IMPORTANT: Providers must not refuse or delay when a woman asks to have her IUD removed, whatever her reason, whether it is personal or medical. All staff must understand and agree that she must not be pressured or forced to continue using the IUD.
If a woman is finding side effects difficult to tolerate, first discuss the problems she is having (see Managing Any Problems). Ask if she would rather try to manage the problem or to have the IUD removed immediately.
Removing an IUD is usually simple. It can be done any time of the month. Removal may be easier during monthly bleeding, when the cervix is naturally softened. In cases of uterine perforation or if removal is not easy (for example, when IUD strings are missing), refer the woman to an experienced clinician who can use an appropriate removal technique.
Before removing the IUD, explain to the client what will happen during removal:
1. The provider inserts a speculum to see the cervix and IUD strings and carefully cleans the cervix and vagina with an antiseptic solution, such as iodine.
2. The provider asks the woman to take slow, deep breaths and to relax. The woman should say if she feels pain during the procedure.
3. Using narrow forceps, the provider pulls the IUD strings slowly and gently until the IUD comes completely out of the cervix.