Table 2

Postpartum intrauterine device use utilisation and continued use at 3, 6, and 12 months post-insertion

First author, publication yearStudy designData source standardCountryYears of data collectionSample sizeIUD typeDelivery typeUtilisation (%)IUD in at 3 monthsIUD in at 6 monthsIUD in at 12 months
Higher-Income
Kestler, 201185Prospective observationalMulticentre (n=34)Guatemala2006–200863 188CopperCaesarean0NRNRNR
Kestler, 201185Prospective observationalMulticentre (n=34)Guatemala2006–2008155 468CopperVaginal0.16NRNRNR
Moniz, 201971RetrospectiveClaims databaseUSA2013–2016396 073NRNR0.06NRNRNR
Whiteman, 201228RetrospectiveClaims databaseUSA2001–2008920BothBoth2001–2001: 0.10 per 10 000 deliveries.
2007–2008: 0.55 per 10 000 deliveries
P for trend: <0.01
NRNRNR
Ritter, 202172RetrospectiveThe Kids’ Inpatient Database, HCUPUSA201687 193NRNR1.3%
(4.3% had IUD or implant)
NRNRNR
Sinkey, 202173RetrospectiveSingle centreUSA2015–2019159NRNRPre-LARC programme: 1.6%; post-LARC programme: 10.4%NRNRNR
Cooper, 202031Non-randomised interventionMulticentre (n=2)UK (Scotland)2017–2019379BothVaginal4.788%84%80%
Wu, 202078RetrospectiveSingle centreUSA2015–20169561BothBoth6.2NRNRNR
Cole, 201942RetrospectiveSingle centreUSA2016–2017116 IUDs (out of 1506 deliveries)HormonalBoth7.7NR77%NR
Wallace Huff, 202176Prospective observationalSingle centreUSA2015199NRNR1291.687.5NR
Heller, 201730Non-randomised interventionMulticentre (n=2)UK (Scotland)2015–2016877BothCaesareanConsented: 13.7
Inserted: 12.9
At 6 weeks: 111/120 (99%)99%72%
Trigueiro, 202190RetrospectiveSingle centreBrazil2016–2017828CopperNR27.9 (of women who received IUDs)NRNRNR
Smith, 202127Cross-sectionalMulticentre (n=NR)USA2015–20175648NRNR700/5,648=12.4 (note: includes IUDs and implants)NRNRNR
da Silva, 202080Cross-sectionalSingle centreBrazil2018184NRBoth46NRNRNR
da Silva Nobrega, 202181Non-randomised interventionSingle centreBrazil2017–2018997CopperBoth70.7Of 574 at 45–90 days visit: 84.8%Of 371 at 6–9 months visit: 99.4%NR
Colwill, 201839RetrospectiveSingle centreUSA2014–2015210CopperBothNRAt 6 weeks: 89%NRNR
Gurney, 201847Prospective observationalSingle centreUSA2015–2017200CopperVaginalNR75% (112/149 patients who completed visit had IUDs in place and correctly positioned at 6 weeks)56% (90/162 patients who completed visit had IUD in place and correctly positioned)
Goldthwaite, 201767Prospective observationalMulticentre (n=2)USA2014–201555CopperVaginalNR93%NRNR
Goldthwaite, 201767Prospective observationalMulticentre (n=2)USA2014–201568HormonalVaginalNR80%NRNR
Levi, 201270Prospective observationalMulticentre (n=2)USA2008–200990CopperCaesareanNRNR (6 weeks: 100%)100%NR
Dahlke, 201164RCTSingle centreUSA2009–201315HormonalVaginalN/A87%87%NR
Dahlke, 201164RCTSingle centreUSA2009–201315HormonalVaginalN/A93%93%NR
Gunardi, 202183Prospective observationalSingle centreIndonesia2018–201994CopperBothNR93.198.6NR
Levi, 201537RCTSingle centreUSA2012–2014112BothCaesareanN/ANR83%NR
Hinz, 201949Prospective observationalSingle centreUSA2016–2018114BothBothNRNR94%NR
Cohen, 201656Prospective observationalSingle centreUSA2010–201182BothBothNRNR71% (49/69 patients with 6 month follow-up)76% (51/67 patients with 12 month follow-up)
Eggebroten, 201765Prospective observationalSingle centreUSA2013–201688CopperBothNRNR83%NR
Eggebroten, 201765Prospective observationalSingle centreUSA2013–2016123HormonalBothNRNR81%NR
