Pregnant With an IUD: What Happens Next

Intrauterine devices, or coils, are highly effective, but pregnancies do occasionally happen with one in place. This can be a shock and brings specific decisions. This page explains the risks, what happens to the coil, and how a pregnancy with an IUD is managed in the UK.

How rare it is

Both hormonal and copper IUDs are over 99 per cent effective, so pregnancy with one is uncommon. When it happens, the first step is confirming the pregnancy is in the right place, because ectopic pregnancy is more common with an IUD in situ. An early scan, usually transvaginal, is arranged promptly. If the IUD threads cannot be found, ultrasound is used to locate the device. In most cases the IUD is still in the uterus and can be removed with specialist instruments, sometimes under ultrasound guidance.

First steps after a positive test

Contact your GP or local sexual health service quickly. They will arrange an ultrasound to check the pregnancy location and the IUD position. If the pregnancy is intrauterine and the IUD is visible, removal is usually recommended to reduce infection risk, as long as the threads are accessible. If the pregnancy is ectopic, you will be referred for urgent management. If you choose to continue the pregnancy with the IUD in place, your team will monitor you closely for signs of infection, such as fever, pain, or unusual discharge. Report any of these immediately.

Risks and complications

With the IUD left in place there is a higher risk of miscarriage, infection, and premature birth. Removing it when threads are visible reduces these risks. If threads are not visible, or if removal is difficult, your team will weigh options. Some women choose to continue the pregnancy with the coil in place, and this can still lead to a healthy outcome, though risks remain higher. If you have a copper IUD and wish to continue the pregnancy, there is a slightly higher risk of miscarriage, but many pregnancies continue normally with the device in place. The hormonal IUD has a similar risk profile.

What to expect from your care

Your care will be shared between sexual health, early pregnancy, and maternity teams. Scans confirm location and dating. If the coil is removed, watch for bleeding or cramping afterwards. If you wish to continue the pregnancy, standard antenatal care follows, with attention to signs of infection. You are not alone in this situation, and your team will explain each step without judgement. If you want another IUD after this pregnancy, discuss this with your GP or sexual health clinic. It can usually be inserted from around six weeks after birth, depending on your recovery and feeding method.

This page is for general information only and does not replace advice from your UK maternity or mental health team. If you are worried about your physical or mental health in pregnancy, contact your midwife, GP, or call 111. In an emergency, call 999.