Home
The woman will meet with the clinician prior to placement. She or he will review the medical history and may ask questions regarding sexual history. Inform the woman that some clinicians offer same-day placements to those who bring the device or have access to a pharmacy on site.
“A health care professional should be reasonably certain that the woman is not pregnant before inserting an intrauterine contraceptive at any time during the menstrual cycle.” - SOGC
Depending on the woman’s risk of unintended pregnancy, or due to clinic policy, a woman may be expected to take a pregnancy test prior to placement. A urine test is usually sufficient. For further information on pregnancy confirmation, see “How to be reasonably certain that a woman is not pregnant”.
“Bimanual examination and cervical inspection should be performed to assess uterine position and size as well as any abnormalities that might preclude IUC use. STI testing should be performed in women at high risk for STI infection; however, it is not necessary to delay IUC placement until the results are available. STI screening on the day of placement is a reasonable strategy. If there is evidence of mucopurulent discharge or pelvic tenderness, IUC placement should be delayed until the swab results are known and the woman is treated.” - SOGC
Women can expect to have a pelvic examination and speculum placed prior to IUC placement. This is much like a “pap” test. Women at increased risk of STI (under 26, history of STU, non-monogamous) should be screened at the time of placement: Not all women will require STI screening.
“Most women either experience “nothing/minimal discomfort” (up to 42%) or feel “uncomfortable” (41%) during their IUC insertion. Prophylactic NSAIDs have not been shown to improve pain associated with IUC insertion but may improve pain after insertion.” - SOGC
Pain is a subjective experience, but women should be reassured that the pain of placement is seldom severe. Most women report that the discomfort of placement is as expected or better, and is between a 2-3 on a 10-point scale (10 being the worst pain imaginable). Smaller devices are associated with less pain, while a history for dysmenorrhea is associated with greater pain.
SOGC Clinical Practice Guideline, Canadian Contraception Consensus (part 3): Chapter 7 – Intrauterine Contraception