Gather ‘round, children: I’m going to tell you the story of my IUD insertion. It’s… uh… slightly unusual; it’s probably also not for the squeamish, so consider yourselves warned. But there is a point to it — I promise. And it has to do with why people are currently suggesting that if you want an IUD, go get it now.
What follows is the long version of the story, but the short version is this: What should have been a 15-minute procedure requiring one doctor and one IUD ended up being a several hours-long event that required three different doctors and two IUDs. It was, in a word, epic, although not in the cool, Star Wars kind of way. It was also expensive; I paid for it out of pocket, because this story takes place in a pre-Affordable Care Act era and my job at the time didn’t provide insurance. But at least it wasn’t as expensive as it could have been — Planned Parenthood’s sliding scale helped bring the cost down. But it was messy, and costly, and although it wasn’t extremely painful or anything, it was not generally a fun time.
And I would do it all again. Yes, exactly as it happened. That is how strongly I feel about how great an option IUDs are, and why they — and all other forms of birth control — need to be available to anyone who needs them, and how important Planned Parenthood and organizations like it are.
That's also why it’s so incredibly upsetting that, as a result of the 2016 presidential election, IUDs — and, again, most forms of birth control, as well as safe, legal abortion — and the healthcare providers that allow us access to them are in danger of becoming unreachable for so many people.
In 2012, I was, like many Millennials, struggling to make ends meet. I was in a better position than most; I didn’t have any student loan debt, and I was never in danger of not being able to pay my rent or buy groceries. (I am intensely aware of my privilege — and, indeed, the fact that I was so privileged ultimately just strengthens my point about how important organizations like Planned Parenthood are.) But money was tight regardless, and because your health matters, I did what I could to keep myself healthy: I got my yearly exams at Planned Parenthood, and I carved out the money needed in my monthly budget to be able to afford birth control.
Around that time, I started seeing a number of stories supporting the IUD as a pretty fantastic birth control method pop up. These weren't the Dalkon Shield of the 1970s, which, due to a design issue, resulted in serious bacterial infections and complications for countless users; new developments in IUD technology had created safe, extremely effective, immediately reversible devices. The two I heard most about were the Mirena, a progesterone (hormone)-based device, and the ParaGard, a copper-based one, primarily through this piece about IUDs on The Hairpin. (These days, Skyla, another hormone-based device, is also an option.) “Huh,” I thought. “That might be worth looking into.”
So I did the research. Plenty has been written about the pros and cons of IUDs elsewhere — here’s a good place to start — but here are the Cliff's Notes: According to Planned Parenthood, IUDs are 99 percent effective, and they’re long-lasting — great for a variety of situations, but especially attractive to me as someone in a long-term relationship. The Mirena is good for five years, although research indicates that it’s effective for up to seven; the ParaGard, meanwhile, is good for 10. If you opt for a hormonal IUD, you’ll probably end up with a lighter period — or it might even stop all together, something known as amenorrhea. According to The Hairpin's article, an IUD would cost approximately $10 to $160 with insurance or $210 to $800 without; generally, according to CostHelper, I could expect to spend around $500 to $600 paying for it out of pocket, since I didn’t have insurance. After doing the math, I realized that it would ultimately pay for itself after three or four years, compared to the price of my birth control pills.
So I made the preliminary appointment, which went without incident; then I scheduled the appointment for the actual insertion.
And here’s where the story starts to get… interesting.
Typically, an IUD insertion is an office procedure that’s both quick and “tolerated well,” according to Dr. Chavone Momon-Nelson, DO, MBA, FACOOG. “The procedure can take anywhere from five to 10 minutes. … Sometimes the cervix needs to be gently dilated to accommodate for the insertion of the IUD,” Dr. Momon-Nelson tells Bustle. No matter which type of IUD you get, the process is always the same: Explains Dr. Momon-Nelson, “A speculum [is] placed in the vagina and the IUD is ultimately passed through the cervical os into the uterus. Before the IUD is inserted, the uterus is measured for correct placement of the IUD. After the IUD is released, the strings are cut to one to two cm [in] length.” Most providers will clean the cervix with Betadine prior to insertion; some will also use anesthetic on the cervix or intrauterine.
Sounds pretty straightforward, right? But, uh, as I mentioned earlier, that’s not exactly how my own IUD insertion went.
On the day of the insertion appointment, I brought my boyfriend at the time to Planned Parenthood with me in case I needed help getting home afterwards (not a thing I expected to happen, but I am nothing if not prepared). After my name was called, I left him in the waiting room and disappeared into the labyrinthine corridors of the office. My doctor and I entered the examination room and got the preliminaries out of the way, after which I changed into a hospital johnny and settled myself on the examination table. Fun fact: Those stirrups never get any more comfortable, no matter how long you spend in them.
My doctor, a cheerful yet realistic woman, warned me that the insertion would probably hurt a bit. To insert an IUD, your cervical os has to open up enough for the device to actually be able to get into your uterus — and as you probably know, that’s also the same opening that babies come out of when you give birth. To say that getting an IUD inserted feels kind of like giving birth in reverse isn’t totally accurate (since, y’know, an IUD fits in the palm of your hand and a baby generally cannot); the sensation, however, is in the same family. If you’ve never experienced it before — which, not having given birth, I hadn’t — it’s kind of hard to prepare for.
After checking in with me to make sure that I was feeling OK about the whole thing, my doc hunkered down in front of me and got to work.
It did hurt, a bit. But not the kind of pain I’m used to; there was an initial sharp pinch, yes, but then there was a kind of ache underneath it that was a new sensation. That ache was the whole cervix opening thing I’d been warned about. But neither the pinch nor the ache was unmanageable, so I gritted my teeth and tried to stay relaxed.
