Chapter 21: How to insert an IUD
Help a woman decide if the IUD is
right for her
The IUD is a very effective family planning method, but it has risks. Before inserting
an IUD, help the woman decide if the IUD will be a good method for her.
Advantages of the IUD
• It is very effective. Very few women with IUDs become pregnant.
• It can be taken out at any time if the woman wants to become pregnant.
• It is easy to use. Once it has been inserted into the womb, the woman only
has to check to make sure it is still there once a month. She does not need to
check it before or after having sex.
• One IUD (the Mirena) contains a small amount of hormones. This IUD can
make monthly bleeding very light or stop altogether, and can reduce cramping.
Disadvantages of the IUD
• IUDs do not protect women from getting HIV or other sexually transmitted
infections (STIs) — see Chapter 18.
• A woman cannot put in or take out an IUD herself. A woman who uses an IUD
must be able to get to a medical center that can help her if she has problems
because of the IUD or that can remove the IUD if she wants to get pregnant.
• IUDs can cause changes in monthly bleeding. Most types may cause an
increase in cramping or bleeding. The Mirena IUD may cause light, irregular
bleeding or spotting.
IUDs are harmful for some women
Do not insert an IUD in a woman who:
• has an STI. If a woman has an IUD inserted when she has an STI, that infection
can easily spread to her womb. Womb infections can cause infertility and are
very dangerous. Before you insert an IUD, the woman should be tested for STIs.
• recently had an infection in her womb.
• had an abortion, miscarriage, or gave birth within the last 6 weeks.
• has anemia, or who already has very painful or heavy monthly bleeding.
• has fibroids or whose womb has an unusual shape.
Do not insert an IUD made with copper in a woman who is allergic to copper.
Freedom to choose or refuse an IUD
In some places, women are pushed to use IUDs. Some women are given IUDs
without even being told that an IUD has been inserted. This happens when doctors
or health workers are under pressure from local or international governments and
aid groups to give IUDs to women even if the women do not want them.
A Book for Midwives (2010)