Women who receive a contraceptive known as an intrauterine device or IUD immediately following a first trimester abortion experience few complications and are less likely to have an unintended pregnancy than those who delay getting an IUD by several weeks, according to a new study the University of New Mexico Health Sciences Center participated in with three other academic medical centers.
Research has shown that IUDs are safe, highly effective, long-term reversible contraceptives that don't require active use once inserted, but a primary concern with inserting an IUD immediately after an abortion is the risk of expulsion, or having it fall out.
"This study was performed to address concerns about the possibility of a higher expulsion rate in IUDs placed immediately after a D&C; for early abortion or miscarriage than for IUDs placed a few weeks later," said Eve Espey, MD, co-investigator and professor of obstetrics and gynecology in the UNM School of Medicine. "The study found no difference in expulsion rates or complications, confirming that placing an IUD right away is an ideal time. This study supports the safety of placing an IUD immediately after an early abortion or miscarriage, and could significantly reduce the high unintended pregnancy rate in the U.S."
The study involved 575 women, ages 18 and older, who requested abortions at a Planned Parenthood affiliate in Albuquerque and the three other U.S. academic health centers which included Oregon Health and Science University, University of Pittsburgh, and Emory University. The women were randomized into two groups: one group received an IUD within 15 minutes of their abortion, and the other group received an IUD two to six weeks later.
At six months, the researchers found the 258 women who immediately received IUDs had no significant adverse effects and no pregnancies, and more than 90 percent of the women were still using the device. Of the 226 women who underwent delayed insertion, there were, likewise no adverse events; however, five of the 226 women became pregnant – all were not using IUDs – and only 77 percent were using the device at six months.
Complete findings were published in the June 9 New England Journal of Medicine, Immediate versus Delayed IUD Insertion after Uterine Aspiration.
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