The Insertion of Intrauterine Devices in the Immediate Postpartum Period Remains an Important Missed Opportunity to Prevent Unplanned Pregnancies in Brazil - Revista Brasileira de Ginecologia e Obstetrícia

Editorial

The Insertion of Intrauterine Devices in the Immediate Postpartum Period Remains an Important Missed Opportunity to Prevent Unplanned Pregnancies in Brazil

Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(9):501-502

DOI: 10.1055/s-0043-1774737

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Unplanned pregnancy continues to be a public health problem in Brazil, particularly for the most vulnerable segment of the population. According to data from the Birth in Brazil study, 55% of pregnancies are unplanned, a proportion that reaches 65.3% among adolescents. Although the copper IUD is a highly effective long-term contraceptive method, it is still little used in Brazil for several reasons, including access barriers in outpatient clinics. The offer of IUD insertion immediately after childbirth or abortion is a window of opportunity to avoid unplanned pregnancies.

In 2017, the Ministry of Health launched a project to expand access to this method by encouraging the offer and insertion of copper IUDs in the immediate postpartum and post-abortion periods in Brazilian maternity hospitals for all women willing to use this contraceptive. Despite this initiative, in 2021 the postpartum IUD insertion rate in Brazilian maternity hospitals was less than 1.5% compared with 18% in Mexico in 2014, where the unplanned pregnancy rate was 36%. These data show the need for advances in existing strategies to expand the use of IUDs in Brazilian maternity hospitals, including a continuous public policy by the Ministry and Departments of Health, in addition to studies on the various factors involved in this process.

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