A 32-year-old woman requests a copper intrauterine device (Cu-IUD). She had an uncomplicated delivery 6 weeks ago. She is breastfeeding and has no history of STIs. What is the WHO Medical Eligibility Criteria category for Cu-IUD insertion at 6 weeks postpartum?

• A Category 2 (advantages generally outweigh theoretical risks)
• B Category 3 (risks generally outweigh advantages)
• C Category 4 (unacceptable health risk — method not to be used)
• D Category 1 (no restriction, use the method) ✓

Explanation

Per WHO MEC 5th edition, Cu-IUD insertion from 4 weeks postpartum onwards in a breastfeeding woman without pelvic infection risk is MEC Category 1 — no restriction on use. The period from 48 hours to 4 weeks postpartum is Category 3 due to higher expulsion rates. At 6 weeks, all risk factors have resolved and it is Category 1.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.