If your healthcare practitioner is concerned about the placement of your IUD or suspects it may have been inserted too far in, they may perform a transvaginal or abdominal ultrasound to check its position. These strings will allow your physician to check that the IUD is still in place - you might be able to feel them if you insert your finger into your vaginal canal, but many folks do not. Your physician will trim those strings so that only about one to two inches hang into the vaginal canal. Once it’s in place, the IUD will have strings that hang down through the cervix into the vaginal canal. Once the IUD is out of the tube, the arms will open into its “T” shape. The tube or slider will have a plunger to move the IUD into place. Your physician will remove the IUD from its sterile packaging, bend its arms back, and use a tube or slider to insert it through your vaginal canal and cervix into your uterus to the depth indicated by the sound. These measurements are taken with an instrument called a sound, which has a round tip at the end so that it doesn’t injure your uterus when it is inserted. If your IUD is inserted incorrectly, it could perforate your uterus. They do this to make sure your uterus is at least 6 to 9 centimeters deep and to make sure they don’t insert the IUD too deeply or at the wrong angle. Measurements are nextĪlthough there’s only one IUD size, your practitioner still needs to measure the length of your cervical canal and uterus. Next, they’ll stabilize your cervix for the procedure by using a long-handled, slender instrument called a tenaculum. Some healthcare professionals may apply a local anesthesia, such as lidocaine, after the cleaning is complete to help minimize any discomfort you might feel. Once inserted, “the vagina is cleansed with an antiseptic solution,” explains Gaither. This instrument is inserted into your vagina to help open the canal and allow your doctor to see your cervix. If you’ve never seen one before, a speculum looks a little like a metal duck beak. The pelvic exam is performed as a bimanual examination, which means they will insert two fingers into your vagina and press their other hand on your abdomen to feel your internal pelvic organs. The exam also determines the size, consistency, and mobility of your uterus, and they’ll check for any pain (which could be the sign of an infection). Your uterus might be anteverted (which means it tilts towards the bladder), midline, or retroverted (which means it tilts away from the bladder). This is done to confirm the orientation of your uterus. Next, your physician will perform a pelvic exam Your practitioner might also perform an STI test by taking pelvic cultures. “Many times your health provider will opt to place an IUD with menses, as the cervix will be slightly dilated,” says Kecia Gaither, MD, double board-certified in OB-GYN and maternal fetal medicine and director of perinatal services at NYC Health + Hospitals/Lincoln. However, if you’re using another form of hormonal contraception or getting the insertion done at the beginning of your period, this might not be necessary. “Inserting a device in an early pregnancy can cause a miscarriage,” explains Kimberly Langdon, MD, an OB-GYN based in Ohio. Unless you’re menstruating, you’ll take a pregnancy test They might also offer you oral pain medication, such as Motrin, to help with pain and cramping, unless you already took some before you arrived.

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