Baby Holding IUD: Understanding Rare Contraceptive Failure Cases

Direct Answer: A baby holding an IUD at birth is an extremely rare event that occurs when contraceptive failure happens despite the intrauterine device being in place. In 2025, a newborn in Brazil named Matheus Gabriel gained international attention after being photographed holding his mother’s copper IUD immediately after delivery—an incident that spotlighted the less than 1% failure rate of this highly effective birth control method. While the device is designed to prevent pregnancy with over 99% effectiveness, mechanical failures like device displacement can occasionally result in conception, making the baby’s arrival a remarkable exception rather than a typical scenario.

What Is an IUD and How Does It Work

An intrauterine device (IUD) is a small, T-shaped contraceptive device inserted into the uterus to prevent pregnancy. The copper IUD works by releasing copper ions into the uterine cavity, creating an environment hostile to sperm mobility and preventing fertilization or embryo implantation. The hormonal IUD, by contrast, releases the hormone levonorgestrel (or progesterone), which thickens cervical mucus, thins the uterine lining, and sometimes prevents ovulation entirely. These mechanisms make IUDs among the most reliable reversible contraception methods available globally.

Both types of IUDs are designed for long-term protection, with copper IUDs providing contraception for up to 12 years and hormonal IUDs typically lasting 3 to 7 years depending on the brand. The device’s effectiveness comes from its dual-action approach: it prevents sperm from reaching eggs while simultaneously making the uterine environment inhospitable to pregnancy establishment. According to the World Health Organization, IUDs represent one of the most effective reversible contraceptive methods currently available to women worldwide.

The Viral Case: Brazil’s “Victory Trophy” Baby

In September 2025, a newborn baby in Goiás state, Brazil, made international headlines after being photographed holding his mother’s IUD immediately following delivery. The baby, named Matheus Gabriel, was born at Hospital Sagrado Coração de Jesus in Nerópolis after his mother, Queidy Araujo de Oliveira, discovered she was pregnant despite using a copper IUD for nearly two years. The attending physician, Dr. Natalia Rodrigues, placed the expelled device into the infant’s hand for a memorable photograph, captioning it “Holding my victory trophy: the IUD that couldn’t handle me!”

This incident was not entirely unprecedented. In 2020, a similar case occurred in Vietnam at Hai Phong International Hospital, where a newborn was photographed holding his mother’s failed contraceptive device after birth. Both cases demonstrate that while extraordinarily rare, IUD failure leading to successful pregnancy and delivery does occur. In both instances, mothers had carried their pregnancies with the device remaining in place, facing increased medical complications but ultimately delivering healthy babies.

IUD Failure Rates and Contraceptive Effectiveness

The failure rate for intrauterine devices ranks among the lowest of all contraceptive methods available. Copper IUDs demonstrate a first-year failure rate of approximately 0.41 to 0.8 pregnancies per 100 women, with cumulative seven-year failure rates around 1.4 to 2.0 per 100 users. Hormonal IUDs show even better performance, with failure rates of 0.16 to 0.3 pregnancies per 100 women annually. This means that less than 1% of IUD users become pregnant each year when the device remains properly positioned.

Comparative contraceptive effectiveness reveals that IUDs rival female sterilization in reliability, significantly outperforming hormonal birth control pills (which have actual use failure rates around 7% annually) and far exceeding barrier methods like condoms. The most critical factor affecting IUD success is proper placement and retention within the uterus. When devices remain securely positioned at the apex of the uterine cavity, the failure rate stays below 0.5% annually. However, device displacement dramatically increases pregnancy risk, making proper insertion technique and regular monitoring essential components of IUD contraceptive success.

Why IUDs Sometimes Fail

Device displacement, also called IUD expulsion, represents the primary mechanism of contraceptive failure. Expulsion occurs in approximately 2 to 3% of IUD users overall, with higher rates in specific populations. Women under 25 years old experience higher expulsion rates, as do those using copper IUDs compared to hormonal versions. Additionally, IUD placement immediately after childbirth carries significantly higher expulsion risks—ranging from 5.8 to 24%—compared to delayed postpartum insertion at 2.9 to 3.5%.

