The importance of immediate contraception
Within 3 weeks after the birth, a non-breastfeeding woman can be fertile again, without having had her first menstruation. The ideal time to evaluate the patient’s future contraceptive needs and to discuss the individual benefits and risks is close to birth since it may be one of the few opportunities when she is in contact with medical services and acutely aware of the importance of contraception in future family planning.
Gyn-CS: Post-placental contraception
More than 30 years ago, an article titled ” Immediate Postplacental IUD (coil) Insertion (IPPI): the problem of expulsion ” was published.  The authors had extensive experience with the use of IUDs (both vaginal and caesarean), having used more than 2600 IUDs between 1974 and 1983.
They concluded that “IPPI insertion,” postplacental contraception, meets the basic requirements of any contraceptive method: easy insertion, safety, and high efficacy. But most of all, it enables contraceptive decisions at a time when the patient’s consciousness is highest. IUD insertion immediately after birth does not increase the risk of infection or uterine perforation, has no effect on uterine involution and / or resumption of menstrual activity, and has no negative impact on lactation. So far, however, there has been a major problem with postplacental-related contraception: a much poorer retention of the IUD. 
High rates of expulsion and displacement with post-placental IUDs
Numerous studies in recent years confirm the problem of post-placental contraception: rates of expulsion of up to 40% or more (excluding the rates of dislocation).  A comparative WHO study had to be terminated prematurely because “the given expulsion index was exceeded after only six months”; after one year, the rates of expulsion were 41%, 44% and 35% for different IUDs.  The clinical and societal benefits of post-placental contraception are clear, but current methods are considered by many to be unacceptable for general use. High rates of expulsion can also affect the economics of the method. 
Studies on post placental contraception with Gyn-CS
1. Eser A, Unal, Albayrak B, Wildemeersch D. Clinical experience with a novel anchored, frameless copper-releasing contraceptive device for intracaesarean insertion to prevent displacement and expulsion – A 3-month study. Eur J Contracept Reprod Health care. 2018 Aug;23(4):255-259
2. Unal C, Eser A, Tozkir E, Wildemeersch D. Comparison of expulsions following intracesarean placement of an innovative frameless copper-releasing IUD (Gyn-CS®) versus the TCu380A: A randomized trial. Contraception. 2018;98:135-140
3. Wildemeersch D. Intracesarean Insertion and Fixation of Frameless IUD for Immediate Postpartum Contraception. Clin Surg. 2017; 2:1536.
4. Xiaoming Caoa et. al. Three-year efficacy and acceptability of the GyneFix 200 intrauterine system. Contraception 2004;69:207-211
5. Li Hui-Qin, Feng zhuam-Chong, Wang Yu-Bao, Han Yiao-Lin, H. Van Kets and D. Wildemeersch. Performance of the Frameless IUD (Flexigard prototype inserter) and the TCu380A after six years as part of a WHO multicenter randomized comparative clinical trial in parous women. Advances in Contraception. 1999;15:201-209.
6. Shangchun Wu, Jing Hu, D. Wildemeersch. Performance of the Frameless GyneFix and the TCu380A IUDs in a 3-Year Multicenter, Randomized, Comparative Trial in Parous Women. Contraception;61:91-98
If you are interested in a training, please contact us
GYN-CS is approved for use and sale throughout the EU!
 Thiery M, Van Kets H, Van Der Pas H. Immediate postplacental IUD insertion: The expulsion problem. Contraception 1985;31:332-34
Cole, L.P., Edelman, D.A., Potts, D.M., Wheeler, R.G., Laufe, L.E. Postpartum insertion of modified intrauterine devices. J Reprod Med 1984; 29: 677-682.
Chen BA, Reeves MF, Hayes JL, Hohmann HL, Perriera LK, Creinin MD. Postplacental or delayed insertion of the levonorgestrel intrauterine device after vaginal delivery: a randomized controlled trial. Obstet Gynecol.2010;116:1079-1087.
 World Health Organization Task Force on Intrauterine Devices for Fertility Regulation. Comparative multicenter trial of three IUDs inserted immediately following delivery of the placenta. Contraception 1980;22:9-18
Çelen S, Sucak A, Yildiz Y, Danisman N. Immediate postplacental insertion of an intrauterine contraceptive device during caesarean section. Contraception 2011;84:240-3.