Pre-Insertion Counseling for Copper T IUD

Essential Counseling Components

The American College of Obstetricians and Gynecologists recommends counseling patients on the procedure, which takes 5-10 minutes, and can typically be completed in a single visit including any necessary STI or pregnancy screening 2
Prepare patients for three distinct sensation points after speculum placement: (1) application of the cervical stabilization instrument, (2) uterine sounding, and (3) IUD placement through the cervix into the uterus, as recommended by the American College of Obstetricians and Gynecologists 3, 4
Compare discomfort levels to familiar experiences like menstrual cramps, using a 0-10 scale, and acknowledge that while most patients report mild-to-moderate pain, nulliparous patients may experience higher pain scores, according to the American College of Obstetricians and Gynecologists 3, 4
The American College of Obstetricians and Gynecologists suggests offering specific pharmacological options to all patients, as analgesia should be discussed and made available regardless of perceived risk level 1, 4
The Centers for Disease Control and Prevention recommends that patients be advised to take NSAIDs with food, such as naproxen 500-550 mg orally 1-2 hours before insertion, or ibuprofen 800 mg 1-2 hours prior 2, 3

The American College of Obstetricians and Gynecologists recommends nonpharmacological comfort measures including eating a light meal and drinking water beforehand, wearing comfortable clothing, and considering bringing a support person 2

The Centers for Disease Control and Prevention advises counseling that unscheduled spotting, light bleeding, heavy bleeding, or prolonged bleeding are common during the first 3-6 months of Copper T use, and are generally not harmful 5, 6
The American College of Obstetricians and Gynecologists notes that heavy or prolonged menstrual bleeding is a common reason for discontinuation but can be managed with NSAIDs during bleeding days if needed 5

The American Academy of Pediatrics reassures patients that the Copper T IUD is extremely safe and highly effective with a failure rate of less than 1% 7
The American Academy of Pediatrics states that the risk of pelvic infection occurs only during the first 20 days after insertion, not throughout use 7
The American Academy of Pediatrics notes that IUDs do not cause tubal infertility in nulliparous women, and fertility returns rapidly after removal 7

The American College of Obstetricians and Gynecologists clarifies that insertion can occur at any time in the menstrual cycle as long as pregnancy is reasonably excluded—there is no "best time" for placement 2
The American College of Obstetricians and Gynecologists recommends that patients be informed that the Copper T is immediately effective for contraception after insertion with no need for backup contraception 2

The American Academy of Pediatrics screens for absolute contraindications which are limited to current purulent cervicitis, active gonorrhea or chlamydia infection, current pelvic inflammatory disease, or other active pelvic infections 7
The Centers for Disease Control and Prevention instructs patients to seek care if they develop new-onset heavy or prolonged bleeding after initial months of use, as this may indicate IUD displacement, STI, pregnancy, or new uterine pathology 5

The American Academy of Pediatrics informs patients the Copper T380A is approved for 10 years of highly effective contraception 7

The American College of Obstetricians and Gynecologists uses trauma-informed care principles by screening for history of trauma before any pelvic procedure and using therapeutic language throughout 9
The American College of Obstetricians and Gynecologists establishes mutual trust and avoids minimizing pain, which can lead to feelings of betrayal 1, 4