Other failure mechanisms include inadequate IUD placement, where the device sits too low in the uterine cavity rather than at the fundus (top). Exceeding the recommended lifespan of the device increases failure risk, as copper effectiveness diminishes over time. Uterine perforation, though rare at 0.3 to 2.6 per 1000 insertions, can cause device migration outside the uterus where it cannot prevent pregnancy. In rare cases, partial fragmentation of copper IUDs has been documented, compromising their contraceptive function.

Pregnancy Complications With IUD in Place

When pregnancy does occur with an IUD remaining in the uterus, the pregnancy faces substantially elevated complication risks compared to pregnancies without intrauterine devices. Research demonstrates that retaining an IUD during pregnancy significantly increases the likelihood of miscarriage, with rates climbing to approximately 48 to 53.8% when the device remains in place throughout gestation, compared to just 8 to 16% when the device is removed early in pregnancy.

Preterm delivery risk elevates dramatically in retained-IUD pregnancies, with studies documenting preterm birth rates of approximately 90% when the device remains in place. This contrasts sharply with the 34% preterm delivery rate among women whose IUDs were removed after pregnancy confirmation. Vaginal bleeding during pregnancy occurs more frequently in IUD pregnancies, with bleeding complications nearly four times more common in retained-device pregnancies compared to normal pregnancies without IUDs.

Chorioamnionitis—a serious infection of the amniotic fluid and fetal membranes—represents one of the most concerning complications. Research indicates that histologic evidence of chorioamnionitis or inflammation of fetal membranes appears in over 54% of pregnancies with retained IUDs, contributing to increased neonatal complications including admission to intensive care units. Placental abruption (premature placental detachment) occurs significantly more frequently in IUD pregnancies, as does placental abnormalities including previa.

Neonatal Outcomes and Infant Health

Babies born after pregnancy with retained IUDs face higher rates of serious health complications. Studies document increased neonatal intensive care unit (NICU) admissions among infants born to mothers with retained IUDs, with these babies showing higher rates of severe neonatal morbidity even after accounting for gestational age. Among neonates born at term without chorioamnionitis, those exposed to retained IUDs in utero demonstrated higher rates of neonatal sepsis or suspected sepsis, indicating maternal-fetal transmission of infection despite the absence of clinical chorioamnionitis.

Low birth weight occurs more frequently in IUD pregnancies, and intrauterine growth restriction—where babies develop smaller than expected—appears significantly more common. However, in cases where IUDs are removed in early pregnancy and pregnancies proceed to term delivery, neonatal outcomes generally normalize to rates observed in the general population without intrauterine devices.

Medical Management: IUD Removal During Pregnancy

When pregnancy is discovered with an IUD in place and the patient chooses to continue the pregnancy, medical guidelines recommend attempting IUD removal during the first trimester if possible. Early removal dramatically improves pregnancy outcomes compared to retention. Removing the IUD reduces miscarriage rates from 48% to approximately 20 to 16%, and preterm delivery risk drops from 90% to about 34%.

If the IUD strings remain visible, removal can be accomplished by simply grasping and carefully withdrawing the device. When strings are not visible, physicians may use ultrasound-guided removal with alligator forceps or hysteroscopic removal techniques. Hysteroscopic removal—where a small camera and instruments are inserted through the cervix to visualize and extract the device—has demonstrated success rates exceeding 85% when performed in early pregnancy. This minimally invasive procedure carries approximately a 10% miscarriage risk and 12% preterm delivery rate even after removal, indicating that some increased risk persists even after device extraction.

The timing of IUD removal matters significantly. Removal in the first trimester, before the uterus becomes substantially enlarged, generally provides better outcomes than attempting removal later in pregnancy. As pregnancy advances and the uterus expands, the technical difficulty of device retrieval increases, and some physicians may recommend leaving the device in place to avoid disturbing an increasingly sensitive pregnancy.

Ectopic Pregnancy Risk With IUD Failure

While IUDs effectively reduce overall ectopic pregnancy rates by preventing intrauterine pregnancy entirely, women who do become pregnant despite IUD use face elevated ectopic pregnancy risks compared to the general population. The cumulative ectopic pregnancy rate for copper T380A IUDs is approximately 0.4%, meaning that when IUD failure does occur, a portion of resulting pregnancies implant outside the uterus (most commonly in the fallopian tubes).