Woo, 201577Prospective observationalSingle centreUSA2011–2012133NRNRNRNR91%81%
Gonzalez, 202068Prospective observationalMulticentre (n=2)USA2013–201793BothCaesareanNRNRNR76%
Chen, 201063RCTSingle centreUSA2007–200851HormonalVaginalN/ANR74%NR
Soon, 201874RCTSingle centreUSA2013–20156HormonalVaginalN/ANR67%NR
Whitaker, 201455RCTSingle centreUSA2007–201142HormonalCaesareanN/ANR70%60%
Stuart, 201538RCTSingle centreUSA2012–201317HormonalVaginalN/ANRNR29% (within 8 months)
Zaconeta, 201992Prospective observationalSingle centreBrazil2012–2013100CopperCaesareanNRAt 6 weeks: 91%84%NR
Çelen, 201158Non-randomised interventionSingle centreTurkey2006–2008245CopperCaesareanNRNR (6 weeks: 93%)82%62%
Sucak, 201589Non-randomised interventionSingle centreTurkey2009–201251CopperCaesarean (planned)NRNRNR87%
Sucak, 201589Non-randomised interventionSingle centreTurkey2009–201262CopperVaginalNRNRNR77%
Sucak, 201589Non-randomised interventionSingle centreTurkey2009–201247CopperCaesarean (emergent)NRNRNR84%
Unal 201891RCTSingle centreTurkey2016–201770Copper (IUD inserter)CaesareanN/ANRAt median 96 days: 88%NR
Unal 201891RCTSingle centreTurkey2016–201770Copper (sponge-holding forceps)CaesareanN/ANRAt median 96 days: 79%NR
Laporte, 202086RCTSingle centreBrazil2018–201970CopperBothN/AVaginal delivery: 44%
Caesarean delivery: 65%
NRNR
Laporte, 202086RCTSingle centreBrazil2018–201970HormonalBothN/AVaginal delivery: 60%
Caesarean delivery: 89%
NRNR
Braniff, 201561RCTSingle centreAustralia2011–201225HormonalCaesareanN/ANR96%NR
Lower income
Makins 201833Non-randomised interventionMulticentre (n=6)Nepal2016–2017119 844CopperBoth2.16 weeks: 93%NRNR
Puri, 2020166RCT (same data source as Huber-Krum, 2020)Multicentre (n=6)NepalSep 2015–Mar 201775 571CopperBoth281.5NR68.8
Huber-Krum, 2020123RCT (same data source as Puri, 2020)Multicentre (n=6)Nepal2016–201869 210NRBoth2.2NRNRNR
Makins 201833Non-randomised interventionMulticentre (n=NR)Sri Lanka2015–2017291 861CopperBoth2.76 weeks: 96%NRNR
Makins 201833Non-randomised interventionMulticentre (n=6)Tanzania2015–201781 456CopperBoth3.26 weeks: 92%NRNR
Dasanayake, 2020167RetrospectiveSingle centreSri Lanka2014–201914 051NRBoth3.4NRNR80%
Weerasekera 2018152Non-randomised interventionMulticentre (n=18)Sri Lanka2014–2017184 433NRBoth3.7%NR (4–6 weeks: 93%)NRNR
Pfitzer, 2015137Cross-sectionalMulticentre (n=NR)Ethiopia2012–201316 389CopperBoth3.8NRNRNR
Dewan, 201936RetrospectiveSingle centreIndia2010–2017208 210NRBoth2010: 4.7
2011: 5.03
2012: 6.7
2013: 7.6
2014: 13.4
2015: 17.2
2016: 17.7
2017: 21.4
NRNRNR
Melkie, 2021162Cross-sectionalMulticentre (n=4)Ethiopia2019423NRBoth4.0NRNRNR
Agrawal, 202195Non-randomised interventionSingle centreIndia2019–2020NRNRNR4.5–35% over a year and a half time of a PPIUD quality improvement initiative to increase the PPIUD coverageNRNRNR
Wayessa, 2020165Non-randomised interventionMulticentre (n=NR)Ethiopia2017No PPIUD counselling: 471
PPIUD counselling: 237
NRNRNo PPIUD counselling: 4.8
PPIUD counselling: 12.4
NRNRNR
Karra, 2017127Cross-sectionalMulticentre (n=NR)Sri Lanka2015–201513 731NRNR4.9NRNRNR
Makins 201833Non-randomised interventionMulticentre (n=48)Sri Lanka, India, Nepal, Bangladesh, Tanzania, Kenya2014–2017725 647CopperBothConsent: 5.1
Inserted: 5.0
6 weeks: 96%NRNR
Thapa, 2020149Cross-sectionalMulticentre (n=7)Nepal2018–201929 072NRNR5.4NRNRNR
Rwegoshora, 2020142Non-randomised interventionMulticentre (n=6)TanzaniaDec 2017–Apr 201820 276CopperBoth5.5NRNR86
