Follow Up & Removal
Follow Up Instructions
Follow up may be required for women who have received LARC immediately postpartum for routine or special cases.
Immediate postpartum IUD follow up instructions
Many will need a follow up appointment to have strings trimmed
- Offering, but not mandating, a string check is important
- Instruct patient not to mess with strings if bothersome
If patient experiences usual bleeding accompanied by cramping different from lochia or postpartum cramps, she should be seen by a provider for possible partial expulsion
- Instruct patient to inspect pads for evidence of expelled IUD
Instruct patient to remind her provider that an IUD was placed postpartum and to notify a provider if she has:
- Fevers, chills, severe abdominal pain or temperature > 100.4°F
- Heavy bleeding
- Expulsion of the device
Immediate postpartum contraceptive Implant follow up instructions
Bruising and soreness around the insertion site is normal and should resolve within 1-2 weeks after placement
A patient should see a provider if they:
- Have redness, swelling or drainage near the implant
- Cannot feel the implant under their skin
A patient should always remind their provider that they had an implant placed postpartum
The technique for removing a LARC device placed immediately postpartum does not differ from that for interval insertion.
The removal of a LARC device creates reliance on a provider. Providers must always respect patient autonomy and remove a device when requested by a patient.