Promoting family planning - and access to preferred contraceptive methods for women and couples - is essential to achieving women's well-being and autonomy while supporting sexual and reproductive health.
Post-abortion insertion should be considered as a possibility for adolescents and women whose contraceptive method has failed and who must undergo an abortion but who wish to use a long-term contraceptive method.
Placing an intrauterine device after a first-trimester spontaneous or induced abortion is a safe procedure, however, it is essential to rule out current infection of the genital tract or risk of infection or bleeding and injury beforehand.
Intrauterine devices can be inserted interchangeably at other times; during menstruation and immediately postpartum, it is attractive because the woman is not pregnant and may be highly motivated to use contraception.
After delivery, postpartum women remain amenorrhoeic for varying periods, depending on their breastfeeding practices. For women who do not breastfeed, pregnancy may occur within 45 days after delivery. Women who do not exclusively breastfeed may become pregnant before the return of menstruation. Postpartum contraception should take into account the clinical safety of the methods and the special circumstances of the individual patient.
Immediate postpartum IUD insertion appears to be safe and effective.
The demand for post-obstetric IUDs is high and the rate of expulsions and other complications is within those endorsed by the World Health Organisation, making it a valuable alternative to be offered to all women assisted.
Unmet need for family planning is a major cause of induced abortion. Women can become pregnant almost immediately after an abortion. Ovulation often occurs within two weeks after a first-trimester abortion.
For medical abortion, when expulsion occurs at home, the contraceptive method can be IUD insertion as soon as it is certain that the woman is no longer pregnant.