Red flags & when to go in person for IUD Counseling (Pre-insertion Teleconsult)

Audience: pediatric

Intrauterine devices (IUDs) are a common form of long-term birth control. Before getting an IUD, a telemedicine visit can help you learn about the options, risks, and benefits. This pre-insertion counseling often covers your health history and answers your questions. However, some health issues or symptoms require an in-person visit to ensure safety. This guide explains when you should see a healthcare provider face-to-face before an IUD insertion. It also highlights warning signs, or "red flags," that need urgent attention. Telemedicine can provide education and basic screening but cannot replace physical exams or procedures needed for safe IUD placement. Knowing when to seek in-person care helps protect your health and ensures the best outcomes.

Red flags — go in person / ER

• Current pelvic infection or untreated STI — see a healthcare provider in person before IUD insertion.
• Unexplained vaginal bleeding or severe pelvic pain — requires prompt in-person evaluation.
• Pregnancy or suspicion of pregnancy — do not proceed with IUD insertion until confirmed safe.

What telemedicine can do

• Providing education about IUD types, benefits, and risks.
• Reviewing medical history and answering general questions.
• Planning and scheduling in-person visits for insertion.
• Discussing preparation steps and follow-up care.

What telemedicine cannot do

• Performing physical pelvic exams or ultrasounds.
• Diagnosing infections or pregnancy without tests.
• Inserting the IUD device.
• Managing complications or emergencies related to IUD insertion.

What is IUD Counseling?

IUD counseling is a conversation with a healthcare provider about using an intrauterine device for birth control. It includes discussing how IUDs work, types available, benefits, risks, and what to expect during and after insertion. This counseling can happen over a telemedicine visit to prepare you for the next steps.

When Telemedicine Works Well for IUD Counseling

Telemedicine is helpful for answering questions, reviewing your medical history, and discussing your preferences. It allows you to learn about IUDs from home and decide if you want to proceed. Providers can help you understand the process and plan for an in-person visit if needed.

Red Flags That Need In-Person Evaluation Before IUD Insertion

Certain symptoms or health issues mean you should see a provider in person before getting an IUD:

If you have any of these, an in-person exam and tests are important for your safety.

Preparing for Your Telemedicine Visit

To get the most from your teleconsultation:

After Your Telemedicine Visit

After counseling, your provider may:

When to Seek Emergency Care

If after IUD insertion you experience:

Seek emergency medical care immediately.

How to prepare for your tele-visit

• Prepare a list of your medical history including infections and surgeries.
• Note any current symptoms like pain or bleeding.
• Write down questions or concerns about IUDs.
• Find a private, quiet space with reliable internet for your tele-visit.
• Have your menstrual cycle dates available if possible.

After your tele-visit

• Follow provider instructions for scheduling in-person IUD insertion.
• Complete any recommended tests such as STI or pregnancy screening.
• Watch for any new or worsening symptoms and report them promptly.
• Attend follow-up appointments as advised.
• Seek emergency care if severe pain, heavy bleeding, fever, or dizziness occur.

FAQs

Can I get an IUD completely through telemedicine?

No. While telemedicine can provide counseling and education, the IUD insertion requires an in-person visit with a healthcare provider to perform a physical exam and place the device safely.

What if I have pain or bleeding after my IUD insertion?

Some mild pain or spotting is common after insertion. However, if you experience severe pain, heavy bleeding, fever, or dizziness, seek medical care immediately as these may be signs of complications.

Do I need to be on my period to get an IUD?

Many providers prefer to insert an IUD during your menstrual period to help confirm you are not pregnant, but this can vary. Your healthcare provider will guide you on the best timing.

Can I have an STI test done through telemedicine?

Telemedicine can order STI tests, but you will usually need to visit a lab or clinic to provide samples. Your provider will explain how to complete testing safely.

What if I am unsure about getting an IUD?

Telemedicine counseling is a good opportunity to ask questions and discuss your concerns. Your provider can help you understand options and support your decision-making.

Sources

1. Intrauterine Devices (IUDs) — MedlinePlus, U.S. National Library of Medicine.
2. Contraception: Intrauterine Devices — Centers for Disease Control and Prevention (CDC).
3. Long-Acting Reversible Contraception (LARC) — American Academy of Pediatrics (AAP).
4. Intrauterine Device (IUD) Insertion and Removal — Mayo Clinic.

This telemedicine education is for informational purposes only and is not a substitute for professional in-person medical care. If you have any urgent symptoms or concerns, please seek immediate medical attention.