Using Clinical Judgment in Special Cases

Usually, a woman with any of the conditions listed below should not have an IUD inserted. In special circumstances, however, when other, more appropriate methods are not available or acceptable to her, a qualified provider who can carefully assess a specific woman's condition and situation may decide that she can use an IUD. The provider needs to consider the severity of her condition and, for most conditions, whether she will have access to follow-up.

• Between 48 hours and 4 weeks since giving birth
• Noncancerous (benign) gestational trophoblast disease
• Current ovarian cancer
• Is at very high individual risk for gonorrhea or chlamydia at the time of insertion
• Has AIDS and is not on antiretroviral therapy and clinically well
• Has systematic lupus erythematosus with severe thrombocytopenia