PPIUS and Breastfeeding

• Research type

  Research Study

• Full title

  Immediate Postpartum Intrauterine System and its Influence on Breastfeeding

• IRAS ID

  336686

• Contact name

  Magdalena Bachmann

• Contact email

  magdalena.bachmann@wrh.ox.ac.uk

• Sponsor organisation

  University of Oxford

• Duration of Study in the UK

  3 years, 0 months, 1 days

• Research summary

  
  Background
  Breastfeeding is vital for infant health, reducing the risk of infections, sudden infant death syndrome, obesity, and diabetes. The World Health Organization (WHO) recommends exclusive breastfeeding for six months, followed by continued breastfeeding alongside solid foods for at least two years. However, breastfeeding rates in the UK are low, with only about 31% of mothers exclusively breastfeeding at 6-8 weeks.

  Many new mothers become pregnant again soon after childbirth, often unintentionally. WHO recommends waiting at least 24 months between pregnancies for the best health outcomes. Postpartum contraception (birth control used after childbirth) helps prevent unintended pregnancies. One highly effective method is the immediate postpartum intrauterine system (PPIUS), a small device placed in the uterus that releases a hormone called progesterone to prevent pregnancy. However, the effects of immediate PPIUS placement (right after childbirth) on breastfeeding are unclear. Some studies suggest it may reduce breastfeeding duration, while others find no impact.

  Aim:
  The research aims to determine whether PPIUS affects breastfeeding initiation (starting breastfeeding), continuation (how long breastfeeding lasts), and exclusivity (whether the baby receives only breastmilk) compared to women using non-hormonal contraception or not using any contraception.

  Study Design
  - An observational data analysis of routinely collected clinical data
  - Cohort study with participant questionnaire
  - Conducted at John Radcliffe Hospital, Oxford
  - Participants: Women aged 18+ who had a C-section at the hospital
  - Data collection: Information on breastfeeding and contraception will be gathered from hospital records and an online questionnaire

  A qualitative study with in-depth interviews will also be conducted to explore mothers' experiences with PPIUS and breastfeeding, as well as healthcare providers’ perspectives on PPIUS and breastfeeding.

  Potential Benefits and Impact
  This study will provide crucial evidence about whether immediate postpartum PPIUS insertion influences breastfeeding. The findings will help healthcare providers give better guidance on postpartum contraception while supporting breastfeeding.
  

• REC name

  South West - Cornwall & Plymouth Research Ethics Committee

• REC reference

  26/SW/0043

• Date of REC Opinion

  2 Apr 2026

• REC opinion

  Favourable Opinion