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Highly effective reversible contraceptives such as intrauterine devices (IUDs) and subdermal implants are commonly offered and placed at a postpartum visit. However, many women do not adhere to this visit — and some will become pregnant again within 24 months. For these women, placement of an IUD at birth or an implant before hospital discharge will provide long-acting contraception. To synthesize the available information on likelihood of IUD expulsion following postpartum placement, investigators identified 48 studies including some 8000 placements. Timing was categorized as immediate (within 10 minutes of placental delivery), early (>10 minutes to <4 weeks postpartum), or interval (≥4 weeks postpartum).
Interval placement was associated w…