For most intrauterine devices like IUDs, women have them inserted and placed by a healthcare provider. It’s a fairly easy process and takes about 5 minutes to complete. IUDs are a non-surgical, effective, low maintenance and a long-term option for birth control. 

Considering the procedure is non-surgical, there is no need for incisions or administered anesthesia; daily activities can continue immediately after IUD placement. When the IUD is placed, some women reported mild menstrual-like cramping and others reported it a little more painful than average. 

Discomfort is common with IUD placement. Over the counter pain medication can be helpful in improving the pain and cramping. Some anti-inflammatory over the counter medications can be taken prior to your IUD placement to relieve you and prevent discomfort.  For other healthcare providers, applying local anesthesia like lidocaine gel into the cervical canal to help reduce comfort is better as an alternative option.. 

In severe cases, less than 5% of women experience extreme side effects like vomiting, fainting, severe bleeding and cramping. The connection with severe side effects and some women come from women who have had very few births or never given birth at all. One of the major correlations with severe side effects and women with mild side effects.

On the day of the appointment the doctor will ask a few questions before inserting the IUD as well as check the vagina, uterus, and the cervix. Your doctor will also check for sexually transmitted diseases, infection, and pregnancy. If you are within the first 7 days of your period, your doctor may perform a pregnancy test to rule it out. With any of these complications, the IUD cannot be inserted. 

Along with the tests, your healthcare provider will perform a pelvic exam. With two fingers inserted into the vagina and the other hand on the abdomen, your healthcare provider can determine the size, position, mobility, and consistency of your pelvic organs. This can help pin-point any tenderness that might indicate an already existing infection.

All equipment will be prepared prior to insertion. Your healthcare provider will explain the procedure and answer any and all questions and concerns prior to placement. 

Proper IUD Placement Procedure

At placement, your doctor will:

• Apply antiseptic solution to your vagina and cervix
• Insert a small tube applicator into your vagina and then your uterus
• Position the IUD placement
• Remove the applicator and leaving the IUD in place
• Ensure the threads attached extend through your cervix and out of your uterus
• Trim the string to the correct length

IUDs are shaped like the letter ‘T’. The arms get folded down and placed into the applicator tube. At this point, the vagina will be held open by a speculum which allows the applicator to be inserted into the vagina and into the cervix. The antiseptic solution will then help create a sterile environment to reduce the likelihood of infection. 

Your doctor will insert a sterile tool called the sound (or an alternative called the endometrial aspirator) to help measure the length and direction of the uterus and cervical canal. These tools allow your healthcare provider to understand how far and deep the IUD placement can be. With a round tip at the end of the tool to avoid perforation, void of contact with the vagina or speculum, this tool determines the uterine depth is between 6 and 9 centimeters. This helps ensure that the wrong IUD placement doesn’t cause the IUD to eventually puncture through the uterus. Which, in turn, can cause complications and infections. If the depth of the uterus is less than 6 centimeters the IUD should not be inserted. 

Once the IUD gets removed from it’s sterile packaging, the arms are pulled back and slide into the applicator tube. The applicator helps the IUD get pushed into place.

When the IUD is placed correctly the applicator releases the IUD and the arms on either side of the ‘T’ are released. 

Once the IUD is correctly in its place, all tools will be removed from the vagina. The doctor will leave the string intact; hanging about 1 to 2 inches out of the cervix. The strings are not visible from outside the vagina but can be felt with the insertion of one finger. This helps you check that your IUD is still in place. 

IUD placement takes anywhere from 5 to 15 minutes to complete.

After IUD placement, your healthcare provider should explain how to self-check the string to ensure your IUD placement is correct, once a month. As well as schedule a follow up appointment within the next 4 to 6 weeks to check to see if your IUD is properly in place. Normally scheduled within the time of your annual check up depending on the type of IUD you had inserted. 

Some women have reported some cramping after the uterus adjusts to the IUD placement. All which should pass over time. It is normal to have some bleeding or spotting for the first few days following your IUD insertion. If the bleeding is heavy, it is wise to call your healthcare provider to ensure there is no worry for infection. 

However, it is normal for your period to be heavier than normal after an IUD placement.  As well as come a few days earlier than your normal cycle. 

It is important to check the IUD strings a few days in to the first few weeks. Especially after and between periods. It’s good practice to schedule a check up after your first period or no longer than three months after insertion to make sure the IUD placement is still correct.

After the first IUD placement and the few check ups following post procedure, the wonderful thing about an IUD is that women don’t have to do anything. Once it’s in proper placement, it can be regularly checked in coordination with her annual gynecological exams. 

Call Rosh Maternal & Fetal Medicine in NYC

Wondering if an IUD for birth control would be good for you? Talk to our team by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today about IUD for birth control. They’ve helped thousands of women. Come visit your NYC OBGYN.