The American College of Obstetricians and Gynecologists (ACOG) is now recommending intrauterine devices (IUDs) as safe and effective birth control.

“What you see now is a rethinking of the idea of how to prevent unintended pregnancy,” Adam Jacobs, MD, director of the family planning division at The Mount Sinai Medical Center in New York City and an author of the recommendations, said in a press release. The recommendations are published in a practice bulletin in Obstetrics & Gynecology (July 2011).

The endorsement represents a new chapter in the history of IUDs, which were once unpopular in the United States but remain in use. The devices may raise the risk of pelvic inflammatory disease and subsequent infertility. However, many experts say the risk is small, and Jacobs called the IUD “the most cost-effective form” of birth control available.

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In other birth-control news, the CDC is advising postpartum women to avoid combined hormonal contraceptives during the first 21 days after delivery because of the high risk for venous thromboembolism. Some women should discontinue use for up to 42 days postpartum (MMWR Morb Mortal Wkly Rep. 2011;60:878-883).