Can you get an IUD after giving birth?

When you’re about to have a baby, getting pregnant again or even having sex may be very far down your list of priorities. However, planning your postpartum birth control can help you feel more prepared for life after your little one has arrived. 

You may have heard that an intrauterine device (IUD) — a small T-shaped device that sits inside your uterus — can be fitted soon after delivery. But how soon can it be done, and will it hurt?

Key takeaways

• You can get an IUD immediately after giving birth or at any point afterward, whether you have a vaginal birth or cesarean section. 
• IUDs are one of the most effective forms of birth control, with a typical use failure rate of less than 1%, and won’t affect your ability to get pregnant again quickly in the future. 
• Getting an IUD right after giving birth may increase the risk of the device falling out. But if this happens, it won’t actually harm you — you’ll just need to use backup birth control and visit your health care provider to get a new one. 

Can you get an IUD after giving birth? 

In short, yes, you can. Often, IUDs are placed by health care providers around four to six weeks after birth during your postpartum follow-up, but increasingly, people are getting them fitted within three days of delivery. 

“An IUD is really safe to place in the immediate postpartum period, and there are some additional benefits to placing them then,” says Dr. Nazaneen Homaifar, obstetrician and gynecologist, Inova Health System, Washington, DC, US. 

“In the United States, between 40% and 57% of women have unprotected sex before their routine, six-week postpartum visit. That puts postpartum people at risk of unintended and short-interval pregnancy [when there’s less than two years between the birth of one child and conception of another].”

Many people don’t realize how quickly fertility can return after giving birth. If you’re not breastfeeding, ovulation usually starts up again within a few weeks of delivery. And while nursing can delay ovulation for up to six months postpartum, this is only possible if you’re breastfeeding exclusively. The bottom line is that if you’re not using birth control, it’s possible to get pregnant very soon after delivery. 

And it happens more often than you might think. “At least 70% of pregnancies in the first year postpartum are unintended in the United States,” Dr. Homaifar adds. “So placing an IUD in the immediate postpartum period can help prevent pregnancy for many people.”

Pros and cons of getting an IUD after pregnancy 

When it comes to postpartum contraception, you’re certainly not short of options. Along with IUDs, other methods like the implant and progestin-only birth control pills (a type of oral contraceptive), plus barrier methods like condoms, are also considered safe birth control for breastfeeding moms. 

So, what’s special about IUDs? “If you’re looking for very effective contraception that you don’t have to think about on a daily basis and that can last a long time, IUDs are a really great option,” says Dr. Homaifar. Let’s take a closer look at the pros and cons. 

Pros of IUDs 

• Effectiveness: IUDs are one of the most effective forms of birth control, with a typical use failure rate of less than 1%. That means for every 100 people using IUDs in a year, fewer than one person will get pregnant. 
• Convenience: Once your health care provider has placed an IUD inside your uterus, you simply leave it there to do its thing. That means no more annoying pill reminders! 
• Long acting: IUDs work for between three and 10 years, depending on the type of IUD and brand you choose.
• Reversible: That means you can have the IUD removed at any point. Then, if you decide you want another baby, you can start trying again immediately after your doctor has removed it. 
• Safe to use while breastfeeding: Plus, IUDs won’t impact your milk supply. 
• Helps with period symptoms: Hormonal IUDs can improve menstrual cramps and heavy periods over time.

Cons of IUDs

• Need to visit a clinic: IUDs have to be fitted and removed by a doctor. 
• No protection against sexually transmitted infections (STIs): In fact, the only type of contraception that can reduce your chances of catching an STI is condoms.  
• Spotting between periods: During the first few months, this is a common side effect. 
• Side effects: Copper IUDs can cause heavier, longer, and more painful periods. It’s common to experience cramping after you’ve had an IUD placed, which can range from low back pain to severe pelvic pain and last from several hours to days. If you’ve given birth vaginally, you may be less likely to experience pain. 
• IUD expulsion: IUDs can fall out of place and need to be removed — especially if you get one within the first three days after birth — although this is rare.
• Need to remember to change the IUD: When your IUD reaches the end of its lifeline (between three to 10 years, depending on the type), you’ll need to remember to discuss your options with your doctor.

How soon after birth can you get an IUD? 

There’ll be a lot going on in the delivery room, so how soon after birth are we talking? It turns out it can be very soon. “Immediate post-placental insertion is performed within 10 minutes of delivery of the placenta,” says Dr. Homaifar. 

In case you aren’t already aware of the stages of labor, the delivery of your baby is only stage two of the process. The third and final stage of labor is when you deliver the placenta (or afterbirth), the temporary organ that’s been busy removing waste and providing oxygen and nutrients to your developing baby in your uterus. 

However, fitting an IUD this soon after birth can be tricky. “The main challenge is placing the IUD high enough in the uterus so it’s at the top,” says Dr. Homaifar. That’s really important because your IUD can fall out, known as IUD expulsion. And this is more likely right after birth. “For post-placental [placements], the expulsion rates of the IUD have been reported to reach 10% to over 27%,” Dr. Homaifar adds.

