COMPARING OUTCOME OF IMMEDIATE POSTPARTUM INSERTION OF INTRAUTERINE CONTRACEPTIVE DEVICE IN VAGINAL VERSUS CESAREAN SECTION DELIVERY

Abstract

Background: Early post-partum insertion of intrauterine contraceptive device is a good measure to lower the unmet family planning need, but the results are not predictable depending on the mode of delivery. There is a paucity of local data relating safety and effectiveness between vaginal and cesarean delivery in Pakistani women. Aim: To compare outcomes of immediate postpartum IUCD insertion after vaginal versus cesarean delivery with respect to expulsion, lost string, infection, menstrual irregularity, and user satisfaction. Methods: This descriptive study was carried out at the Department of Obstetrics and Gynecology, DHQ Teaching Hospital Gujranwala from 24th November 2025 to 23rd may, 2026.Gestational age of 36 weeks and above was used to select one hundred women aged 18-40 years who were delivered by cesarean section and 47 vaginal delivery. IUCD was placed within six hours of birth and the participants were followed up to three months. The SPSS 25 was used to analyze the data through chi-square and independent t-tests. Results: Expulsion was significantly higher after vaginal delivery (21.3%) compared with cesarean (7.5%). Lost string was more frequent in the cesarean group (18.9% vs 6.4%). Infection (5.7% vs 6.4%) and menstrual irregularity (11.3% vs 12.8%) were similar between groups. User satisfaction remained high in both cesarean (86.8%) and vaginal (83.0%) cohorts. Quantitative variables showed no significant association with expulsion. Conclusion: Postpartum IUCD is safe and acceptable, and the method of immediate postpartum can be used after both delivery modes, which has a high retention after cesarean and high expulsion after vaginal birth. Enhancement of counseling and follow up services can also enhance results.