Cu T 380 A

No Touch Loading Technique

Female Sterilisation Condoms

PillIUCD

Male Sterilisation

Several problems with IUCD

Often, they are not inherent problems of IUD

Poor motivation of Client

Poor Selection of Cases Poor insertion techniquePoor infection prevention strategiesPoor post procedural counseling

Poor motivation of Client

Poor Selection of Cases Poor insertion techniquePoor infection prevention strategiesPoor post procedural counseling

Provider dependent problemsPoor training.Provider dependent problemsPoor training.

Some of you may have a bad impression of Copper T

Some of you may have a bad impression of Copper T

Perforation,

Expulsion,

Failure,

Ectopic………

Don’t condemn !look at the evidence Don’t condemn !look at the evidence

It is uselessIt is useless

Rate of Pregnancy With Typical Use

TC

u380

A

0%

5%

10%

15%

20%

25%

30%

TC

u380

A

Min

i Pil

l

Com

bine

dPi

ll

Mal

eC

ondo

m

Dia

phra

m

Fem

ale

Con

dom

Spe

rmic

ide

Methods

Per

cent

age

High Failure Rate ?Failure percentage of different methods with typical use

Source…Contraceptive Technology Update Series…Family Health International

ESTIMATED ECTOPIC PREGNANCY AND CONTRACEPTIVES

0

1

2

3

4

5

6

7

No

Met

hod

Dia

phra

m

Con

dom

Fem

ale

Ste

rili

zati

on

OC

P

TC

u38

0A

METHOD

RA

TE

LOW ECTOPIC PREGNANCIES

Use of TCu 380 A has one of the lowest rates of ectopic pregnancies.

Source…Contraceptive Technology Update Series…Family Health International

91% less chance of developing Ectopic than control

CONTINUATION RATE• IUD has one of the highest continuation

rates at first year of use

Continuation Rate of different contraception methods

80%

72% 70% 67%63%

58%

43%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

IUD

Com

bina

tion

pill Dep

o-Pr

over

a

Perio

dic

abst

inen

ce  

Mal

eco

ndom

Dia

phra

gm

Sper

mic

ides

Contraception methods

Perc

enta

ge

IUD

Combination pill

Depo-Provera

Periodic abstinence  

Male condom

Diaphragm

Spermicides

Source…California Journal of Health-System Pharmacy

Why the failures?Why the failures?

Poor positioning of CuTFaulty Insertion TechniquePoor positioning of CuTFaulty Insertion Technique

Higher Infection rates ?Higher Infection rates ?

Poor infection prevention strategies

Providers not familiar with “No touch Technique”

Poor infection prevention strategies

Providers not familiar with “No touch Technique”

Loading Copper TLoading Copper T

Overlooking the “No touch technique”Overlooking the “No touch technique”

Usual Technique Usual Technique

Copper T is not touched at any stage

Copper T is not touched at any stage

Inspection of Copper T

Expiry Date

Step 1

Open the pack at the far end

Step 1

Open the pack at the far end

Holding the package with open end up, put the white solid rod into the insertion tube to almost touch the bottom of the T

Step 2

Step 3

Withdraw the Copper T with insertion tube a little downwards

Step 4

Place the package on the clean, hard, flat surface.

Fix the arms

Push up the tube

Insert the arms

Step 3

Step 5

Adjusting blueLength gauge

Step 6

Step 7

It directly goes into the uteruswithout touching vaginal walls

Withdrawal

Technique

Client is ready, Cervico vaginal

preparation done already

Step 8

Remove the Plunger first

Step 9

If the plunger and The tube together

withdrawn

Step 10Second Push

Step 11

Don’t catch the tail with Artery forceps

Rest for few minutes after insertionReassureReview

Referral of complicated case

IUDs: Client Information and Instructions

Return to clinic immediately if you:

Experience any of the warning signs

“PAINS”

Feel the hard part of the IUD,

Expel the IUD, or

Miss a period.

Post procedural Counseling

Subsequent reviewPossible discomfortMedication sosContact detailsFollow up visit

etc etc

Post procedural Counseling

Subsequent reviewPossible discomfortMedication sosContact detailsFollow up visit

etc etc

TCu RegularTCu Regular

TCu with safe load deviceTCu with safe load device