Preparation

Here are a few things to consider prior to insertion:

• any chance of pregnancy? Many choose to do a pregnancy test first. 
• timing in relation to menstural cycle - the IUCD can be inserted at any phase. Last 2 days of menses makes pregnancy less likely and may also make insertion easier. 
• some like to use misoprostol 400mcg hs before procedure. It may make insertion easier but can make cramping worse. Evidence is not strong. Can be given orally or vaginally. 
• some like to use ibuprofen 600mg 1 hr before procedure. It may ease cramping but does not make insertion easier. 
• since they have opposite effects on the prostaglandin chain, concurrent use does not make much sense
• being able to check her own cervix for thread presence and IUCD stem after insertion is considered advisable