Can the IUD move out of place or fall out completely?

Sometimes. Occasionally it can work its way part or all of the way out, down through the cervix (the opening to the uterus)—that’s called expulsion. If that happens, it means you don’t have birth control any more, but it’s not usually dangerous. Expulsion is more common right after you have an IUD placed, if your IUD is placed right after giving birth or having an abortion after 14 weeks, if you have you haven’t been pregnant before, or are younger than 20 years old. If your IUD is expelled, you can have another IUD placed or start another method of birth control to prevent pregnancy.

In rare cases, the IUD can work its way up, and either get stuck in the muscle of the uterus or through the muscle of the uterus and into your abdomen—that’s called perforation. That really doesn’t happen often, less than 1 in 2,000 insertions. If it does happen, your IUD isn’t working as birth control and you may need surgery to remove it. While it’s not required, you can have a follow up visit with a provider to check the IUD 4-6 weeks after it’s placed or check the IUD strings in the vagina yourself: if you can feel the strings with your fingers, everything’s probably okay.