Prospective Randomized Study to Compare the Acceptability and Safety Profile of a Dedicated Postpartum Intrauterine Contraceptive Device Inserter over Conventional Kelly’s Forceps for Postpartum Intrauterine Contraceptive Device Insertion

Objective: To compare the acceptability, safety, and clinical outcomes of a dedicated postpartum intrauterine contraceptive device (PPIUCD) inserter versus conventional Kelly’s forceps for immediate postpartum intrauterine contraceptive device (IUCD) insertion. Methodology: This was a prospective, randomized controlled trial conducted at HIMSR, New Delhi, for a period of 18 months. A total of 100 consenting women meeting WHO criteria for PPIUCD were randomized into two groups: Group A ( n = 50) received IUCD via a dedicated PPIUCD inserter, and Group B ( n = 50) via Kelly’s forceps. Primary outcomes included fundal placement assessed by transabdominal sonography and provider satisfaction (Likert scale). Secondary outcomes included insertion-related pain (VAS score), complications, insertion time, and expulsion/removal rates at 6 weeks and 3 months. Results: Both groups were comparable in age, parity, and gestational age. Provider satisfaction was significantly higher in Group A (86% vs. 58%, P = 0.0018). Mean fundal distance of IUCD was similar in both groups (5.1 mm vs. 5.6 mm, P = 0.62). At 6–8 weeks follow-up, complete expulsion was higher in Group B (13.3% vs. 4.25%, P = 0.018), while partial expulsion was higher in Group A (12.7% vs. 2.2%). Conclusion: The dedicated PPIUCD inserter demonstrated higher provider satisfaction, similar fundal placement, reduced expulsion rates, and a comparable safety profile to Kelly’s forceps.