Postpartum insertion of levonorgestrel–intrauterine system at three time periods: a prospective randomized pilot study ★

BackgroundThe study was conducted to determine the feasibility of levonorgestrel–intrauterine system (LNG-IUS) insertion at three different times postpartum.Study DesignFrom August 2009 to January 2010, all women desiring LNG-IUS for postpartum contraception were offered enrollment into our study and randomized to three insertion times: immediate (within 10 min of placenta delivery), early (10 min to 48 h postpartum) or interval (≥6 weeks postpartum).ResultsForty-six women met inclusion criteria and were analyzed. There was no difference in utilization rates at 3 and 6 months between groups (p=.931). Expulsion rates were significantly higher and pain during insertion was significantly lower in the immediate and early groups (p<.001) when compared to the interval group.ConclusionInsertion of LNG-IUS ≤48 h postpartum is feasible in our institution and may be associated with similar utilization at 6 months, increased expulsion rates and decreased pain at insertion when compared to placement after 6 weeks.