Post-Partum IUD Insertion Carries Increased Uterine Perforation Risk: Study

The findings of a new study suggest that women face an increased risk of complications when an intrauterine device (IUD), such as Mirena or Paragard, is implanted for birth control after having a child, with the small device more likely to punch a hole through the uterus.

A group of researchers from across the U.S. warn that receiving a post-partum IUD birth control implant increases the risk of uterine perforation sevenfold. However, in findings published in the medical journal The Lancet on June 4, they caution that that risks are already very low, and that sevenfold increase will still not cause problems for a large percentage of IUD users. Their

IUDs are birth control devices that are implanted in the uterus for long periods of time to prevent pregnancy. They work by physically blocking the sperm from getting to the egg, and in the case of drug-coated IUDs, like the Mirena, also release birth control hormones.

In this study, researchers who were members of the APEX-IUD study team from across the U.S. conducted a multisite cohort study involving data on more than 325,000 individuals. The identified 1,008 incidents of uterine perforations.

According to the findings, post-partum women who received an IUD within four days to six weeks after giving birth faced seven times the risk of uterine perforation than their peers. The was also an increased risk among women who breastfed, the researchers found. However, they cautioned that the overall risk of uterine perforation was low.

“Despite a slight increased risk of perforation with breastfeeding at IUD insertion, the benefits of breastfeeding and effective contraception generally outweigh risks and should have little clinical impact. Therefore, IUD insertion timing should be based on individual desire for IUD contraception and patient convenience to assure an IUD insertion can occur,” the researchers concluded. “Careful follow-up of individuals at higher risk of uterine perforation is warranted.”

Both the Mirena and Paragard IUD have been suspected of uterine perforations and other health risks over the years, resulting in years of litigation. There are still currently hundreds of unresolved Paragard lawsuits filed in federal courts nationwide, each involving similar allegations that women suffered painful and debilitating injuries when the small plastic device fractured as doctors attempted to remove it, often resulting in the need for emergency surgery to retrieve pieces of the IUD, which may cause severe internal injuries.