Expulsion of intrauterine devices after postpartum placement by timing of placement, delivery type, and intrauterine device type: a systematic review and meta-analysis

To provide updated and more detailed pooled intrauterine device expulsion rates and expulsion risk estimates among women with postpartum intrauterine device placement by timing of insertion, delivery type, and intrauterine device type to inform current intrauterine device insertion practices in the United States. We searched PubMed, Cochrane Library, and ClinicalTrials.gov through June 2019. We included all studies, of any study design, that examined postpartum placement of Copper T380A (copper) or levonorgestrel-containing intrauterine devices that reported counts of expulsion. We evaluated intrauterine device expulsion among women receiving postpartum intrauterine devices in the “immediate” (within 10 minutes), “early inpatient” (>10 minutes to