IUDs after abortion
Implanting an intrauterine device (IUD) in the womb immediately after an abortion poses few risks.
Implanting an IUD immediately, instead of waiting 2 to 6 weeks after the abortion
, increases the chance - but only slightly - that it will fall out within 6 months, the new study of 575 women has concluded.
Switching to immediate insertion "could prevent more than 70,000 unintended pregnancies annually in the United States," the research team, led by Dr. Paula Bednarek notes in the New England Journal of Medicine.
The study was designed to see if IUDs, implanted immediately after an abortion or miscarriage, would remain in place. The study also gauged the risk of infection or tears of the uterus. All the volunteers had been pregnant for 5 to 12 weeks.
Six months after insertion, the researchers found, IUDs had been expelled in 5% of the 258 women who had received an immediate insertion, compared to less than 3% of the 226 volunteers who had been required to wait. About four-fifths of the expulsions occurred within the first 2 months.
By that 6-month mark, more than 90% of the women who had immediately gotten their IUD were still using it, versus about three quarters who received a delayed insertion.
Five pregnancies occurred in the delayed insertion group, all among women who never received their IUD. There were no pregnancies in the immediate insertion group.
Heavier women were more likely to expel their IUDs, a finding that surprised researchers. "It wasn't a strong risk," said Bednarek, "but it was the only association we noticed in this study."
Immediate insertion "will prevent unintended pregnancies," said Bednarek. "It's more convenient, it's less expensive, it's less painful all around, it's good for the individual and it's good for society. We just need to create a system that makes it more doable." Have you used an IUD?