This can sound scary, but if an IUD does fall out, it won’t harm you. The issue is that it wouldn’t work properly, and you’d need to use another form of birth control (like condoms) until you can have the IUD replaced by your health care provider.

For that reason, you might decide to wait until your six-week checkup. “The risk of the IUD falling out is higher [immediately postpartum] than if you were to wait six weeks,” Dr. Homaifar explains. “Now, some hospitals will do early-delayed IUD insertion, which means placing it between 10 minutes and one week after delivery. At this point, the uterus is quite strong, but it still hasn’t quite settled, so the chance of the IUD coming out is about the same as with post-placental insertion.”

It’s also worth noting that, in some instances, it will not be safe to place an IUD immediately after birth, for example, if there are any signs of infection or serious bleeding. 

Every labor is different, so speak to your doctor if you’re thinking of getting an IUD fitted after you give birth. 

What about IUD insertion after a C-section?

You can still have an IUD placed immediately after delivery if you have had a cesarean section. Your obstetrician and gynecologist would remove the placenta and then place the IUD in your uterus, making sure the strings extend into the vagina. They’d then close the cut in your uterus that they made to deliver your baby. 

Does getting an IUD hurt less after having a baby?

Childbirth can be daunting enough on its own, so it’s natural to want to avoid signing yourself up for any more discomfort. The good news is that if you get an IUD placed immediately after delivery of the placenta, there’s a chance you may not feel it. 

“If you’re getting a cesarean section, you’ll definitely be having either a spinal or epidural anesthesia, so you’re not going to feel the placement at all,” Dr. Homaifar explains. “After vaginal delivery, if you happen to have an epidural, then you won’t feel the placement.” 

Even if you haven’t taken any pain relief, the physical changes that happen during labor can make IUD insertion less painful. 

“If you have an unmedicated delivery, you might feel it a little bit, but because the cervix has dilated to 10 cm, you’re not going to feel any discomfort from the IUD having to pass through the cervix,” Dr. Homaifar adds. “This is usually a source of discomfort when people get it placed in the doctor’s office when their cervix is only around 0 to 1 cm dilated.” 

What’s the recommended type of IUD to use postpartum? 

“There’s no specific type of IUD that’s recommended immediately postpartum,” says Dr. Homaifar. “It really depends on your needs.”

So what are your options? Well, there are broadly two types of IUDs to choose from: the copper IUD and the hormonal IUD. Both open out to form a T shape in the uterus and have strings at the bottom that extend into your vagina. This means your doctor can easily remove them when needed.  

Let’s look at the two types of IUDs in more detail: 

Copper IUDs

These nonhormonal birth control devices have a thin copper wire that wraps around the bottom part of the T. And why would you want to have copper in your uterus? It sounds strange, but the copper wire plays an important role in preventing pregnancy by making the environment in your uterus toxic to sperm and interfering with its ability to move. It also works for up to 10 years, so you know you’re covered. Another plus point of the copper IUD is that it has been approved as a form of emergency contraception. Talk to your doctor for more information on that. Copper IUDs have a perfect-use failure rate of 0.6% and a typical-use failure rate of 0.8%. 

Hormonal IUDs

As the name suggests, these are a type of hormonal birth control. They contain a type of progestin (a synthetic version of the sex hormone progesterone) called levonorgestrel in the top part of the T. This hard-working hormone helps to prevent pregnancy in three ways: 

• Thinning the lining of your uterus (making it harder for a fertilized egg to implant there)
• Thickening your cervical mucus (making it harder for sperm to swim to your tubes)
• Suppressing ovulation in some (but not all) cycles (Ovulation is when you release an egg around the midpoint of your cycle.) 

Depending on the brand you choose, a hormonal IUD can work for three to eight years. This type of IUD is also very slightly more effective than the copper IUD, with a perfect and typical use failure rate of just 0.2%. 

The two types of IUDs can have different benefits and side effects. For example, some people find that hormonal IUDs make their periods lighter, shorter, and less painful. Unfortunately, copper IUDs can sometimes have the opposite effect, although this is often just for the first few months. It often depends on the person, as we all react to birth control in different ways. Speak to your health care provider about which IUD might be the best type for you. 

Choosing the right birth control after pregnancy

If you want to avoid pregnancy after childbirth, an IUD can be a great option. IUDs are not only one of the most effective kinds of birth control but one of the most convenient, requiring no effort or upkeep from you for up to 10 years. 

If you get an IUD placed immediately after delivery, it’s one less thing you have to think about during those magical  — but often overwhelming — first weeks with a newborn. If all this sounds appealing, it’s a good idea to speak to your health care provider about it while you’re still pregnant. 

“Make sure that they offer it where you deliver,” says Dr. Homaifar. “Not every institution or hospital is going to be able to place immediate postpartum IUDs. So it’s something to discuss with your provider ahead of time to see if it’s something they are equipped to place.”