Title: When to start using an IUCD
Course: Family Planning - Ethiopia (Full)

When to start using an IUCD

An IUCD is usually inserted during a menstrual period, when the cervix is slightly open and pregnancy is least likely. There is, however, a greater chance of expulsion if a device is introduced early in the cycle, because the uterus can squeeze the device back out. Therefore, the best time for insertion is just after a period. However, an IUCD may be inserted at any time. Table 7.1 shows the best timing for IUCD insertion for women in different situations.

Table 7.1 Time of IUCD insertion.

Woman's situation | When to start
Having menstrual cycles | • Any time within the first 12 days after the start of menstrual bleeding, preferably after bleeding has stopped, at the woman's convenience. • Any other time during the menstrual cycle (not just during menstruation) if the woman is not pregnant and has a healthy uterus. • If a woman has been using a reliable contraceptive, or has not been having sex, the best time to insert her IUCD is when she asks for it.
After childbirth | • During a hospital or health centre stay following childbirth, if she has decided voluntarily in advance. The IUCD is best inserted within ten minutes of delivery of the placenta. • It can be inserted at any time within 48 hours after childbirth (special training is required). • If not immediately after childbirth, then as early as four weeks after childbirth for Copper T IUCDs, such as TCu-380A. At least six weeks after childbirth for other IUCDs.
After miscarriage or abortion | • Immediately, if no infection is present. • If an infection is present, treat it and help the client choose another effective method. • The IUCD can be inserted after three months, if no infection remains and re-infection is not likely, and the woman is not pregnant.
Lactating mothers with lactational amenorrhoea (LAM) | • Any time, providing the mother is not pregnant.
When stopping another method | • Immediately.