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Intrauterine devices (IUDs) are one of the most-effective, long-acting, reversible contraceptive options. Immediate postplacental IUD insertion and IUD insertion in the early postpartum period are increasingly popular choices, but limited data suggest early postpartum IUD insertion is associated with excess risk for perforation. In this retrospective cohort study from the Kaiser Permanente health system, researchers evaluated women (age, ≤50) who had a first IUD insertion between 2001 and 2018.
About 1000 perforations occurred among 327,000 women (0.3%). Compared with the 232,000 women in the non-postpartum cohort (nulliparous women and women >12 months postpartum), the 95,000 women whose IUDs were inserted ≤12 months postpartum had signific…