(note: only 46% of sample available at 1 year)
Muganyizi 2018134Prospective observationalMulticentre (n=6)Tanzania2016–201740 470CopperVaginal5.8%NR (6 weeks: 94%)NRNR
Fatima 2018113Non-randomised interventionMulticentre (n=6)Bangladesh201716 359CopperNRInserted: 6.5
Consent: 9.5
NR (4–6 weeks: 98.2%)NRNR
Pleah 201635Cross-sectionalMulticentre (n=5)Benin, Ivory Coast, Niger, Senegal, Togo2014–201515 394NRBoth2014: 8.6
2015: 22.7
NRNRNR
Nigam 2018135Non-randomised interventionSingle centreIndia2013550CopperBoth9.1NRNRNR
Pradhan, 201925RCTMulticentre (n=6)Nepal2015–201715 607NRBoth10.8NRNRNR
Pfitzer, 2015137Cross-sectionalMulticentre (n=NR)Guinea2011–201320 699CopperBoth11.8NRNRNR
Butt, 2020102Prospective observationalSingle centrePakistan2016–2018324CopperBoth15.4NRNR88.8
Qazi, 2020140Prospective observationalSingle centrePakistan2018–20196283CopperBoth15.9NRNRNR
Omona, 2020164RetrospectiveSingle centreUganda2018202CopperBoth16.3NRNRNR
Mishra, 2014133Non-randomised interventionSingle centreIndia2012–2013564CopperBoth17.6NR81NR
Halder, 2016120Non-randomised interventionSingle centreIndia2012–2013100CopperCaesarean17.9NR (6 weeks: 99%)97%96%
Yadav, 2020154RetrospectiveSingle centreIndia2013–201920 418CopperBoth18.4NRNRNR
Halder, 2016120Non-randomised interventionSingle centreIndia2012–201310CopperVaginalInserted: 18.2
Consent: 32.7
NRNRNR
Halder, 2016120Non-randomised interventionSingle centreIndia2012–201390CopperVaginal19.2NR (6 weeks: 97%)94%92%
Jairaj, 201654Non-randomised interventionSingle centreIndia2015–2015370NRBoth19.7NR (at 6 weeks: 43.5%)NRNR
Nisar, 2020136RetrospectiveSingle centrePakistan2014–20168003NRBoth25.1NRNRNR
Divakar, 2019106Non-randomised interventionMulticentre (n=6)India2015–201766 508CopperBoth25.5NRNRNR
Geda, 2021158Cross-sectionalMulticentre (n=13)Ethiopia2019286NRBoth26.6NRNRNR
Espey, 2021157Non-randomised interventionMulticentre (n=6)Rwanda2017–201812 068CopperBoth27.9NRNRNR
Kanakuze, 2020160Cross-sectionalSingle centreRwanda2019–2019383CopperBoth28.1NRNRNR
Ingabire, 2018159Non-randomised interventionMulticentre (n=2)Rwanda2017–20189020CopperBoth28.5NRNRNR
Ghafoor, 2020114Cross-sectionalSingle centrePakistan2019–2019108NRNR32.5NRNRNR
Fatema, 2018112Non-randomised interventionSingle centreBangladesh2013–2013370NRBoth35.7NRNRNR
Bhadra 201899Prospective observationalSingle centreIndia2015–201719 170NRBoth37.4NR (at 6 weeks: 93.7%)NRNR
Wasim, 2018151Non-randomised interventionSingle centrePakistan2015–20178000CopperBoth37.6NRNRNR
Kant, 2016126RetrospectiveMulticentre (n=2)India2014–2014611CopperVaginal38.9NRNRNR
Eluwa 2016111Cross-sectionalMulticentre (n=11)Nigeria2014–2015728CopperNR41NRNRNR
Ndegwa, 201434RCTSingle centreKenyaNR127NRNR45.7NR (6 weeks: 98.3%)NRNR
Vishwakarma, 2020150Non-randomised interventionSingle centreIndia2016–20191029CopperCaesareanNRNR (6 weeks: 98.3%)88.7NR
Lerma, 202033Cross-sectionalMulticentre (n=5)India2015–201693CopperVaginalNRNR (6–8 weeks: 83%)NRNR
Lerma, 202033Cross-sectionalMulticentre (n=5)India2015–2016467CopperVaginalNRNR (6–8 weeks: 77%)NRNR
Ngonzi, 2021163Prospective observationalSingle centreUganda2014–2015167CopperVaginalNRNR (6–8 weeks: 91%)NRNR
Khurshid, 2020129Prospective observationalSingle centreIndia2015–2016238CopperVaginalNRNR (at 6 weeks: 96%)97%94%
Jakhar, 2019125Prospective observationalSingle centreIndia2013–2014200CopperCaesareanNRNR (at 6 weeks: ‘wanted to continue’: 89%)‘Wanted to continue’: 82%NR
