Levonorgestrel-Intrauterine System (LNG-IUS) Insertion in the Postpartum Period

Inclusion Criteria:

- All reproductive age women who express a desire for the LNG-IUS (Mirena©) at routine
questioning at their 36-38 week prenatal appointment or upon admission to labor and
delivery are eligible for our study.

Exclusion Criteria:

- Contraindications to the LNG-IUS include: Pregnancy or suspicion of pregnancy,
Congenital or acquired uterine anomaly including fibroids if they distort the uterine
cavity, Postpartum endometritis within the past 3 months, Known or suspected uterine
or cervical neoplasia or unresolved, abnormal pap smear, untreated acute cervicitis
or vaginitis including bacterial vaginosis or other lower genital tract infections,
acute liver disease or liver tumor, hypersensitivity to any component of the product,
known or suspected carcinoma of the breast. Any of these conditions would exclude the
patient from our study.

- Delivery <36 weeks

- Intrapartum chorioamnionitis (defined as maternal fever >100.4 and two of the
following conditions: Maternal leukocytosis (greater than 15,000 cells/cubic
millimeter), Maternal tachycardia (greater than 100 beats/minute), Fetal tachycardia
(greater than 160 beats/minute), Uterine tenderness, Foul odor of the amniotic fluid

- Postpartum Hemorrhage (defined as >500cc EBL for spontaneous vaginal delivery)

- Cesarean delivery if randomized to IPP or EP placement