Averbach SA, Ermias Y, Jeng G, et al. - Via performing a systematic review and meta-analysis, researchers sought to present updated and more detailed pooled intrauterine device expulsion rates and expulsion risk estimates among women with postpartum intrauterine device placement by timing of insertion, delivery type, and intrauterine device type to inform current intrauterine device insertion practices in the United States. Searching PubMed, Cochrane Library, and ClinicalTrials.gov through June 2019, they identified 48 level I to II-3 studies of poor to good quality that involved a total of 7,661 intrauterine device placements. Analysis revealed variation in intrauterine device expulsion rates by timing of placement, type, and mode of delivery. However, intrauterine device insertion can be performed at any time. Compared with interval placement, greater risk of complete expulsion was observed in correlation with immediate and early postpartum placements (inpatient and outpatient combined). Greater risk of expulsion was observed for placement after vaginal vs cesarean deliveries among immediate postpartum placements. Among immediate placements at the time of vaginal delivery, a greater risk of expulsion was observed in correlation with levonorgestrel intrauterine devices vs copper intrauterine devices. .