Yes, a gynecologist can and frequently does insert an intrauterine device (IUD), a highly effective, long-acting reversible contraceptive (LARC). The IUD is a small, T-shaped device placed inside the uterus to prevent pregnancy, offering over 99% efficacy and lasting three to ten years. IUDs work either by releasing progestin hormone to thicken cervical mucus and thin the uterine lining, or by using copper to create an environment hostile to sperm. The procedure is performed in a healthcare provider’s office and is a common part of reproductive healthcare.
The Expertise of Gynecologists in IUD Placement
Obstetrician-Gynecologists (OB-GYNs) are specialist physicians whose comprehensive training focuses on the female reproductive system, including the uterus and cervix. This anatomical knowledge makes them primary experts for IUD placement and management. Their residency training includes extensive practice in pelvic procedures, ensuring proficiency for safe and accurate IUD insertion.
Gynecologists are familiar with the nuances of different IUD types, such as hormonal and non-hormonal copper models. This expertise allows them to counsel patients on the best option based on medical history and contraceptive needs, including managing conditions like heavy menstrual bleeding. They are also prepared to address anatomical variations or potential complications that might arise during the procedure.
Other Healthcare Providers Qualified for Insertion
While gynecologists specialize in reproductive health, several other qualified medical professionals are trained and certified to perform IUD insertions. These providers expand access to contraception, particularly in primary care settings or specialized reproductive health clinics. Family Medicine physicians frequently incorporate IUD placement into their scope of practice following specialized training.
Advanced practice clinicians like Nurse Practitioners (NPs), Physician Assistants (PAs), and Certified Nurse Midwives (CNMs) also routinely offer IUD services. These professionals undergo rigorous training, including hands-on practice, to demonstrate competency in intrauterine techniques.
Step-by-Step Guide to the IUD Insertion Procedure
The IUD insertion procedure is typically quick, often lasting less than five minutes in the examination room. The patient is positioned on the table with feet in stirrups, similar to a standard pelvic exam. A speculum is inserted into the vagina to hold the walls open, allowing the provider a clear view of the cervix.
Preparation and Measurement
The cervix is gently cleansed with an antiseptic solution to minimize the risk of infection. A tool called a tenaculum may be used to stabilize the cervix, which helps straighten the path into the uterus. A sterile instrument known as a uterine sound is then passed through the cervical opening to measure the depth and direction of the uterine cavity. This measurement is crucial for confirming the uterus is an appropriate size for the IUD and helps set the inserter device.
Insertion and Placement
Once the uterine depth is confirmed, the IUD is folded inside a thin applicator tube and gently inserted through the cervix into the uterus. The provider releases the IUD, allowing its arms to open into the T-shape, securing it at the top of the uterus. Many people experience a sharp pinch or strong cramping sensation during the sounding and insertion steps, which is temporary. Finally, the inserter tool is removed, and the small retrieval strings attached to the IUD are trimmed to hang a short distance into the upper part of the vagina.
Preparing for the Procedure and Follow-up Care
Pre-Procedure Preparation
Preparation begins with an initial consultation where the provider reviews the patient’s medical history, performs a pelvic exam, and often conducts a pregnancy test and STI screening. Patients are advised to take an over-the-counter pain reliever, such as ibuprofen, about 30 to 60 minutes before the appointment to mitigate potential cramping. Eating a light meal beforehand is also recommended to prevent lightheadedness or dizziness.
Post-Procedure and Follow-up
After the IUD is placed, the provider discusses common post-procedure experiences, which can include light bleeding and cramping for a few days to weeks. A follow-up visit is typically scheduled four to six weeks after insertion to ensure the IUD is correctly positioned. During this appointment, the provider checks the strings that extend from the cervix to confirm the device is securely in the uterine cavity. The patient is also taught how to check for the IUD strings themselves.