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Postpartum IUDs: a boon to family planning.


 Postpartum IUDs offer many benefits: 1) at time of childbirth, most women are receptive to the idea of planning their family using a reliable and effective method; 2) the bleeding that naturally follows childbirth coincides with and masks any bleeding associated with IUD use (this is an important factor as IUD-related bleeding is one of the most common complaints of women and is a deterrent to its acceptance in some cultures); and 3) nonmedicated or copper-bearing IUD does not effect quantity nor quality of mother's milk for those desiring to breastfeed their babies. Modification of the Cu-220 C or LLD for postpartum insertion (called Delta-T and Delta-Loop) can be done easily and inexpensively (direction briefly outlined). The modifications enhance the retention of IUD in the enlarged postpartum uterus. When the uterus has returned to its normal size after 6 weeks, the standard IUD is left in position. Preliminary results from clinical trials show that the Delta-T and Delta-Loop IUDs may significantly reduce high expulsion rate usually associated with immediate postpartum. The Food and Drug Administration has already approved use of Delta-T for investigational purposes, while approval for Delta-Loop is expected to follow shortly. Proposed studies on quinacrine hydrochloride (a chemical means of permanently occluding fallopian tubes) and Collatex sponge (a vaginal contraceptive) are briefly discussed.
