Copper T IUD Insertion Guidelines

Pre-Procedure Preparation

The American College of Obstetricians and Gynecologists recommends explaining the three key moments when discomfort occurs: cervical stabilization, uterine measurement, and device placement, to prepare the patient for the procedure 1, 3
The American College of Obstetricians and Gynecologists suggests using trauma-informed language, such as "gentle placement" instead of "insertion," to minimize patient anxiety 1
The American College of Obstetricians and Gynecologists advises obtaining informed consent after discussing the procedure, anticipated pain, and all pain relief options 2, 4
Administering naproxen 500-550 mg or ketorolac 20 mg orally 1 hour before the procedure, always with food, is recommended for pain management 1, 5, 3

The American College of Obstetricians and Gynecologists recommends performing bimanual examination to determine uterine size, position, and direction before insertion 3
High fundal placement of the copper T IUD is critical to reduce expulsion rates, according to the American College of Obstetricians and Gynecologists 3

The American College of Obstetricians and Gynecologists advises keeping the patient lying flat for 5 minutes with legs out of stirrups after insertion, and gradually raising the head of the table to prevent vasovagal reactions 3
The patient should be informed that the copper IUD is immediately effective for contraception, with no backup method needed, as stated by the American College of Obstetricians and Gynecologists 5, 3

Nulliparous patients may experience higher pain scores, with an average of 6.6-8.1/10, compared to 3.7/10 for multiparous patients, according to the American College of Obstetricians and Gynecologists 3
The copper T IUD may be placed at any time in the menstrual cycle if pregnancy is reasonably excluded, and can be used as emergency contraception up to 5 days after unprotected intercourse, as recommended by the American College of Obstetricians and Gynecologists 1, 5, 6