Women offered an intrauterine device (IUD) for birth control at the same time they're having a uterine aspiration due to miscarriage or abortion are much more likely to get one compared to women offered one later on.
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IUDs are a safe, extremely effective form of birth control. They're more effective than the contraceptive pills, condoms and diaphragms at preventing pregnancy. But, IUDs are underutilised. Intrauterine devices are effective forms of birth control that don't require active use once they have been inserted.
The use of IUDs fell out of favour decades ago when the devices were linked to high risk of pelvic inflammatory disease. But that risk was due to the design of past devices. An IUD is T-shaped, and has a string or tail that hangs out of the cervix that aids in the removal of the device. Older devices had strings that were braided or contained numerous strings twisted together. That design seemed to allow for the growth of bacteria, which then contributed to pelvic inflammatory disease. Newer IUDs have better designs, and do not have a higher risk of pelvic inflammatory disease.
Researchers recruited 575 adult women at four sites across the United States. All of the women were undergoing uterine aspiration (also referred to as dilatation and curettage - D and C; or a suction evacuation) due to miscarriages or planned abortion. All of the women in the study expressed an interest in getting an IUD. The women were randomly selected to receive the IUD just after the uterine aspiration (immediate placement) or were scheduled to have the IUD inserted at their follow-up appointment two to six weeks later (delayed placement). All of the women in the immediate group had an IUD inserted, while only 71 percent of those in the delayed group ended up getting an IUD.
No pregnancies occurred in the immediate IUD placement group, while five women in the delayed group who did not opt for the IUD became pregnant. Rates of complications didn't differ between the groups. Most of the women in the delayed group who ended up not getting an IUD hadn't changed their minds about wanting an IUD, but instead cited logistical reasons, such as transportation or not being able to get time off work or find child care as excuses for missing their appointment.
The study shows that when birth control options are given to women just after an abortion, the risk of having an unwanted pregnancy and abortion are reduced.
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