Post Partum period is the ideal time for family planning counselling. Accessibility to health care facility is more during this period in our country. In view of repeated pregnancies, the present study is planned to evaluate the expulsion, removal and continuation of PPIUCD (Cu 380A and Multiload 375) in women delivering vaginally or by caesarean section in a tertiary care facility.
Material and Methods: 220 women had PPIUCD insertion immediately after delivery of the placenta in vaginal and caesarean section (110 each in CuT 380A and Multiload 375) after applying inclusion and exclusion criteria. They were then followed up at 6 weeks and 3 months.
Results: There were total of 6 expulsion, 4 in CuT 380A and and 2 in Multiload at 6 weeks follow up and 2 expulsion in Copper T 380A and none in Multiload at 3 months. Expulsion was more in case of vaginal delivery. There was 5.5% removal at 3 months (7.8% in Cu T 380A and 3.8% in Multiload 375). Main reasons for removal were pain lower abdomen (23.1%, Bleeding 38.4%, Discharge 15.3% and Family Pressure 23.1%).At the end of 3 months 86.7% continued with Copper T 380 A and 94.6% in the Multiload 375.
Conclusion: Immediate postpartum IUCD insertion provides highly effective contraception immediately after delivery with minimal side effects. The expulsion in our study was not very high and can be reduced with skill and practice. Cash incentives to the acceptor, motivator and provider could bring about a substantial progress in the PPIUCD use in developing countries like India.