CONTENTS
HIGHLIGHTS
December 1995 |
The IUD is a safe and effective contraceptive method for many women. Like any other method, however, it is better suited for some women than others. Health care providers must be familiar with the medical conditions that make another method preferable or that rule out IUD use altogether (see sidebar, WHO Scientific Group Updates Eligibility Guidelines for Copper IUDs). The health care provider should question the client to find out if she has any of these conditions and, if not, perform a pelvic exam. All clients should be carefully evaluated for clinical signs of sexually transmitted diseases (395, 398) (see sidebar, Clinical Signs of Genital Infections). When clients are at low risk of exposure to such diseases, routine lab tests are not necessary (634). If a woman shows signs of STDs, examining fluids under a microscope can help determine appropriate treatment quickly (614). As part of the counseling process (see sidebar, The GATHER Approach to Counseling About IUDs). the health care provider also should seek to find out from the client whether she and her partner have a mutually faithful sexual relationship (to assess her potential exposure to STDs). Since women may find it difficult to speak openly about their sexual behavior or that of their sexual partners, family planning programs need to look for other ways to tell women about STD risk before they meet one-on-one with a provider to choose a method. Then women can decide for themselves whether an IUD suits them. For example, in the clinic a provider can address a group of clients to describe family planning methods, or radio broadcasts can describe who are good candidates for different methods. IUDs can be inserted postpartum within 48 hours or postabortion within seven days or, after four weeks postpartum, at any time the provider can be reasonably sure that the woman is not pregnant. There are several additional situations in which postpartum or postabortion IUD insertion is not appropriate, however:
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