IUD placement begins like a routine pelvic exam with the patient lying on her back on the exam table. The vaginal canal will be gently widened using a lubricated speculum so the cervix (the opening of the uterus) can be reached. The IUD is inserted into the uterus through the cervix with the upper “T” portion serving as an anchor. The long tail of the T will hang down into the vaginal canal. Very rarely, and IUD may fall out on its own. Before having intercourse, feeling for the tail helps ensure the IUD is still in place. The tail is also used by the doctor to extract the IUD when it’s time to replace it. Some women may have a little cramping during the IUD insertion placement procedure. Women who are anxious or very sensitive may have a local anesthetic injected into the cervix to numb it prior to insertion of the IUD.