Hesperian Health Guides

Hesperian Health Guides

Before you insert the IUD

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HealthWiki > A Book for Midwives > Chapter 21: How to insert an IUD > Before you insert the IUD


Be sure that the woman does not have an STI

Ask the woman if she has any signs of an STI.
Some signs of STIs are:

  • bad-smelling discharge from the vagina.
  • pain, itching, or a burning feeling in the vagina.
  • pain, itching, or a burning feeling when urinating.
  • sores on the vagina or anus.


Remember, many women have STIs but do not have any signs. Always test a woman for STIs before inserting an IUD. If you cannot test the woman, but she is sure she wants an IUD, you can treat her for chlamydia and gonorrhea and put in the IUD. Do not insert an IUD for a woman unless you are sure she does not have an STI.

Be sure that the woman is not pregnant

If you insert an IUD when a woman is pregnant, the IUD can cause a miscarriage. Make sure that a woman is not pregnant before inserting an IUD. You can be sure that she is not pregnant if:

  • she is having her monthly bleeding.
  • she has not had sexual intercourse any time since her last monthly bleeding.
  • she is using a hormonal family planning method such as pills, injections, or implants (and wants to use an IUD instead).
a health worker speaking with a woman while showing her a speculum and IUD.
First I will use a speculum to gently hold open the vagina, so I can find the opening to your womb.
Will that hurt?

Explain what will happen during the IUD insertion

Before you insert the IUD, explain to the woman what you are going to do. Tell her that inserting the IUD may hurt a little but should not hurt much. Tell her that you will stop inserting the IUD if it hurts too much or if she wants you to stop for any reason. Answer any questions she has about the IUD or the insertion.



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