Very rare (1 in 1,000 Insertions)
- Linked to skill and experience of provider
- Reduced through supervised training
- Greater for postpartum insertions performed between
48 hours and 4 weeks after delivery
Although rare, the womans uterus or cervix can be perforated
when an IUD is inserted. When perforation occurs, it is a potentially
serious event. According to the World Health Organization, rates
of perforation at the time of insertion are generally 1 in 1,000.
Perforation of the uterus after IUD insertion is also very rare.
The risk of perforation is directly linked to the skill and
experience of the provider. Thus, the World Health Organization
recommends that, whenever possible, providers perform at least
50 to 60 pelvic examinations and 10 to 15 IUD insertions under
supervision before inserting an IUD without supervision. Carefully
following the instructions for IUD insertion will also reduce
the risk of a perforated uterus.
The risk of perforation is greater for postpartum insertions
performed between 48 hours and four weeks after delivery, as
the uterus returns to its normal size. For this reason, it is
recommended that postpartum insertions be done within the first
48 hours after delivery or after four weeks.