Post partum IUCD insertion

1. PPIUCD-
A GAME CHANGER
DR. MONIKA BHATIA
MBBS,DCH,MS,DNB,MRCOG,DIP IN MIS
SENIOR CONSULTANT AND HEAD
VENKATESHWAR HOSPITAL DWARKA,DELHI

3. THE WAKE UP CALL
2022 State of World Population Report
Globally 48% of all pregnancies are unintended
61% of which ended in induced abortion
45% of all abortions are termed unsafe
Putting women and young girls at risk triggering a public health crisis

4. We are facing a Silent crises
of unintended /short interval pregnancy
With
One in Seven
such cases worldwide occurring in India

5. Despite Advances in reproductive health
In spite of availability of
safe, modern and reversible contraceptives
The most popular method is female sterilization
with its acceptance at 38%

6. BARRIERS TO CONTRACEPTIVE ACCESS
Lack of Awareness/ Public and Providers
Misconceptions about Methods
Lack of Provider knowledge/ Bias and Training
Cost
Additional Visits
Need for Follow up
Side Effects

7. PP IUCD
CAN CERTAINLY BE A
GAME CHANGER

8. WHY POSTPARTUM
Womon is already in a Health Facility
Highly Motivated
She may never come back for a follow up visit particularly
o LSES (Lower Socio Economic Status)
o Uneducated
o Young
o Minorities

9. ADVANTAGES OF PPIUCD
Convenient
Safe
Efficacious
No Effects on Breast feeding
No Systemic Side effect
Long Life
Reversible
Immediate Return of Fertility

10. RISKS
Pain Abdomen (None to 13.3%)
Excessive Bleeding (13% to 27%)
Vaginal Discharge
Perforation (0%)
Infection (None to 11.2%)
Threads Coming out
Lost Threads (3% to 36%)
Expulsion (2.5% to 22%)
Loss to Follow up (21% to 58%)

11. ALTERNATIVES DISCUSSION / INFORMED DECISION
Barrier
Combined Hormonal
Progesterone Only
Interval IUCD
Sterilization

12. HOW DO WE OVERCOME BARRIERS
Counselling All Women Antenatally
Improve Knowledge/ Training and Technique of Provider
Timing
System/ Resources in place
Hospital Policy
Monitor outcomes and Improvise

13. THANK YOU