We recommend removing the IUD after you immerse since it is easier to deal with staining from removal that occurs at that point. Any bleeding that occurs within 48 hours may be attributed to injury from the removal and disregarded. Staining may continue beyond the initial 48 hours but after mikveh, you may take precautions against becoming niddah from the staining by wearing colored underwear (or disposable pantyliners) and waiting at least a few seconds (ideally 15 seconds) after urinating before wiping.

On the other hand, if you have the IUD removed while you are niddah, you will need to wait until the bleeding subsides to start the clean days. If you have it removed during the clean days (after having performed at least the hefsek taharah and a day 1 bedikah) you may still disregard any bleeding during the initial 48 hours after the removal, but subsequent staining might make it difficult to get a clean day 7 bedikah.

Some doctors recommend starting the pill on day 1 of your cycle (first day of your period) but others say it is acceptable to start at any point in your cycle. You may start the pills right after having the IUD removed or even when it is still in place. If you wait until after the IUD is removed to start, you should use backup protection (such as spermicide) for the first seven days (assuming you are tehorah at that point). If you are still staining from the IUD removal, we recommend abstaining from intercourse until 24 hours after the staining subsides.

It is common to experience irregular staining during the first 1-3 cycles on the pill, so we recommend reviewing the laws of ketamim since not all stains will render a woman niddah.

Please feel free to get back to us with any further questions.

B’hatzlacha!

This response has been updated to reflect the rulings of our current Rabbinic Supervisor, Rav Kenneth Auman, regarding waiting before wiping.