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Copper-Bearing Intrauterine Devices (IUDs)

Copper-Bearing Intrauterine Devices (IUDs). Session III: Providing IUDs. Copper T 380A. You May be Able to Get Your IUD Now. Copper IUD. You May be Able to Get Your IUD Now. Copper IUD. Copper IUD. Correcting Rumors and Misconceptions. IUDs: Rarely lead to PID

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Copper-Bearing Intrauterine Devices (IUDs)

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  1. Copper-Bearing Intrauterine Devices (IUDs) Session III: Providing IUDs Copper T 380A

  2. You May be Able to Get Your IUD Now Copper IUD

  3. You May be Able to Get Your IUD Now Copper IUD Copper IUD

  4. Correcting Rumors and Misconceptions IUDs: Rarely lead to PID Do not increase risk of STIs, including HIV Do not work by causing abortion Do not make women infertile Do not move to the heart or brain Do not cause birth defects Do not cause pain for woman or man during sex Significantly reduce risk of ectopic pregnancy Source: CCP and WHO, 2011.

  5. What Will Happen When You Get Your IUD Steps: Pelvic examination Cleaning the vagina and cervix Placing IUD in the womb through the cervix    • May hurt at insertion • Please tell us if it hurts • Rest as long as you like afterwards • May have cramps for several days after insertion Afterwards: you can check your IUD from time to time if you want.

  6. Explaining the IUD Insertion Procedure Cleans the cervix and vagina with an antiseptic Inserts a small rod into the uterus to measure the depth of the uterus Inserts the IUD through the vagina and into the uterus using a small applicator You may feel discomfort, like heavy menstrual cramps. • The provider: • Performs a pelvic examination After the insertion, you will rest.

  7. Post-Insertion Instructions Tell client to expect cramping and spotting for a few days If client wants to check strings, teach her how: Use clean hands Check after menses If convenient for client, schedule follow-up visit for 3–6 weeks Counsel to return immediately if there are any signs of complications. Source: CCP and WHO, 2011; WHO, 2004, updated 2008.

  8. Complications of IUDs Potential complications of IUDs include perforations, pelvic inflammatory disease (PID), and expulsions. Biases in early research overstated risks of PID. Most research since the 1980s has concluded that serious complications are rare with modern IUDs.

  9. Complications of IUDs, continued

  10. Signs of Possible IUD Complications Advise client to return immediately in case of: • Bleeding and severe abdominal cramping within a few days post-insertion perforation • Irregular bleeding or pain every cyclepartial expulsion, perforation • Fever, unusual vaginal discharge, low abdominal pain infection • Missing IUD strings, missed period expulsion,pregnancy Source: CCP and WHO, 2011.

  11. Explain Removal Procedure to Client The provider: Inserts a speculum to see the cervix and IUD strings. Cleans the cervix and vagina with an antiseptic. Asks the woman to take slow, deep breaths, and tell the provider if she feels pain during the procedure. Using forceps, pulls the IUD strings slowly and gently until the IUD is completely out of uterus. IUD removal is quick and usually quite painless. Source: CCP and WHO, 2011.

  12. Managing IUD Side Effects or Complications:Heavy, Prolonged or Irregular Bleeding Counseling and reassurance are key Source: CCP and WHO, 2011.

  13. Managing IUD Side Effects or Complications: Cramping and Mild Pain Counseling and reassurance are key Source: CCP and WHO, 2011.

  14. Managing IUD Side Effects or Complications: Severe Pain in Lower Abdomen (Rare) Rule out PID, ectopic pregnancy or perforation. If PID is suspected, treat with appropriate antibiotics for gonorrhea, chlamydia and anaerobic bacterial infection. There is no need to remove the IUD. If ectopic pregnancy is suspected, refer immediately. Source: CCP and WHO, 2011.

  15. Managing IUD Side Effects or Complications: Suspected Perforation Stop procedure immediately, remove IUD Observe vital signs for an hour; check for signs of bleeding If rapid pulse, falling blood pressure, or increased pain: refer Provide alternative contraception Advise avoid sex for 2 weeks Follow-up in a week or as needed Source: CCP and WHO, 2011.

  16. Managing IUD Side Effects or Complications: Missing Strings Determine risk of pregnancy Perform pelvic exam, probe for strings in cervical canal If cannot locate strings, consider X-ray or ultrasound, or refer Give choice of another contraceptive method Insert another IUD if expulsion is confirmed and Woman is not pregnant She still wants to use an IUD Source: CCP and WHO, 2011.

  17. Managing IUD Side Effects or Complications: Suspected Pregnancy Assess for pregnancy, including ectopic pregnancy If the client is pregnant and wishes to continue the pregnancy: Explain that using an IUD during pregnancy increases the risk of preterm delivery or miscarriage If possible, remove the IUD If not possible to remove, advise close follow-up for signs of septic miscarriage Source: CCP and WHO, 2011.

  18. Copper IUDs: Summary Copper IUDs are: Safe, highly effective, convenient, reversible, long lasting, cost-effective, easy to use, and appropriate for the majority of women. Providers can ensure safety by: Informative counseling Careful screening Appropriate infection prevention practices Proper follow-up

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