IUD Insertion After Early Pregnancy Termination

Timing of Insertion

The Centers for Disease Control and Prevention recommends that an IUD can be inserted immediately following an early pregnancy termination, including at the time of surgical abortion, without any waiting period 1, 2
The American College of Obstetricians and Gynecologists suggests that a Copper IUD can be inserted at any time postabortion, including immediately, if it is reasonably certain the woman is not pregnant 1, 2
The Centers for Disease Control and Prevention states that no waiting period is required after early pregnancy termination for Copper IUD insertion 1, 2
The American College of Obstetricians and Gynecologists recommends that a Levonorgestrel IUD can be inserted within the first 7 days postabortion, including immediately 1, 2
The Centers for Disease Control and Prevention classifies Levonorgestrel IUD insertion within the first 7 days postabortion as US MEC category 1 (no restriction) for first-trimester abortion 1, 2
If a Levonorgestrel IUD is placed at the time of surgical abortion, no backup contraception is needed, according to the American College of Obstetricians and Gynecologists 1, 2

The American College of Obstetricians and Gynecologists states that the only absolute contraindication to immediate postabortion IUD insertion is septic abortion (US MEC category 4) 1, 2
In cases of septic abortion, IUD insertion must be delayed until the infection has completely resolved, as recommended by the American College of Obstetricians and Gynecologists 1, 2, 3

Before insertion, it is essential to confirm that the woman is not experiencing signs of septic abortion and that it is reasonably certain she is not pregnant with a different pregnancy, according to the Centers for Disease Control and Prevention 1, 2
The American College of Obstetricians and Gynecologists suggests that the optimal approach is to offer and insert the IUD at the time of surgical abortion to ensure immediate contraceptive coverage and eliminate access barriers 1, 2, 3

The Centers for Disease Control and Prevention recommends that a Copper IUD can be inserted at any time postabortion, including immediately, with no waiting period required, for both first-trimester and second-trimester pregnancy losses 4
The Centers for Disease Control and Prevention recommends that a Levonorgestrel IUD can be inserted within the first 7 days after miscarriage, including immediately, and is classified as US MEC Category 1 for first-trimester abortion and Category 2 for second-trimester abortion 4
If a Levonorgestrel IUD is placed at the time of surgical abortion/D&C, no backup contraception is needed, according to the Centers for Disease Control and Prevention 4

The Centers for Disease Control and Prevention states that the only absolute contraindication to immediate IUD insertion after miscarriage is septic abortion, which is a US MEC Category 4 condition 4

The Centers for Disease Control and Prevention reports that IUD expulsion rates are higher after second-trimester losses than after first-trimester losses, though immediate insertion remains safe and acceptable 4