Family Planning

Woman’s situationFully or nearlyfully breastfeeding(continued)More than 6 monthsafter giving birthWhen to startóóIf her monthly bleeding has not returned,she can have the IUD inserted any time it isreasonably certain she is not pregnant. No needfor a backup method.If her monthly bleeding has returned, she canhave the IUD inserted as advised for womenhaving menstrual cycles (see previous page).Partially breastfeedingor not breastfeedingMore than 4 weeksafter giving birthNo monthlybleeding (notrelated to childbirthor breastfeeding)óóóIf her monthly bleeding has not returned, shecan have the IUD inserted if it can be determinedthat she is not pregnant. No need for a backupmethod.If her monthly bleeding has returned, she canhave the IUD inserted as advised for womenhaving menstrual cycles (see previous page).Any time if it can be determined that she is notpregnant. No need for a backup method.9Copper-Bearing Intrauterine DeviceAftermiscarriage orabortionóóóóImmediately, if the IUD is inserted within 12days after first- or second-trimester abortionor miscarriage and if no infection is present. Noneed for a backup method.If it is more than 12 days after first- or secondtrimestermiscarriage or abortion and noinfection is present, she can have the IUDinserted any time it is reasonably certain she isnot pregnant. No need for a backup method.If infection is present, treat or refer and help theclient choose another method. If she still wantsthe IUD, it can be inserted after the infectionhas completely cleared.IUD insertion after second-trimester abortionor miscarriage requires specific training. If notspecifically trained, delay insertion until at least4 weeks after miscarriage or abortion.Providing the Intrauterine Device141