sehat. Get informed about family planning options.

What is PPIUCD?

PPIUCD is a convenient, long-acting, and highly effective contraceptive option for women immediately after childbirth

Introduction

According to the WHO, out of the 1.9 billion women of reproductive age (15-49 years) worldwide in 2021, 1.1 billion need family planning. Of these, 874 million use modern contraceptives, while 164 million still lack access to the contraception they need.

Postpartum intrauterine contraceptive device (PPIUCD) is a form of long-acting reversible contraception inserted into the uterus within 48 hours of childbirth, either immediately after the placenta is delivered or within the first 48 hours after childbirth. This period is advantageous because the cervix is still dilated, making the procedure easier and less painful for new mothers who wish to space their future pregnancies.

The insertion of a PPIUCD is a medical procedure that requires specialized instruments. The primary tool used is the Kelly forceps, which are curved and long, allowing for safe and precise placement of the IUD in the uterus. 
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Understanding PPIUCD

PPIUCDs are over 99% effective in preventing pregnancy. Once inserted, no daily or monthly action is required by the user.

<ol>
	<li>Long-Acting: PPIUCDs protect for up to 10 years, depending on the type of device used.</li>
	<li>Immediate Contraception: Since fertility can return quickly after childbirth, immediate insertion ensures continuous contraception without a gap.</li>
	<li>A Non-Hormonal Option: Copper IUDs do not affect breastfeeding, making them ideal for new mothers.</li>
	<li>Cost-Effective: Over the long term, PPIUCDs are more cost-effective compared to other forms of contraception.</li>
	<li>Reversible: Fertility returns quickly once the device is removed. 
	&nbsp;</li>
</ol>

Common side effects include:

<ol>
	<li>Mild-to-moderate cramping</li>
	<li>Heavier periods</li>
	<li>Spotting between periods, especially in the first few months</li>
	<li>Pain or discomfort during and immediately after insertion</li>
	<li>Pain or discomfort during intercourse 
	&nbsp;</li>
</ol>

While PPIUCDs are usually safe and effective, there are potential complications that users should be aware of.

<ul>
	<li>Uterine Perforation &ndash; A rare but serious complication; the device punctures the uterine wall during insertion, causing pain and requiring surgical intervention</li>
	<li>Infection &ndash; The risk of infection is generally low but slightly higher immediately after childbirth</li>
	<li>Expulsion &ndash; Risk increases if the device is not inserted correctly or the uterus contracts strongly postpartum</li>
</ul>

Heavier and prolonged menstrual bleeding can be a significant drawback for some women. Additionally, some women may experience persistent discomfort or pain. The device becomes embedded in the uterine wall in rare instances, making it difficult to remove.

Discuss any previous health conditions, such as pelvic infections or heavy menstrual bleeding, with your healthcare provider to ensure PPIUCD is a suitable option. Regular follow-up visits with your healthcare provider can help manage any side effects and ensure the IUD is properly in place. 
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Conclusion

It offers numerous advantages, including immediate contraception and high efficacy. However, like any medical procedure, it comes with its own set of potential side effects and complications. Understanding these can help women make informed decisions about their postpartum contraception choices.

[1] Family planning/contraception methods. World Health Organization. Accessed July 12, 2024.

[2] Najan A, Dixit P, Bhalerao A. The Acceptance of Postpartum Intrauterine Contraceptive Devices Among Women Who Receive Focused Family Planning Counseling in the Antenatal Period Compared to Those Who Receive Routine Counseling: A Randomized Controlled Trial. Cureus. 2023;15(6):e40344. Published 2023 Jun 12.

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