Insertion
POIm should only be inserted by health care professionals who hold the FSRH Letter of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI), or have achieved equivalent recognised competencies, maintaining their skills as per FSRH guidelines.
At the time of insertion, the health care professional should be reasonably sure the woman is not pregnant (this may involve a pregnancy test if there is any doubt, and again 3 weeks after the last episode of unprotected sexual intercourse). If inserted after Day 5 of the woman’s cycle or switching from CHC/IUC/POP, she should be advised to use extra precautions.
Before insertion, the woman should be fully counselled about the procedure for insertion, including the possible adverse outcomes (failure of insertion, too deep insertion, infection, nerve injury) as well as expected side effects (in particular, unscheduled bleeding). Consent must be obtained.
The POI should be inserted into the upper arm, 8-10cm above the medial epicondyle under sterile conditions. Both health care professional and patient should palpate the inserted implant at the end of the procedure. A sterile dressing and bandage should be left on for at least 24 hours after insertion.
It is not necessary to follow-up women with POIm until the next implant is due. However, women should be encouraged to come back if they cannot feel their implant, notice any changes to the shape of the implant/it breaks, or if there are any skin reactions or pain around the site. They should also seek medical advice if they start any new medication or develop any new medical problem that may affect the implant.
