{"id":2266,"date":"2018-11-02T03:00:33","date_gmt":"2018-11-02T07:00:33","guid":{"rendered":"https:\/\/natural-womanhood.local\/?p=2266"},"modified":"2024-04-21T13:14:57","modified_gmt":"2024-04-21T18:14:57","slug":"replantearse-el-iud-posparto","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/es\/rethinking-the-postpartum-iud\/","title":{"rendered":"Replantearse el DIU posparto"},"content":{"rendered":"

Un mes antes de dar a luz a mi primog\u00e9nito, mi querida amiga tuvo a su cuarto hijo. Mientras sosten\u00eda en brazos por primera vez a mi dulce ahijado, mi amiga me cont\u00f3 la historia de su parto desde la cama del hospital. \"Estoy tan contenta de no tener que volver a hacer eso en mucho tiempo\", brome\u00f3 a medias, cuando termin\u00f3 de describir una larga noche de trabajo de parto.<\/p>\n

Cuando lleg\u00f3 el momento de dar a luz a mi hijo, recuerdo que me sent\u00ed de la misma manera mientras lo ve\u00eda dormir a mi lado despu\u00e9s de que toda la conmoci\u00f3n del parto hubiera desaparecido por fin. Estaba encantada de que estuviera ah\u00ed y orgullosa de todo lo que mi cuerpo hab\u00eda conseguido con su crecimiento y parto, pero los dolores del parto a\u00fan estaban lo bastante frescos en mi memoria (y en mi cuerpo) como para querer darme un tiempo antes de volver a hacer \"eso\".<\/p>\n

Por ello, no me sorprende que los m\u00e9dicos recomienden a las pu\u00e9rperas que se coloquen dispositivos intrauterinos (DIU) inmediatamente despu\u00e9s del parto; incluso una mujer que se haya mostrado indecisa sobre la conveniencia de colocarse un DIU podr\u00eda cambiar de opini\u00f3n y optar por varios a\u00f1os sin parto despu\u00e9s de recordar un parto especialmente duro o una ces\u00e1rea dolorosa.<\/p>\n

Y una nueva investigaci\u00f3n ha demostrado que para prevenir mayor riesgo de expulsi\u00f3n del DIU<\/a>El dispositivo debe insertarse inmediatamente despu\u00e9s del parto, y realmente quieren decir inmediatamente, ya que una inserci\u00f3n realizada incluso 10 minutos despu\u00e9s del parto conlleva mayores tasas de expulsi\u00f3n que las realizadas inmediatamente o al cabo de 4 semanas.<\/p>\n

Hay razones para creer que inmediatamente despu\u00e9s del parto no es el mejor momento para tomar decisiones de planificaci\u00f3n familiar a largo plazo. Si a una mujer se le propone un DIU por primera vez inmediatamente despu\u00e9s del parto, existe el riesgo de coacci\u00f3n por parte del m\u00e9dico; tambi\u00e9n hay motivos para preguntarse si la paciente puede dar un verdadero consentimiento informado en ese contexto tan cargado que es justo despu\u00e9s de dar a luz<\/em>. Yo dir\u00eda que tal decisi\u00f3n no ser\u00eda \u00e9tica si la mujer no ha discutido previamente la decisi\u00f3n con su m\u00e9dico en profundidad, decidiendo de antemano que la inserci\u00f3n de un DIU forma parte de su plan de parto, si as\u00ed lo ha decidido la paciente.<\/p>\n

El mismo estudio muestra<\/a> que si una mujer no desea que se le coloque el DIU inmediatamente despu\u00e9s del parto, debe esperar 4 o m\u00e1s semanas para que se lo coloquen, o el riesgo de expulsi\u00f3n del DIU puede ser tan alto como 30%, durante las primeras semanas del posparto, mientras el \u00fatero sigue encogi\u00e9ndose hasta alcanzar el tama\u00f1o anterior al embarazo. Sobre todo si la mujer no est\u00e1 amamantando, podr\u00eda experimentar un retorno de la fertilidad durante el tiempo que transcurre antes de tener la oportunidad de colocarse el DIU y, en tal caso, podr\u00eda quedarse embarazada si mantiene relaciones sexuales durante ese periodo. Pero teniendo en cuenta que el ginec\u00f3logo aconseja a la mayor\u00eda de las mujeres que dan a luz por v\u00eda vaginal que no mantengan relaciones sexuales hasta pasadas seis semanas, no hay motivos para precipitarse.<\/p>\n

Para muchas mujeres, la inserci\u00f3n del DIU no es un paseo. Las historias de inserciones dolorosas de DIU podr\u00edan animar a las mujeres posparto a aprovechar las epidurales y los analg\u00e9sicos ya administrados para someterse a una inserci\u00f3n inmediatamente despu\u00e9s del parto. En un art\u00edculo para TheOutline.com titulado \"If Men Had to Get IUDs, They'd Get Epidurals and Hospital Stays\" (Si los hombres tuvieran que colocarse el DIU, tendr\u00edan que someterse a epidurales y hospitalizaciones), la autora Casey Johnston se\u00f1ala:<\/p>\n

