No touch loading technique

1. Cu T 380 A
No Touch Loading Technique

2. Female Sterilisation
Condoms
Pill
IUCD
Male Sterilisation

3. Several problems with IUCD
Often, they are not inherent problems of IUD
Poor motivation of Client
Poor Selection of Cases 
Poor insertion technique
Poor infection prevention strategies
Poor post procedural counseling
Provider dependent problems
Poor training.

4. Some of you may have
a bad impression of Copper T
Perforation,
Expulsion,
Failure,
Ectopic………
Don’t condemn !
look at the evidence
It is useless
It is useless

5. Rate of Pregnancy With Typical Use
T
C
u
3
8
0
A

0%
5%
10%
15%
20%
25%
30%
T
C
u
3
8
0
A
M
i
n
i
P
i
l
l
C
o
m
b
i
n
e
d
P
i
l
l
M
a
l
e
C
o
n
d
o
m
D
i
a
p
h
r
a
m
F
e
m
a
l
e
C
o
n
d
o
m
S
p
e
r
m
i
c
i
d
e
Methods
P
e
r
c
e
n
t
a
g
e
High Failure Rate ?
Failure percentage of different methods with typical use
Source…Contraceptive Technology Update Series…Family Health International

6. ESTIMATED ECTOPIC PREGNANCY AND CONTRACEPTIVES
0
1
2
3
4
5
6
7
N
o
M
e
t
h
o
d
D
i
a
p
h
r
a
m
C
o
n
d
o
m
F
e
m
a
l
e
S
t
e
r
i
l
i
z
a
t
i
o
n
O
C
P
T
C
u
3
8
0
A
METHOD
R
A
T
E
LOW ECTOPIC PREGNANCIES
Use of TCu 380 A has one of the lowest rates of
ectopic pregnancies.
Source…Contraceptive Technology Update Series…Family Health International
91% less chance of developing
Ectopic than control

7. CONTINUATION RATE
•IUD has one of the highest continuation
rates at first year of use
Continuation Rate of different contraception methods
80%
72%
70%
67%
63%
58%
43%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
I
U
D
C
o
m
b
in
a
t
io
n
p
ill
D
e
p
o
-
P
r
o
v
e
r
a
P
e
r
io
d
ic
a
b
s
t
in
e
n
c
e

M
a
le
c
o
n
d
o
m
D
ia
p
h
r
a
g
m
S
p
e
r
m
ic
id
e
s
Contraception methods
P
e
r
c
e
n
t
a
g
e
IUD
Combination pill
Depo-Provera
Periodic abstinence
Male condom
Diaphragm
Spermicides
Source…California Journal of Health-System Pharmacy

8. Why the failures?
Poor positioning of CuT
Faulty Insertion Technique

9. Higher Infection rates ?
Poor infection prevention
strategies
Providers not familiar with
“No touch Technique”

10. Loading Copper T

11. Overlooking the “No touch technique”
Usual
Technique

12. Copper T is not touched
at any stage

13. Inspection of Copper T
Expiry Date

14. Step 1
Open the pack at the far end

15. Holding the package with
open end up, put the white
solid rod into the insertion
tube to almost touch the
bottom of the T
Step 2

16. Step 3
Withdraw the Copper T with insertion tube a little downwards

17. Step 4
Place the package on the clean, hard, flat
surface.
Fix the arms
Push up the tube
Insert the arms
Step 3

18. Step 5
Adjusting blue
Length gauge

19. Step 6

20. Step 7
It directly goes into the uterus
without touching vaginal walls

21. Withdrawal
Technique
Client is ready,
Cervico vaginal
preparation done
already
Step 8

22. Remove the Plunger first
Step 9
If the plunger and
The tube together
withdrawn

23. Step 10
Second Push

24. Step 11
Don’t catch the tail with
Artery forceps

25. Rest for few minutes after insertion
Reassure
Review
Referral of complicated case

26. IUDs: Client Information
and Instructions
Return to clinic immediately if you:
Experience any of the warning signs
“PAINS”
Feel the hard part of the IUD,
Expel the IUD, or
Miss a period.

27. Post procedural Counseling
Subsequent review
Possible discomfort
Medication sos
Contact details
Follow up visit
etc etc

28. TCu Regular
TCu with safe load device