Contraception

 CONTRACEPTION 

Cu-T INSERTION 

REQUIREMENTS:  

Written Informed consent, IUD, Povidone Iodine, Spirit and drapes, Sims’s speculum, Allis forceps, Uterine Sound 

 

PROCEDURE: 

• Begin with the history and clinical examination to rule out contraindications. 

• Before inserting the IUD, always do UPT to rule out pregnancy. 

• The patient is taken up in the OT (but can be done in OPD or labour ward immediately post-partum). An anaesthetist should be present if in case perforation occurs. 

• POSITION: Standard lithotomy position with legs in stirrups. 

• Scrubbing, painting, and draping should be done. 

• Bimanual examination to check for uterine size, position, version, and adnexal pathology. 

• Depress posterior vaginal wall with Sim’s speculum and hold the anterior lip of cervix using Allis forceps. 

• Using uterine sound, measure utero-cervix length and the accordingly adjust the bobbin. 

• The technique used is “No Touch/ Withdrawal technique”. 

• CuT is self-loaded. Remove the whole thing without touching CuT. 

• Plunger should not touch the vaginal wall. Reach upto the uterine fundus. Pull the ring behind on the plunger. CuT is unfolded. 

• Slowly remove the loader so as not to disturb the CuT. 

• Cut the tail (2.5-3 cm). The patient should be made to feel the tail. 

• Observe for about half an hour for uterine cramps (since foreign body inserted so uterus tries to expel it)  

Managed by giving Drotaverine/Dicyclomine. 

 

• Record the date of insertion. Document it on CuT card and mention the date of expiry. Give it to the patient. 

• Counsel the patient regarding all the possible complications and also regarding the follow-ups. 

 

ANTARA 

Injectable Contraceptive DMPA (Under ANTARA programme) given as i.m. injection on outer upper quadrant of buttock. 

Dose: 150 mg every 3 months  

Written by our guest author - Ayushi Gupta

Illustration by Devi Bavishi

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