This optional additional content can be used as the basis for a fourth training session on IUDs covering:

• The steps for inserting and removing a copper-bearing IUD and for preventing infection during insertion and removal.
• Complications such as perforation of the uterus or expulsion are associated mainly with provider skill.
• Extensive practice on models, observations of master clinicians and supervised practice are necessary for the provider to be skillful in the IUD insertion and removal procedures.