Consenting and Pre-procedural Counseling for IUD Insertion: What to Expect and What to Talk About

  • Katherine Blumoff GreenbergEmail author


It is important that providers are knowledgeable of the minor consent laws in their state regarding reproductive health care for adolescents and young adults, especially in regard to IUD provision. Providers should also have proficient knowledge of the risks and benefits of IUD placement to provide optimal pre- and post-procedural counseling for patients. As some adolescents or young adults have never had a pelvic exam, or may have experienced trauma in the past, it is imperative that providers approach these conversations in a sensitive, step-wise manner that optimizes patient education and comfort. This chapter will review how informed consent applies to adolescents and young adults, including those seeking IUD services, describe the risk and benefit profile of IUDs that should be included in the informed consent process, and offer sample language for how to provide pre-procedural, pelvic exam, and IUD insertion counseling for patients seeking IUD placement.


Adolescent Young adult IUD Insertion Counseling Consenting Expectations Copper IUD Levonorgestrel IUD 



Adolescents and Young Adult


Federal Drug Administration


Intrauterine Device




Non-Steroidal Anti-Inflammatory Drugs


Sexually Transmitted Infection


  1. 1.
    English A. Sexual and reproductive health care for adolescents: legal rights and policy challenges. Adolesc Med State Art Rev. 2007;18:571–81, viii–ix.PubMedGoogle Scholar
  2. 2.
    Jones RK, Purcell A, Singh S, Finer LB. Adolescents’ reports of parental knowledge of adolescents’ use of sexual health services and their reactions to mandated parental notification for prescription contraception. JAMA. 2005;293:340–8.CrossRefGoogle Scholar
  3. 3.
    Padon AA, Baren JM. Achieving a decision-making triad in adolescent sexual health care. Adolesc Med State Art Rev. 2011;22:183–94, vii.PubMedGoogle Scholar
  4. 4.
    An overview of minors’ consent law. In: Guttmacher Institute [Internet]. 14 Mar 2016 [cited 1 Dec 2018]. Available:
  5. 5.
    Minors’ access to contraceptive services. In: Guttmacher Institute [Internet]. 14 Mar 2016 [cited 1 Dec 2018]. Available:
  6. 6.
    Cason P, Goodman S. Protocol for provision of intrauterine contraception. San Francisco: UCSF Bixby Center Beyond the Pill. 2016 [Internet]. [cited 1 Dec 2018]. Available:
  7. 7.
    Long-term reversible contraception. Twelve years of experience with the TCu380A and TCu220C. Contraception. 1997;56:341–352.Google Scholar
  8. 8.
    McNicholas C, Swor E, Wan L, Peipert JF. Prolonged use of the etonogestrel implant and levonorgestrel intrauterine device: 2 years beyond Food and Drug Administration-approved duration. Am J Obstet Gynecol. 2017;216:586.e1–6.CrossRefGoogle Scholar
  9. 9.
    Mirena (levonorgestrel-releasing intrauterine system). Highlights of prescribing information [Internet]. [cited 1 Dec 2018]. Available:
  10. 10.
    Kyleena (levonorgestrel-releasing intrauterine system). Highlights of prescribing information [Internet]. [cited 1 Dec 2018]. Available:
  11. 11.
    Skyla (levonorgestrel-releasing intrauterine system). Highlights of prescribing information [Internet]. [cited 1 Dec 2018]. Available:
  12. 12.
    Daniele MAS, Cleland J, Benova L, Ali M. Provider and lay perspectives on intra-uterine contraception: a global review. Reprod Health. 2017;14:119.CrossRefGoogle Scholar
  13. 13.
    Sufrin CB, Postlethwaite D, Armstrong MA, Merchant M, Wendt JM, Steinauer JE. Neisseria gonorrhea and Chlamydia trachomatis screening at intrauterine device insertion and pelvic inflammatory disease. Obstet Gynecol. 2012;120:1314–21.CrossRefGoogle Scholar
  14. 14.
    Farley TM, Rosenberg MJ, Rowe PJ, Chen JH, Meirik O. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet. 1992;339:785–8.CrossRefGoogle Scholar
  15. 15.
    Jatlaoui TC, Riley HEM, Curtis KM. The safety of intrauterine devices among young women: a systematic review. Contraception. 2017;95:17–39.CrossRefGoogle Scholar
  16. 16.
    Li C, Zhao W-H, Zhu Q, Cao S-J, Ping H, Xi X, et al. Risk factors for ectopic pregnancy: a multi-center case-control study. BMC Pregnancy Childbirth. 2015;15:187.CrossRefGoogle Scholar
  17. 17.
    Rossing MA, Daling JR, Voigt LF, Stergachis AS, Weiss NS. Current use of an intrauterine device and risk of tubal pregnancy. Epidemiology. 1993;4:252–8.CrossRefGoogle Scholar
  18. 18.
    IUD insertion consent form. In: Reproductive health access project [Internet]. [cited 1 Dec 2018]. Available:

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Departments of Pediatrics (Primary) and Obstetrics and Gynecology (Secondary)University of Rochester Medical CenterRochesterUSA

Personalised recommendations