Explore IUCD contraception: a nurse-supported, long-acting reversible method that prevents pregnancy by altering uterine conditions. Copper and hormonal IUCDs offer 3–10 years of protection. Nurses assess eligibility, provide education, and ensure safe insertion and follow-up—empowering informed reproductive choices and reducing unintended pregnancies.
Definition
Removal of IUCD (Copper-T) at the expiration date, when the woman develops a contraindication or adverse effect that do not resolve or when a patient requests.
Types
- Copper IUD (e.g., Cu-T 380A): Non-hormonal, effective for up to 10 years
- Hormonal IUDs (e.g., Mirena, Skyla, Kyleena): Release levonorgestrel, effective for 3–7 years
Mechanism of Action:
- Prevents fertilization by altering uterine and cervical environment
- Hormonal IUDs also thicken cervical mucus and thin endometrial lining
Articles
- Sterile gloves.
- Kidney tray.
- Sterile tray containing:
- Bowl with cotton swabs.
- Vaginal speculum (Cusco’s).
- Vulsellum-1.
- Straight forceps-1.
- Uterine sound.
- Sterile sheet for draping.
- Antiseptic solution.
- Perineal pad.
Procedure
| Nursing Action | Rationale | |
| 1. | Before procedure Explain to the woman about the removal of Copper-T, related steps, and effects. | Promotes compliance and reduces anxiety. |
| 2. | Position the woman on treatment table in lithotomy. | Prepares for the procedure. |
| 3. | Clean the vagina and cervix with antiseptic solution. | Prevents chances of infection. |
| 4. | During procedure Drape the perineal area with sterile sheet. | Obtains sterile field for the procedure. |
| 5. | Insert vaginal speculum. | For obtaining clear view of the cervix. |
| 6. | Hold the lip of cervix with vulsellum. | Keeps the cervix steady and accessible. |
| 7. | Grasp Copper-T strings with long straight forceps. | Avails the device for removal by pulling out. |
| 8. | Physician pulls the strings out by gentle traction. If resistance is felt, the removal should be abandoned until it is determined why the IUCD is not moving. | The IUCD if not moving, it may be embedded and may need to be removed hysteroscopically. |
| 9. | After removal, show the IUCD to the woman and discard it. | The woman confirms that the Copper-T is out. |
| 10. | Determine if the woman feels pain or discomfort. | Any discomfort present may be treated. |
| 11. | Clean the perineum, apply perineal pad, and assist the woman to be out of bed. | Promotes hygiene and comfort. |
| 12. | After procedure Remove gloves and discard all disposable items. | Practices infection control measures. |
| 13. | Wash hands and replace articles. | Ensures infection control steps. |
| 14. | Record the details in patient’s clinical record. | Completes the procedure. |
Special Considerations
- If strings are not visible, ultrasound or hysteroscopy may be required
- Counsel the patient on immediate return of fertility
- Offer alternative contraception if desired
- Monitor for vasovagal response (e.g., dizziness, bradycardia)
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Annamma Jacob, Manual of Midwifery and Gynaecological Nursing, 4th Edition, 2023, Jaypee Publishers, ISBN: 978-9356961593
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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