Intra Uterine Contraceptive Devices (IUCDs) have been used since the first half of the 20th Century. There have been three types of device. Inert, generally made of plastic, (before 1960), containing a metal such as copper (after 1960) and containing a hormone similar to progesterone (after 1980). It is unclear how they work but in principle they create a hostile intra uterine environment not favourable to the sperm fertilising the egg. All are highly effective for contraception and the progesterone containing device is also used to treat gynaecological problems such as heavy periods. The reliability of IUCDs in preventing conception depend on several factors which include the age of the woman, frequency of intercourse, correct placement of the device and, possibly, how long it has been in the womb. They are highly effective, more so than oral contraceptive pills. Devices can be left in place for 5-10 years and longer if the woman was 40 years old or more when it was placed. A device is more difficult to place if there are uterine fibroids and may be less reliable in these circumstances. Certain gynaecological conditions such as pelvic infection is a contra indication to their use.
It is important that this should be done in the first half of the menstrual cycle when the woman is certain she is not pregnant. A detailed history should be taken from the woman to exclude any contra indications to insertion and to establish whether it may be easy or difficult with subsequent discomfort if it is difficult. If insertion is to take place without prior consultation, then a telephone consultation is useful to discuss these issues in advance. The woman may obtain the device from the General Practitioner and bring it for insertion. The advantage is that the device is prescribed free of charge by the NHS but is paid for privately.
If the woman has never been pregnant or has never delivered a baby vaginally then the insertion may be more difficult and painful. Nevertheless, we see many young women who have never had a birth who have a successful and relatively painless insertion. It is useful to take 1milligram (2 tablets of Paracetamol) 1-2 hour before the scheduled insertion. It is important to determine the position in which the woman is lying before insertion determine the angle of insertion. We do this using transabdominal ultrasound in every case. We use a local anaesthetic jelly during insertion. There a three discomfort points for a few seconds during the insertion. The first is when the cervix is grasped in an instrument to steady the position of the womb. The second is when a small instrument is passed through the cervix to verify the position of the womb. The third is when the device is inserted. After insertion the threads on the end of the device are trimmed. Usually the woman rests on the couch for five or ten minutes after the insertion. As a minimum we use ultrasound to check the position of the device just after insertion. She can then usually go home and expect menstrual discomfort for a day or two. She is warned that there may be a little extra vaginal bleeding, usually with a period, for a few months after an insertion. This may be a little more painful than normal, but it is worth seeing how it goes before opting for removal. After six weeks the woman should attend for an ultrasound scan to verify the position is correct. The woman can also be taught to check the threads by self-examination.
It is important to remember that an IUCD may not protect against an ectopic pregnancy although we have never seen such a case.
We undertake routine removals of IUCD. This should not require ultrasound guidance. Women often come to see us when they or their doctor/nurse is unable to locate the IUCD threads. This may be in circumstances when they want to have the IUCD removed. We can usually see it on ultrasound scan and can use a special instrument to remove it. We use anaesthetic jelly for pain relief. Ultrasound scan guidance is very important. We may succeed where others have failed. Anaesthesia in hospital should not be necessary.
An insertion of an IUCD is very effective in preventing an ongoing pregnancy when inserted within 36 hours of unprotected sexual intercourse.
Dr Gibb is available on Thursdays. Please contact our reception team to book an appointment.
We had received possible worrying news from our NHS anomaly scan, without much information provided or confirmation. I am so pleased that we came to The Birth Company for reassurance, as we are now extremely happy that everything is fine. Shahrzad was fantastic and went through the whole anomaly scan thoroughly, explaining everything and looking in detail at each area. Nothing was rushed and she took her time to make sure baby was in the correct position to get the best results. We can’t thank her and Dr Gibb enough for the confidence they have given us. Would highly recommend The Birth Company for all scans.
' Professional and reassuring 'Helen Campbell
The sonographer was ready as soon as I arrived, and she was extremely calming, personable and professional. The scan and blood test where efficient without feeling rushed and all very easy. These appointments can feel uneasy and make you feel anxious but I felt reassured and in professional hands the whole time
I saw Kate throughout my first pregnancy and am now doing so again with my second. She is absolutely amazing, she explains everything really clearly, and has answered all sorts of bizarre questions and worries I have had. On top of being clinically excellent she is also just the loveliest person and always a pleasure to see.Sarah Elliott
We had the harmony test with the Birth Company and had a reassurance scan with sonographer Kirsty McGarry who was absolutely lovely and really put our minds at rest. We had been scared by our NHS dating scan and left feeling like there was something wrong. We explained the situation and was treated very professionally and with good care. Also speedy appointments also as I had phone in the morning and got an appointment by afternoon. So thankful.Ashley and Tom
Really friendly, efficient service. Great experience overall. Had the Panorama. My appointment was with Kate who was absolutely fantastic. The results came really quickly. Have a comparison with private healthcare elsewhere and must say that The Birth Company was just how I would like to be treated when I pay for medical services - attentively, calmly, friendly, in a pleasant environment that doesn't look like hospital. Top marks!Anna
' Efficient, friendly and always on hand to provide last minute appointments 'Hannah Murphy
The Birth Company has been excellent, providing timely scans and blood tests during my IVF treatment abroad. Staff are always friendly and extremely efficient. I would highly recommend coming here.
' Professional and friendly 'Lyndsey Dilla
When I first contacted the Birth Company I spoke to Danielle. She was fantastic. She went above & beyond to put me at easy & make the journey from Kent as stress free as possible. Every staff member that myself and my husband have come into contact with have been approachable, professional and friendly. Kate scanned me the first time and put me completely at easy. Lisa on reception is professional and very approachable. Highly recommended
' Highly recommended 'Emelie
Donald was so lovely! I was so nervous as I have a bad history and he was super quick and confirmed my baby's heartbeat as quickly as he could. He spent time showing me the baby and the anatomy and it was the best money I have ever spent! The reception girls were lovely too - considering they deal with babies day in day out they were super excited for me! Thank you so much one and all! If only I lived in London and could have all my scans with you!
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