Postplacental Insertion of Levonorgestrel-releasing Intrauterine System (LNG-IUS) After Cesarean vs. Interval Insertion

Immediate Post-placental Insertion of the Levonorgestrel-releasing Intrauterine System (LNG-IUS) After Cesarean Delivery vs. 4-8 Week Post-delivery Interval Insertion: A Randomized Controlled Trial

The study is a randomized controlled trial comparing outcomes of immediate postplacental insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) vs. interval insertion of the LNG-IUS performed 4-8 weeks after delivery for patients undergoing scheduled cesarean delivery.

Our primary hypothesis is that the proportion of women using the LNG-IUS for contraception at 12 months after delivery will be higher in the group randomized to immediate post-placental insertion.

Inclusion Criteria:

• Pregnant at time of enrollment
• Planning to undergo a scheduled cesarean delivery
• Desires to use the LNG-IUS for contraception
• Willing and able to sign an informed consent in English
• Willing to comply with the study protocol
• Age greater than or equal to 18 years
• English speaking

Exclusion Criteria:

• Allergy to either polyethylene or levonorgestrel, or other contraindications to use of the LNG-IUS
• Positive testing for Gonorrhea, Chlamydia, or trichomoniasis during the pregnancy without treatment and a subsequent test of cure confirming a negative result
• Presence of leiomyomata significantly distorting the uterine cavity and thus not allowing placement of the LNG-IUS
• Uterine anomaly which would not allow placement of the LNG-IUS
• Current cervical cancer or carcinoma in-situ
• Desire for repeat pregnancy in less than 12 months
• History of postabortal or postpartum sepsis