ABSTRACT

Some doctors are complying too readily with requests for male or female sterilization that originate partly from ‘medical myths’ about the intrauterine alternative. An intra-abdominal intrauterine contraceptive (IUC) is just as useless at stopping pregnancy as one that has been totally expelled. The non-causative association with IUCs comes about because they are even more effective at preventing pregnancy in the uterus than in the tube. Besides excluding conditions such as infection or an ectopic pregnancy or miscarriage, consider malpositioning of the frame of an IUC, which can cause pain through uterine spasms. If the woman wishes to go on to full-term pregnancy, after a pelvic ultrasound scan, the intrauterine device should normally be removed – in the first trimester. Over-reaction may cause more morbidity through pregnancy than through actinomycosis, given the latter’s rarity. The main cause of ectopic pregnancy is previous tubal infection, with damage of one or both tubes.