SMB Intrauterine Device (Copper T) is a T shaped plastic device about 3.5cm long that is placed into the uterine cavity to prevent pregnancy.

SMB Intrauterine Device is highly convenient, over 99% effective, proven safe and easily reversible intrauterine contraceptive that can be used up to 10 years or removed at any time. Copper T 380A conforms to NDA 18-680 developed by Population Council, USA

SMB Intrauterine Device is recommended for women who have at least one child (pregnancy stretches the uterus and reduces the chance that your body will expel the device), are in a stable mutually monogamous relationship and have no history of pelvic inflammatory disease (PID) or do not use hormonal contraceptives. Because it is hormone-free there are no hormone related side effects.

Advantages of Copper T IUD (Intrauterine Device) :

It involves the following :

Explaining the procedure to the client: This helps the client relax, making insertion easier and less painful.

Infection- prevention procedure: It includes use of high-level disinfected instruments, sterile hand gloves and cleaning of the cervix with a water based antiseptic such as chlorhexidine gluconate or an iodophor (for eg. Betadine®). This minimizes the chances of uterine infection following insertion using No- Touch Technique

Speculum examination and bimanual pelvic examination: The speculum examination is done to check for signs of genital tract infection. The bimanual examination determines the size, position, consistency, and mobility of the uterus and identifies any tenderness. A retroverted uterus (that is bent backward) requires special care during insertion.

Sounding of the uterus slowly and gently to determine its depth and direction: This reduces the risk of perforating the uterus, which usually occurs because the sound or IUD is inserted too deeply or at the wrong angle.

Careful and slow technique during all phases of sounding and insertion: This reduces the client's discomfort and minimizes the chances of uterine perforation, cervical laceration, and other complications.

IUD placement high in the uterus (i.e. at the fundus): This minimizes expulsions, accidental pregnancies and possibly bleeding.

Following the manufacturer's instructions for insertion: Most IUDs are inserted by the withdrawal technique. The inserter tube, loaded with the IUD, is inserted to the depth indicated by sounding. Then the inserter tube is withdrawn while the inner plunger is held steady. This leaves the IUD in position. Then the plunger is withdrawn.

Procedure for Loading
The IUD should, be loaded in to the inserter tube not more than five minutes before insertion.

• Partially open the package from the end marked OPEN, approximately halfway to the flange.
• Put the Solid Rod into the insertion tube to almost touch the bottom of the T.
• Peel of the pouch & place thumb and index finger over the ends of the horizontal arms towards the stem of the T. Complete the bending of the arms by bringing thumb and index finger together. Use other hand to push insertion tube to pick up the arms of the T. Insert the folded arms into the tube only as far as necessary to ensure retention of the arms.
• Check the flange position using centimeter scale on ID card so that it indicates the depth of uterus.The IUD is now ready for insertion.

Procedure For Insertion

• Swab the cervix with antiseptic.
• Gently introduce the loaded inserter assembly through the cervical canal until the flange comes in contact with the cervix. This ensures that the T fold is in contact with the fundus.
• Hold the solid rod stationary and withdraw the insertion tube upto the thumb grip of the solid rod so as to release the arms of the T.
• Gently push the insertion tube upwards, towards the top of the uterus until a slight resistance is felt. This ensures that the T is closer to the fundus.
• Withdraw the solid rod while holding the insertion tube stationary. Gently withdraw the insertion tube with a rotation. Cut the threads so that they protrude only 2-3 centimeter into vagina
• Remove the tenaculum and ask the woman to get down from the table slowly (if dizziness, tell her to lie for 5-10 minutes) and instruct how and when to check the string. Invite questions and instruct about return visit as well as what to do, whom to contact for help if needed.

IUD Removal
Can be done easily by any trained health care provider
Be sure to:

• Follow infection prevention guidelines
• Be slow and gentle
• Counsel client that cramping / bleeding may occur
• Refer difficult removals to specially trained provider

IUD removal is usually routine and uncomplicated. The IUD can be removed at any time, although removal during menses may make the procedure easier for the provider. Any trained health care provider, including a nurse or midwife can remove the IUD

If desired, a new IUD can be inserted immediately following removal