Family Planning

Woman’s situationPartially breastfeedingor not breastfeeding(continued)More than 4 weeksafter giving birthNo monthlybleeding (notrelated to childbirthor breastfeeding)Aftermiscarriage orabortionAfter takingemergencycontraceptivepills (ECPs)When to startóóóóóóóóIf her monthly bleeding has not returned, shecan have the LNG-IUD inserted any time if itcan be determined that she is not pregnant. Shewill need a backup method for the first 7 daysafter insertion.If her monthly bleeding has returned, she canhave the LNG-IUD inserted as advised forwomen having menstrual cycles (see p. 161).Any time if it can be determined that she is notpregnant. She will need a backup method for thefirst 7 days after insertion.Immediately, if the LNG-IUD is inserted within7 days after first- or second-trimester abortionor miscarriage and if no infection is present. Noneed for a backup method.If it is more than 7 days after first- or secondtrimestermiscarriage or abortion and noinfection is present, she can have the LNG-IUDinserted any time it is reasonably certain she isnot pregnant. She will need a backup methodfor the first 7 days after insertion.If infection is present, treat or refer and helpthe client choose another method. If she stillwants the LNG-IUD, it can be inserted after theinfection has completely cleared.LNG-IUD insertion after second-trimesterabortion or miscarriage requires specific training.If not specifically trained, delay insertion until atleast 4 weeks after miscarriage or abortion.The LNG-IUD can be inserted within 7 daysafter the start of her next monthly bleeding orany other time it is reasonably certain she is notpregnant. Give her a backup method, or oralcontraceptives to start the day after she finishestaking the ECPs, to use until the LNG-IUD isinserted.10Levonorgestrel IUDProviding the Levonorgestrel Intrauterine Device163