Providing the Levonorgestrel Intrauterine Device

Any time of the month

• If she is starting within 7 days after the start of her monthly bleeding, no need for a backup method.
• If it is more than 7 days after the start of her monthly bleeding, she can have the LNG-IUD inserted any time it is reasonably certain she is not pregnant. She will need a backup method* for the first 7 days after insertion.

• Immediately, if she has been using the method consistently and correctly or if it is otherwise reasonably certain she is not pregnant. No need to wait for her next monthly bleeding. No need for a backup method.
• If she is switching from injectables, she can have the LNG-IUD inserted when the repeat injection would have been given. She will need a backup method for the first 7 days after insertion.

• If not breastfeeding, any time within 48 hours after giving birth. (Requires a provider with specific training in postpartum insertion.) After 48 hours, delay until at least 4 weeks
• If breastfeeding, delay LNG-IUD insertion until 4 weeks after giving birth. (See p. 129, Q&A 8.)

• If she gave birth less than 4 weeks ago, delay insertion until at least 4 weeks after giving birth.(See p. 129, Q&A 8.)
• If her monthly bleeding has not returned, she can have the LNG-IUD inserted any time between 4 weeks and 6 months. No need for a backup method.
• If her monthly bleeding has returned, she can have the LNG-IUD inserted as advised for women having menstrual cycles.

• If her monthly bleeding has not returned, she can have the LNG-IUD inserted any time it is reasonably certain she is not pregnant. She will need a backup method for the first 7 days after insertion.
• If her monthly bleeding has returned, she can have the LNG-IUD inserted as advised for women having menstrual cycles.

• Delay LNG-IUD insertion until at least 4 weeks after giving birth. (See p. 129, Q&A 8.)

• If her monthly bleeding has not returned, she can have the LNG-IUD inserted any time if it can be determined that she is not pregnant. She will need a backup method for the first 7 days after insertion.
• If her monthly bleeding has returned, she can have the LNG-IUD inserted as advised for women having menstrual cycles.

• Any time if it can be determined that she is not pregnant. She will need a backup method for the first 7 days after insertion.

• Immediately, if the LNG-IUD is inserted within 7 days after first- or second-trimester abortion or miscarriage and if no infection is present. No need for a backup method.
• If it is more than 7 days after first- or second-trimester miscarriage or abortion and no infection is present, she can have the LNG-IUD inserted any time it is reasonably certain she is not pregnant. She will need a backup method for the first 7 days after insertion.
• If infection is present, treat or refer and help the client choose another method. If she still wants the LNG-IUD, it can be inserted after the infection has completely cleared.
• LNG-IUD insertion after second-trimester abortion or miscarriage requires specific training. If not specifically trained, delay insertion until at least 4 weeks after miscarriage or abortion.

• The LNG-IUD can be inserted within 7 days after the start of her next monthly bleeding or any other time it is reasonably certain she is not pregnant. Give her a backup method, or oral contraceptives to start the day after she finishes taking the ECPs, to use until the LNG-IUD is inserted.