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Teach clients how to check for strings:
- With clean fingers
- After each menses
(expulsion most likely in first 6 months)
Schedule follow-up visits at:
- 3 to 6 weeks
- 1 year; yearly thereafter
Return to clinic for questions,
problems
or signs of complications
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Another element of counseling is discussion of IUD use and
follow-up care. Teach the client how to check for her IUD by
feeling for the strings. Make sure that she knows to wash her
hands thoroughly before inserting her fingers into her vagina.
If she is unwilling or unable to check with her hand, she can
be counseled to inspect the pads she uses during menses carefully
to check for a possible expelled IUD. Emphasize the importance
of routinely checking for strings after each menses, especially
during the first six months, since this is when the IUD is most
likely to be expelled. The client should be advised to use a
backup method of contraception, such as condoms, and visit the
provider as soon as possibleif
she notices the strings are missing.
Schedule the client for a return visit three to six weeks after
the insertion to check the position of the IUD strings and to
check for signs of infection. If she has no problems at the
time of her checkup or during the following months, she needs
only to return to the clinic yearly for routine checkups. The
client should be encouraged to return to the clinic any time
she has a question or concern. Be sure she knows when to return
to have her IUD replaced or removed.
When the client returns for a checkup, ask her if she is satisfied
with the IUD. Ask if she has any questions or problems, and
whether she is experiencing any unpleasant side effects. A client
who requests that an IUD be removed should have that request
honored as soon as possible. It is not advisable to discourage
the client from having the IUD removed if she does not want
to continue using it.
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