Intrauterine device "coil" at caesarean section

Intrauterine contraception, known as a coil or IUD, is one of the most effective ways of preventing or delaying a further pregnancy.

It is possible to have this fitted at the time of a caesarean birth. It is inserted through the opening in the womb, after the placenta (afterbirth) has been removed.

Caesarean childbirth and coil fitting

There are many benefits to having your contraceptive coil fitted at the time of your caesarean:

It is very safe.
It provides contraception immediately.
It is painless - you will already have an anaesthetic for the operation.
Either the hormone (LNG-IUD) or hormone free, copper coil (Copper-IUD) can be fitted.
Both coils are safe to use while breastfeeding.

About the contraceptive coil

No contraceptive method is 100% effective, but the coil has a very low risk of failure (less than one pregnancy per 100 women over a year).

When a coil is fitted at the time of a caesarean there is a one in 1000 risk of injury to the womb (perforation) at the time of insertion and a one in 20 risk of the device falling out of the uterus afterwards.

There is a small chance of infection (one in 100) in the first few weeks following insertion, this is the same risk as if the coil was fitted later.

Types of contraceptive coil:

Hormonal LNG-IUD

This coil contains a small amount of a hormone (progesterone) that is released directly into the womb. Progesterone causes mucus in the cervix to thicken so sperm cannot get through, and the womb lining to thin so that an egg cannot implant. Only a trace of the hormone enters the blood stream.

Because the hormone causes the womb lining to thin, period pain and bleeding will reduce, although it can take up to 3-6 months for your bleeding pattern to settle or stop totally.

Copper IUD

This coil does not contain hormones. The copper in the device prevents sperm from reaching an egg and implanting in the uterus.

Because there are no hormones in this coil your period cycle will not be affected, although sometimes your periods may be heavier.

Advice after your coil fitting:

What to expect

You will need to have a follow up appointment in the hospital after your coil fit for a scan and possibly a thread trim.

The scan is to confirm the coil remains correctly sited within the uterus once is has returned to its pre-pregnancy size. We would recommend using additional contraception until this follow up appointment has taken place.

When the coil is inserted at the time of a caesarean, there is a higher chance that the threads will not be seen in the vagina at the check-up visit. This does not affect how the coil works and most can be removed easily when required.

I think I can feel the threads, what to do?

When a coil is fitted at the time of caesarean section the threads are left long. Once your uterus has returned to its pre pregnancy size they are then trimmed.

You might be aware of the threads within the vagina or protruding just outside before your follow up appointment is due. If this is the case, please contact the one of the following emails below for any questions or queries.

Try to avoid pulling on the threads yourself as the coil may be removed by accident.

I think my coil has come out, what to do?

Sometimes the coil can expel from the uterus. If you suspect this might have happened, it is important that you contact us as soon as you can and avoid any unprotected sex until this has been checked at your appointment.

When can I have sex again after having a coil inserted?

You can start having sex again whenever you feel ready although the timing of this will vary for each woman.

Post-partum contraception advice

If you are looking for further information or have any further questions or queries, please contact the hospital where you are due to give birth.

St Michael's Hospital: stmikesLARC@ubhw.nhs.uk

Southmead Hospital: contraception@nbt.nhs.uk