This was a study of 206 patients at a tertiary care institute who were counselled for intra cesarean IUCD if they fulfilled the criteria of inclusion. The 105 acceptors (Group A) and 101 who did not accept (Group B) were compared. Systematic follow up of all were done at discharge, 6 weeks and 6 months. 84(80%) did not have any complaints. While irregular bleeding (14.5%), white discharge (4.5%) and abdominal pain (3.4%) were reported in the others. Efficacy of Intracaesarean IUCD was determined by expulsion and continuation rate. In our study, we found zero % expulsion rate and 91.2 % continuation rate. The most common reason for discontinuation of IUCD in our study was bleeding per vagina 5 (4.76 %), pain in abdomen 2 (1.9 %) and white discharge per vagina 1 (0.95 %). Of the total 8/105 who discontinued, majority were for bleeding per vagina. Major reason for refusal in group B were fear of complication (42%) or preference for another method (27.8%). Personal and family issues were sited in 22.8 %. 88(83.9%) of acceptors and 59(58.4%) of non– acceptors had never used any method before. In prior contraceptive use in both groups, all were short term methods and interval IUCD were amongst the least used. As the rate of caesarean section is increasing, intra–caesarean IUCD, represents a golden opportunity to reach one third or more of the obstetric population at the time of delivery. The PPIUCD was demonstrably safe, having no reported incidence of perforation with low rates of expulsion, pelvic infection and lost strings. The Intra–caesarean PPIUCD should be included as a part of obstetrical management of the patient who might be misusing abortion as a form of contraception and gives a chance to meet the unmet need for contraception. The PPIUCD also offers an alternative method to sterilization for patients with low parity but not keen on further child bearing. Our study supports the Govt. Of India guidelines that PPIUCD should be part of every hospital’s Family Welfare Programme to give maximum benefit to patients.