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Step Five: Deal With Any Possible Complications

So we keep hearing about “things going smoothly,” but what if they don’t? There are a few complications that can arise, the most basic being that the provider can’t find the strings used to pull the device out.

“If the strings are really short, then we have a little hook,” says Dr. Alexander. “It’s teeny and it goes in, and you can actually kind of swivel in there and the strings can come out so that we can get a better grasp on the strings.”

If the complications are a little more, well, complicated, then Dr. Wahdan says that there are a couple red flags that providers are trained to recognize, namely that the IUD does not come out as easily as they’d expect. This could mean the device is perforated or embedded, which is something that would happen at the time of insertion but not be recognized.

“When you place the IUD you insert it up until the fundus, and it stays there,” Dr. Wahdan explains. “But in the case of perforation, the insertion can go beyond the fundus, beyond the wall of the uterus, and basically poke through the wall of the uterus... Embedment means it’s in the wall of the uterus.”

If that is the case, the patient may need a procedure to look inside the uterus and see what’s going on, or if it’s perforated, a little more invasive surgery to find the IUD and remove it.

“Those happen less than 1% of the time,” Dr. Wahdan emphasizes. “But they are risks.”