Sospecho que al menos una parte de la raz\u00f3n por la que todo el mundo resta importancia a lo mucho que puede doler la inserci\u00f3n del DIU es que no quieren desanimar a las mujeres. . . . Si te fijas bien, cuando te inscribes, la descripci\u00f3n de lo que vas a pasar cambia mucho desde el d\u00eda en que pides la cita (\"s\u00f3lo un pinchazo para cinco a\u00f1os sin beb\u00e9s\") hasta unos minutos antes de que ocurra (\"un mal d\u00eda, pero a\u00fan as\u00ed, \u00a1cinco a\u00f1os sin beb\u00e9s!\") o despu\u00e9s (\"calambres y manchados durante un mes, pero lo que te ayudar\u00e1 es recordar, \u00a1cinco a\u00f1os sin beb\u00e9s!\"). Dado que ni las instrucciones ni la experiencia son coherentes, incluso si las personas para las que esta operaci\u00f3n es insoportablemente dolorosa fueran una minor\u00eda, ser\u00eda cruel descartarlas como desafortunados casos at\u00edpicos cuando no hacemos lo mismo b\u00e1sicamente para ning\u00fan otro procedimiento.<\/i><\/p>\n

Adem\u00e1s de las inserciones potencialmente dolorosas y sin medicaci\u00f3n y de los riesgos de expulsi\u00f3n, los DIU tambi\u00e9n conllevan riesgos de infecci\u00f3n y perforaci\u00f3n uterina. Aunque estas complicaciones son poco frecuentes, pueden ser muy graves, y los DIU hormonales (es decir, todos, excepto el ParaGuard de cobre no hormonal) conllevan el riesgo de efectos secundarios similares a los de otros m\u00e9todos anticonceptivos <\/a>como la p\u00edldora, el parche o la inserci\u00f3n en el brazo. Mientras tanto, incluso los el DIU de cobre no hormonal puede provocar toxicidad por cobre y alterar el funcionamiento saludable de la tiroides<\/a>un \u00f3rgano importante en la regulaci\u00f3n hormonal.<\/p>\n

Tambi\u00e9n hay pruebas anecd\u00f3ticas de que algunas mujeres han tenido problemas para conseguir que sus m\u00e9dicos les retiren el DIU (aunque est\u00e9n experimentando efectos secundarios negativos) o para que el seguro pague el procedimiento de extracci\u00f3n. Como resultado, algunos m\u00e9dicos est\u00e1n dejando los hilos del DIU m\u00e1s tiempo para que las mujeres pueden quit\u00e1rselos en casa<\/a>aunque se recomienda encarecidamente a las mujeres que no lo hagan.<\/p>\n

Menos invasivos y m\u00e1s naturales: M\u00e9todos basados en el conocimiento de la fertilidad<\/h2>\n

Afortunadamente para m\u00ed y para mi marido (y para mi amiga y su marido), ya ten\u00edamos un plan establecido para nuestras necesidades de espaciar a los ni\u00f1os despu\u00e9s del parto: M\u00e9todos basados en el conocimiento de la fertilidad<\/a> (FABM), tambi\u00e9n conocida como Planificaci\u00f3n Familiar Natural (PFN). Nuestra firme convicci\u00f3n en su eficacia hizo que fuera f\u00e1cil rechazar otros m\u00e9todos anticonceptivos cuando la enfermera vino para \"la charla\" (ya sab\u00e9is, mam\u00e1s posparto, esa en la que te asan a la parrilla en tu estado emocional y f\u00edsicamente vulnerable, sobre c\u00f3mo vas a evitar tener que volver a hacer \"eso\" pronto) despu\u00e9s de que se calmara todo el alboroto del parto.<\/p>\n

Para las parejas que se toman el tiempo de recibir una formaci\u00f3n adecuada en uno de los principales m\u00e9todos de PFN<\/a> (y especialmente si son lactancia posparto<\/a>), no hay raz\u00f3n para temer que la PFN sea menos eficaz que el DIU para espaciar los embarazos. De hecho, muchos m\u00e9todos de PFN pueden ser tan eficaces como el DIU (hasta 99%, seg\u00fan el m\u00e9todo<\/a>), vienen sin ninguna de las potencialmente dolorosas o peligrosas efectos secundarios<\/a> asociados al DIU, y permiten a las parejas espaciar los embarazos sin ninguna de las preocupaciones asociadas a la inserci\u00f3n, expulsi\u00f3n o extracci\u00f3n del DIU.<\/p>","protected":false},"excerpt":{"rendered":"Un mes antes de dar a luz a mi primog\u00e9nito, mi querida amiga tuvo a su cuarto hijo. Mientras sosten\u00eda a mi...","protected":false},"author":31,"featured_media":2267,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5183,5250],"tags":[6215,5256],"class_list":{"0":"post-2266","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-birth-control-issues","8":"category-birth-control-options","9":"tag-natural-family-planning-31","10":"tag-postpartum","11":"cs-entry","12":"cs-video-wrap"},"acf":[],"yoast_head":"\nRethinking the Postpartum IUD - Natural Womanhood<\/title>\n<meta name=\"description\" content=\"Postpartum IUD insertion is not always the easy, painless walk in the park that it is sometimes made out to be. 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