“Recently, TikTok content on IUD insertion has generated hundreds of millions of views, and sparked significant conversation about IUD insertion pain. And, early in June 2022, research funded by the United States Food and Drug Administration (FDA) suggested that uterine perforation by IUDs, though relatively rare, occurs more often than most women (and likely their medical providers) realize. Furthermore, perforation rates are especially high for postpartum women, both those who are breastfeeding and those who are not [1].”
“Study: Risk of uterine perforation by IUDs higher than previously thought, especially for postpartum women”
“While a 2016 study reported uterine perforation occurring in just 1 of 1,000 insertions (0.1%), in contrast, The Lancet study found an overall rate of 6 perforations per 1,000 insertions, with substantially higher risk for any postpartum women (up to one year after giving birth) and highest risk amongst postpartum breastfeeding women [6].
Uterine perforation incidence was two times higher (equivalent to roughly 12 in 1,000 insertions) amongst postpartum women who had an IUD inserted on the day of delivery, or up to 3 days postpartum, versus non-postpartum women. And perforation incidence was nearly seven times higher (equivalent to nearly 42 in 1,000 insertions) amongst postpartum women who had an IUD inserted between 4 days and 6 weeks postpartum, compared to non-postpartum women. “