When pregnancy occurs with an IUD in place, physicians must first confirm the location of pregnancy through ultrasound imaging to exclude ectopic implantation. Ectopic pregnancies cannot develop normally outside the uterus and pose serious maternal health risks, including internal bleeding that can threaten maternal life. Establishing intrauterine pregnancy location becomes the critical first step in managing any IUD failure pregnancy.

History and Evolution of IUD Technology

Intrauterine contraception dates back centuries, with early versions crafted from various materials. Modern IUDs emerged in the 1960s with improved designs. The copper IUD revolution began with the copper T-380A (Paragard), approved in the United States in 1984, which remains among the most effective IUDs available. Hormonal IUDs, including the levonorgestrel-releasing intrauterine system (LNG-IUS or Mirena), gained prominence in the 1990s, offering an alternative mechanism with slightly different side effect profiles.

IUD technology has continuously improved, with newer devices featuring enhanced insertion techniques, better retention rates, and more consistent copper or hormone delivery mechanisms. Third and fourth-generation copper IUDs show incrementally improved effectiveness compared to earlier models. Current hormonal IUD formulations include the 13.5 mg levonorgestrel-releasing system and the 19.5 mg system, each with distinct duration of action and clinical characteristics.

Global IUD Usage and Acceptance

Intrauterine devices represent one of the world’s most widely used contraceptive methods, accounting for approximately 14% of global contraceptive use. Adoption rates vary substantially by region, with IUD prevalence exceeding 30% in some Asian countries and Nordic nations, while remaining below 10% in many English-speaking countries. Over the past two decades, IUD adoption in the United States has increased substantially, driven by improved clinical understanding, better insertion techniques, and growing recognition of their superior effectiveness and safety profile compared to oral contraceptives.

Healthcare provider education has significantly improved IUD insertion and management practices. Professional organizations now recommend IUDs as first-line contraception for most women, including adolescents and nulliparous women (those who have never given birth). This represents a substantial shift from earlier clinical practice that often restricted IUD use to women who had already completed childbearing.

Practical Information and Planning

Understanding IUD Insertion and Maintenance

IUD insertion typically occurs during a gynecological office visit and takes approximately 5 to 10 minutes, though the entire appointment usually lasts 30 to 45 minutes. Healthcare providers perform insertion at any point during the menstrual cycle, though insertion during menstruation may be slightly easier as the cervix is naturally more dilated. Insertion pain varies widely among individuals, ranging from minimal discomfort to moderate cramping, with pain management options available including over-the-counter anti-inflammatory medications taken before the procedure.

After insertion, follow-up appointments are typically scheduled at 4 to 6 weeks to confirm proper device placement through palpation of the IUD strings and, if needed, ultrasound imaging. These confirmation visits are critical safety measures to ensure the device remains properly positioned. Additional annual check-ups allow healthcare providers to verify device retention and screen for complications. Patients should be trained to perform self-checks by feeling for the IUD strings, though string presence does not guarantee proper positioning or contraceptive effectiveness.

Warning Signs Requiring Medical Attention

Certain symptoms necessitate immediate medical evaluation in IUD users. Severe lower abdominal or pelvic pain, particularly pain unrelieved by over-the-counter pain medications, may indicate device migration, perforation, or infection. Unexpected heavy vaginal bleeding or prolonged menstruation beyond normal patterns should prompt medical assessment. Fever combined with pelvic pain suggests possible pelvic inflammatory disease requiring antibiotic treatment. Missing or unable to feel IUD strings during routine checks requires ultrasound evaluation to locate the device.

Symptoms of early pregnancy—including missed periods, nausea, breast tenderness, and fatigue—warrant pregnancy testing despite IUD use, as contraceptive failure is possible. Any sign of pregnancy combined with IUD presence requires immediate gynecological consultation to establish pregnancy location and determine appropriate management.

Duration of Protection and Replacement

Copper IUDs remain effective for 10 to 12 years depending on the specific device type, with some newer copper IUDs demonstrating efficacy extending slightly beyond 12 years. Hormonal IUDs typically provide protection for 3 to 7 years depending on formulation, with specific durations established by FDA approval or clinical trial data. Exceeding the approved duration significantly increases pregnancy risk, making replacement timely when expiration approaches.

