Insertions of the T Cu 200 and the Progestasert IUDs in a total of 400 postpartum women were compared. Insertions were carried out within 10 minutes of delivery, either manually or with an inserter. There was a significant difference in the 6 and 12 month expulsion rates (P0.05) between the 2 groups, but no differences were found related to type of insertion. 12 month expulsion rates for the T Cu hand and inserter groups were 9.0 and 8.1, respectively, and 35.8 and 35.2 for the Progestasert hand and inserted groups, respectively. Overall, significantly fewer Progestasert users reported dysmenorrhea at follow-up and the specific 12 month dysmenorrhea rate was significantly lower for the Progestasert users than for the T Cu users. More women in the Progestasert groups reported intermenstrual spotting and bleeding, but specific 12 month rates of intermenstrual pain, spotting, and bleeding showed no differences between the groups.