A Prospective Study of Immediate Postpartum Intra Uterine Contraception Device (IUCD) Insertion in a Teaching Hospital of South India

Background: The intrauterine contraceptive device (IUCD) is one of the oldest methods of contraception used to prevent pregnancy. Modern IUCDs are highly effective, safe, discreet, long-acting, and reversible. This study aimed to evaluate the acceptability and safety of postpartum intrauterine contraceptive devices (PPIUCD) during the postpartum period, as well as to assess their feasibility, safety, effectiveness, and expulsion rates. Methods: The women presenting to antenatal OPD were counseled about family planning and encouraged to opt for copper-T insertion immediately after delivery. In this study, the Copper T 380A was used, with insertions performed by trained obstetricians following all recommended clinical and infection prevention protocols outlined in the National Family Welfare guidelines. Before hospital discharge, all patients were examined for vaginal bleeding and discharge. Follow-up visits were scheduled at 6 weeks, 6 months, and 1 year. During these visits, pelvic examinations were conducted to check for any signs of bleeding, infection, or displacement, and abdominal ultrasounds (USG) were performed to confirm IUCD positioning. Results: A significant number of women accepted the IUCD as a contraceptive method, with an overall acceptance rate of 52.52%. Antenatal counseling was more effective in promoting IUCD acceptance compared to postpartum counseling. A large majority of women (94.35%) continued using the IUCD for at least 12 months, indicating high satisfaction and effectiveness. The overall complication rate associated with IUCD use was low, with most complications being mild and manageable. Factors such as age, education, and socioeconomic status influenced the decision to accept or refuse the IUCD. Conclusion: Antenatal counseling was more efficient in encouraging IUCD uptake than postpartum counseling. Age, education, and economic class affected their willingness to accept or reject IUCD. A greater proportion of younger women, those with higher education, and those with higher socio-economic status accepted the use of IUCD. A statistically significant number of women (94.35%) continued using IUCD for at least 12 months, suggesting the effectiveness and acceptability of the method.