This document is currently under revision.
Clinical guidance is rigorously developed to reflect the best available evidence at the time of publication. It is designed as a resource to assist clinicians in providing family planning care. It is not intended to substitute for the independent professional judgment of the treating clinician. We recognize that continued research, new understandings of person-centered care, or major changes in the legal landscape can impact clinical guidance. It should not be considered inclusive of all proper treatments or serve as the standard of care. Variations, taking into account individual circumstances, may be appropriate.

Postplacental intrauterine device (IUD) placement, defined as IUD placement within 10 min after delivery of the placenta, is an appealing strategy for increasing access to postpartum IUDs because it does not require a separate postpartum visit. These guidelines present an evidence-based assessment of postplacental IUD placement after vaginal and cesarean delivery. Postplacental IUD insertion is safe and does not have higher risks of complications than interval insertion. Most studies find that the risk of IUD expulsion is higher after postplacental insertion than after interval insertion for both vaginal and cesarean deliveries. Most studies find higher rates of expulsion after vaginal delivery than after cesarean delivery. However, expulsion rates vary widely across studies, without clear evidence about the factors that may influence expulsion. In settings where replacement of expelled IUDs is available, patient populations with low rates of return for the postpartum visit are most likely to benefit from provision of postplacental IUD placement with appropriate counseling about risks and benefits.