Blumenthal, 2018100RCTMulticentre (n=5)India2015–2016239Copper (Kelly’s forceps)VaginalN/ANR (6–8 weeks: 84%)NRNR
Blumenthal, 2018100RCTMulticentre (n=5)India2015–2016241Copper (IUD inserter)VaginalN/ANR (6–8 weeks: 72%)NRNR
Mishra, 201748RetrospectiveSingle centreIndia2010–2012736CopperBothNRNR (at 4 weeks: 94%)NR79%
Chakheni, 2017103Non-randomised interventionSingle centreIndia2013–201450Copper (manual insertion)CaesareanNR94%NRNR
Chakheni, 2017103Non-randomised interventionSingle centreIndia2013–201450Copper (Kelly’s forceps)CaesareanNR92%NRNR
Singh, 2016146Non-randomised interventionMulticentre (n=2)India2015–201580NRVaginalNRNR (6–8 weeks: 76.3%)NRNR
Dias, 2016105Prospective observationalSingle centreSri Lanka2012–201360CopperVaginalNRNR (at 6 weeks: 75%)NRNR
Dias, 2016105Prospective observationalSingle centreSri Lanka2012–201331CopperCaesareanNRNR (at 6 weeks: 74%)NRNR
Singal, 2014144Prospective observationalSingle centreIndia2012–2012300CopperCaesareanNR98%96%91%
Khan, 202050RCTSingle centrePakistan2019–2020152CopperBothNRNR97NR
Bryant, 2013156RCTSingle centreMalawi2010–201112CopperVaginalN/A83%NRNR
Shukla, 2012143Prospective observationalSingle centreIndia1995–20001317CopperBothNRNR (4–6 weeks: 80%NRNR
Bhutta, 201145Cross-sectionalSingle centrePakistan2006–200750CopperCaesareanNR92% (willingness to continue)82% (willingness to continue)NR
El Beltagy, 2011107RCTSingle centreEgyptNR150CopperVaginalN/AAt 6 weeks: 97%At 6 months: 94%NR
El Beltagy, 2011107RCTSingle centreEgyptNR150HormonalVaginalN/AAt 6 weeks: 98%At 6 months: 94%NR
Elsedeek, 2015110Non-randomised interventionSingle centreEgypt2006–201180HormonalCaesareanNRNR (at 6 weeks, centrally placed: 54%)NRNR
Elsedeek, 2015110Non-randomised interventionSingle centreEgypt2006–201163CopperCaesareanNRNR (at 6 weeks, centrally placed: 65%)NRNR
Singal, 2021145Cross-sectionalMulticentre (n=20)India20194012NRNRNR78.574.570.7
Zaman, 2020155Non-randomised interventionSingle centrePakistan2015140CopperNRNRNR84NR
Elshamy, 2021108Non-randomised interventionSingle centreEgypt2018–20191100BothVaginalNRNR88NR
Rani, 2015141Non-randomised interventionSingle centreIndiaNR99CopperBothNRNR92.9NR
Elsedeek, 2012109Non-randomised interventionMulticentre (n=3)Egypt2007–200965HormonalCaesareanNRNRNR97%
Elsedeek, 2012109Non-randomised interventionMulticentre (n=3)Egypt2007–200975CopperCaesareanNRNRNR88%
Bhat 201640Non-randomised interventionSingle centreIndia2011–2014680CopperBothN/ANR86%NR
Abro 201893Non-randomised interventionSingle centrePakistan2016–2017220NRNRNRNR91%NR
Bhat, 201640Non-randomised interventionSingle centreIndia2011–2014339CopperCaesareanNRNR96%NR
Bhat, 201640Non-randomised interventionSingle centreIndia2011–2014130CopperVaginalNRNR78%NR
Bhat, 201640Non-randomised interventionSingle centreIndia2011–2014211CopperVaginalNRNR75%NR
Blumenthal, 2016101Prospective observationalSingle centreZambia2010305NRNRNRNR94%NR
Lester, 2015161RCTSingle centreUganda201134CopperCaesareanN/ANRITT: 79%; with 6 month follow-up data: 93% (7/29)NR
Kumar, 2019131RetrospectiveMulticentre (n=12)India2015844CopperBothNRNRNR63% (60–68% depending on subgroup)
  • ITT, intent-to-treat; IUD, intrauterine device; LARC, long-acting reversible contraception; N/A, not applicable; NR, not reported; PPIUD, postpartum intrauterine device; RCT, randomised controlled trial.