Replacement IUDs can be inserted immediately upon removal of the expiring device during the same office visit, eliminating any period without contraceptive protection. Some patients choose to replace IUDs during menstruation or in the luteal phase of the menstrual cycle based on personal preference, though insertion remains possible at any cycle point.

Comparative Analysis: IUD Versus Other Contraceptives

IUDs demonstrate dramatically superior effectiveness compared to most alternative contraceptive methods. While oral contraceptive pills show approximately 91% effectiveness with typical use (accounting for user error), IUDs maintain over 99% effectiveness regardless of user factors since no ongoing user action is required after insertion. Long-acting reversible contraceptives generally show similar effectiveness, with the contraceptive implant (Nexplanon) matching IUD effectiveness at greater than 99%.

Hormonal versus copper IUD comparison reveals that hormonal IUDs show slightly lower failure rates than copper devices when directly compared in rigorous studies. However, both types demonstrate clinical effectiveness exceeding 99%. The choice between copper and hormonal IUDs typically depends on side effect tolerance, duration needed, and individual preferences regarding bleeding patterns. Copper IUDs frequently cause heavier menstrual bleeding and cramping in susceptible individuals, while hormonal IUDs often result in lighter periods or amenorrhea (absence of menstruation).

Cost Considerations and Accessibility

Intrauterine device costs typically range from $500 to $1,300 for the device plus insertion procedure in the United States, though significant variation exists by location and healthcare facility. Insurance coverage varies substantially, with many private insurance plans covering IUD insertion entirely or requiring only small copayments. Government programs and Medicaid typically cover IUD costs in most states. Out-of-pocket costs burden low-income populations despite IUD superior cost-effectiveness over 5 to 10 years compared to ongoing oral contraceptive expenses.

Removal of IUDs is typically less expensive than insertion, usually costing $150 to $500 depending on removal complexity. Straightforward removals where IUD strings remain visible cost less than removal requiring ultrasound guidance or minor surgical intervention. Most insurance plans cover removal costs at rates comparable to insertion procedures.

When to Choose an IUD: Ideal Candidates

IUDs suit most women seeking reliable, reversible contraception, including nulliparous women, adolescents, and those with multiple contraindications to hormonal methods. Women with irregular work schedules or difficulty remembering daily medications benefit from the “set and forget” nature of IUDs. Breastfeeding mothers can safely use copper IUDs without concern for hormonal effects on milk supply, though hormonal IUDs are also compatible with breastfeeding despite earlier concerns.

Contraindications to IUD use include current pelvic inflammatory disease or untreated sexually transmitted infections, suspected pregnancy, or anatomical abnormalities making insertion impossible or ineffective. While most women with previous pelvic inflammatory disease can safely use IUDs, those with current infection should delay insertion until treatment is complete. Women with copper allergy or nickel sensitivity should avoid copper IUDs in favor of hormonal devices.

Frequently Asked Questions

Can you get pregnant with an IUD inside?

Yes, pregnancy with an IUD is possible though rare. Approximately 0.41 to 0.8 pregnancies per 100 women occur annually with copper IUDs, and 0.16 to 0.3 pregnancies per 100 women occur annually with hormonal IUDs. Device displacement is the most common failure cause. If you suspect pregnancy while using an IUD, pregnancy testing and medical evaluation are essential to establish pregnancy location and safety.

What happens if you get pregnant with an IUD and keep it?

Retaining an IUD during pregnancy dramatically increases complications. Miscarriage risk rises to approximately 48 to 53.8%, preterm delivery reaches 90%, and chorioamnionitis (amniotic fluid infection) develops in over 54% of cases. Babies born after IUD retention show higher NICU admission rates. Early IUD removal reduces miscarriage risk to 16 to 20% and preterm birth to 34%, substantially improving pregnancy outcomes.

Is the IUD 100% effective?

No contraceptive method achieves 100% effectiveness, though IUDs come remarkably close. Copper IUDs prevent pregnancy in approximately 99.2% of users annually, while hormonal IUDs prevent pregnancy in approximately 99.8% of users. However, device displacement, incorrect insertion, or exceeding device lifespan can result in contraceptive failure, as demonstrated by the viral cases of babies born to mothers using IUDs.

How can an IUD fail?

