Intrauterine Copper Contraceptive

Excerpt

The copper IUD is acceptable to use during breastfeeding as a long-term contraceptive. It has been studied extensively during lactation in comparison with other forms of contraception and does not affect lactation performance or the milk copper concentration. In women who are breastfeeding, insertion of the device should be after 4 weeks postpartum. A meta-analysis found that uterine perforation with IUD insertion was 6 to 10 times more likely in breastfeeding mothers than in non-breastfeeding women, but that the risk of expulsion was no greater in breastfeeding mothers.[1] A more recent prospective study found a slight increase in the risk of expulsion of intrauterine devices with breastfeeding,[2] and the American College of Obstetrics and Gynecology recommends that women be counseled that immediate postpartum insertion may have a higher expulsion rate than later insertion.[3] The copper IUD is considered to be the most effective emergency contraceptive when inserted up to 5 days after unprotected intercourse.[4]