The occasional intrauterine contraceptive device insertion.

© 2008 Society of Rural Physicians of Canada Can J Rural Med 2008; 13 (1) T he intrauterine contraceptive device (IUCD) is an effective but underused method of contraception in Canada. In the 1950s, 10% of women who were of reproductive age and using contraception used an IUCD. However, IUCD use quickly fell after the defects of the poorly designed Dalkon Shield (Dalkon Corp., A.H. Robins) were widely publicized in the 1970s. Its multifilament string was associated with an increased rate of pelvic infections that resulted in product litigation and had an impact on the further use of all IUCDs in North America. Recent data shows that the rate of pelvic inflammatory disease (PID) approaches the general population 3 weeks after insertion, showing that previous IUCD infection rates were overestimates. Simultaneously, newer IUCDs such as the Mirena have been shown to be about as effective as a tubal ligation.