IUD failure mechanisms include device displacement or expulsion from the uterus (the most common cause), partial device fragmentation, improper initial placement, exceeding the device’s approved duration, and rarely, uterine perforation. Device strings may also curl into the cervix, preventing correct position assessment while the device remains displaced. Regular monitoring helps detect failures before pregnancy occurs.

What do you do if an IUD expires?

Replace the device during the same office visit when the expired IUD is removed. The removal and insertion can occur sequentially without interruption of contraceptive protection. Replacement should occur prior to the device’s expiration date to maintain continuous contraceptive coverage. Delaying replacement after device expiration substantially increases pregnancy risk.

Can the IUD harm a growing baby?

If pregnancy continues with the IUD in place, the device does not directly harm the fetus but increases pregnancy complications including miscarriage, preterm birth, and infection. Early removal minimizes these risks. In the rare case of successful pregnancy continuation with device retention, babies generally deliver healthy, though with increased NICU admission likelihood. Removal in early pregnancy substantially reduces adverse outcomes.

How long does an IUD stay effective?

Copper IUDs provide effective contraception for 10 to 12 years depending on specific device type, with some showing efficacy extending slightly beyond 12 years. Hormonal IUDs typically provide 3 to 7 years of protection depending on formulation. Exceeding these timeframes significantly increases pregnancy risk, necessitating replacement to maintain contraceptive coverage.

Is the IUD safe after miscarriage?

Yes, IUD insertion after miscarriage is generally safe and can occur immediately following confirmed pregnancy loss. IUDs inserted postpartum (immediately after delivery) show slightly higher expulsion rates than interval insertion but remain effective. Medical evaluation ensures complete miscarriage and absence of infection before IUD insertion.

What is the success rate of removing an IUD during pregnancy?

Hysteroscopic IUD removal in early pregnancy achieves success rates exceeding 85%, with most pregnancies continuing successfully to term. However, miscarriage risk after removal averages approximately 10%, and preterm delivery rates reach 12%, indicating some risk persists even after device extraction. These rates represent substantial improvements compared to retaining the IUD, where miscarriage and preterm delivery rates far exceed these figures.

Can an IUD cause birth defects?

Research shows insufficient evidence establishing associations between IUD exposure in utero and fetal malformations. When pregnancies proceed despite IUD presence, most children born deliver without apparent birth defects. However, elevated infection rates associated with retained IUDs theoretically increase complication risks, making early removal advisable when pregnancy is discovered.

How often should I check my IUD strings?

Monthly string checks following menstruation are recommended, though clinical evidence supporting routine self-monitoring remains limited. String presence alone does not guarantee correct positioning, and absence of palpable strings does not necessarily indicate device expulsion. Any concern about IUD status should prompt professional ultrasound evaluation rather than relying on string checks alone.

What are the side effects of IUD use?

Copper IUDs frequently cause heavier menstrual bleeding and increased cramping, with heavy bleeding being the leading discontinuation reason. Hormonal IUDs often produce lighter periods or amenorrhea, though some users experience spotting or breakthrough bleeding. Common side effects include cramping during insertion and early insertion period, and with hormonal devices, possible progestin-related effects including mood changes, though rates remain similar to background population rates.

How does IUD failure compare to other birth control methods?

IUDs demonstrate superior effectiveness compared to all other reversible contraceptive methods. Birth control pills show approximately 91% typical-use effectiveness, patches and rings 91%, hormonal injections 94%, and condoms 82% typical-use effectiveness. Contraceptive implants and IUDs both exceed 99% effectiveness, making them the only reversible methods approaching sterilization-level reliability.

Can the IUD move out of place after insertion?

Yes, device displacement can occur at any point after insertion but is most common in the first year, particularly in the months immediately after insertion. Risk factors include younger age, high parity, heavy menstrual bleeding, and certain anatomical variations. Most displacements occur silently without warning signs, making periodic professional evaluation important even when users experience no symptoms.

Is pregnancy possible immediately after removing an IUD?

Yes, fertility returns immediately upon IUD removal. Ovulation and conception can occur in the menstrual cycle following device removal. Couples or individuals attempting pregnancy can begin efforts immediately after removal, while those seeking to avoid pregnancy should use alternative contraception immediately following removal if desired.

BySNEHASISH BHOWMICK