Then my doctor pulled out and sat back. She frowned at the IUD. She peered between my legs. "OK," she said, "we’re going to try this again.”
I sat there on the table, my heels in the stirrups and my legs spread, alone with my thoughts: What if it doesn’t work? What if there’s something seriously wrong with me? What if, what if, what if?
She tried a second time. It also hurt, but again, it wasn’t too bad.
Again, though, she pulled out and sat back. After a moment, she said, “Everything is fine, but hang tight. I’m going to get some reinforcements.” She gave me a reassuring smile, and the door hissed shut quietly behind her.
I sat there on the table, my heels in the stirrups and my legs spread, alone with my thoughts: What if it doesn’t work? What if there’s something seriously wrong with me? What if, what if, what if?
A few minutes later, my doctor came back with a second doctor in tow. Like the first, this second one was cheerful yet realistic; these women had truly mastered the art of the bedside manner. “OK,” she said. “Let’s take a look.” She tried inserting the IUD. I was getting used to the sensation at this point, but it still hurt, because, well, it turns out your cervix isn’t wild about getting poked at a ton. But then Doctor Number Two pulled back, too. There was a pause. “…OK. We’re going to need a new IUD,” she said.
I blinked. “What happened?”
“It broke.”
“The IUD broke?”
“Yes,” she said. “Don’t worry — everything is fine. Sometimes the insertion is just a little difficult, depending on the shape of everything inside.”
And now, the surprise reveal: My vaginal canal is apparently… crooked. My doctors explained that it zigzags in a way that isn’t necessarily dangerous; it is, however, a little unusual. And because an IUD isn’t really meant to hug curves like that, navigating one around my own squiggly insides can make the whole thing a little more complicated than it would be for most people. That's how my first IUD met its fate; it bent right out of shape.
This was news to me. I think I took it fairly well, all things considered; if I remember correctly, my reaction was something like this:
But this revelation meant that even more help was required, so my two doctors went to go the clinic’s resident IUD Whisperer.
The first thing the third doctor did was check in with me (again, killing it with the whole bedside manner thing). “Are you OK?” she asked. “Because we can stop if you want.”
“I absolutely want to keep going,” I said, with perhaps a slightly inappropriate degree of conviction. I was determined to walk out of there with my IUD in place.
She nodded. “All right, let’s see what’s going on.”
She opened up another IUD. She hunkered down. And then she got to it.
There’s nothing quite like waiting for important news while also dealing with a weird and painful sensation going on around your uterus. But after a lot more gritting of the teeth and just a few more minutes… “GOT IT!” she yelled.
Jubilation reigned as everyone whooped and hollered with joy. If my legs hadn’t felt so much like jelly at that point, I would have done a victory dance; instead, I applauded everyone in the room, thanked them, and hobbled over to the corner to get my pants back on. I rejoined my boyfriend (visible relief played across his face when he saw me finally come back through the doors), after which we went home and spent the rest of the evening watching Elf. Because that’s what you do when you’re crampy and tired and just had three different people poking around in your nether bits for hours.
Birth control, and reproductive health services of all kinds, are vital and necessary.
I don’t regret any of it. The cost, the pain, the confusion — all of it was ultimately worth it to me to make sure I was getting the type of birth control that best fit my needs. But my fear is that, with Donald Trump as president, too many people will no longer have this option — or even simply access to the healthcare they need.
I’m extremely fortunate that, even uninsured, I was able to afford an IUD out of pocket. It would have been easier, of course, had the Affordable Care Act existed then — and even though I never benefitted from the ACA myself (I was insured by the time it arrived), I rejoiced when it was passed. While not without its flaws, it has put healthcare within reach for millions of Americans who previously had little or no access to it at all. I would even argue that one of the ACA’s most important tenets is that it includes the coverage of birth control for countless people who need it.
Because birth control, and reproductive health services of all kinds, are vital and necessary. To claim otherwise jeopardizes the lives and safety of literally everyone. It’s a thing everyone — everyone, no exceptions — who needs it should have access to. And it is not a thing anyone else should be telling us we’re not allowed to have simply because they don’t like it.
But under a Trump presidency, it is endangered. Trump’s plan for his first 100 days specifically says that he will repeal the Affordable Care Act. He says he’ll replace it with something else (indeed, some existing elements of the ACA might even stay); given the general conservative stance on reproductive rights — and vice president-elect Mike Pence's stance on them in particular — however, I highly doubt any ACA replacement put into place by the Trump administration will include reproductive healthcare. I’m even preparing myself for the fact that we might see a massive curtailing of our reproductive rights. Trump has voiced support for defunding Planned Parenthood, and has said, at various times, that women and/or providers should be punished for either receiving or performing abortions.
Under a Trump presidency, all of these things are endangered:
Our right to reproductive healthcare.
Our right to essential healthcare, period.
Our right to decide when we become pregnant, if at all.
Our right to not become pregnant if we don’t want to.
Our right to end a pregnancy, whatever our reasons.
Our right to have the kind of sex we want to have, when we want to have it, with whom we want to have it (as long as all parties consent).
Our right to decide what to do with our own bodies.
And so many more.
This is why it’s so imperative that we take action to protect these rights. Donate to reproductive rights organizations. Volunteer. Write to — or better yet, call — your representatives. Write to the electors of the Electoral College before they convene on Dec. 19, even if it’s an outside chance. Speak out. Refuse to be silent.
An aching cervix is small potatoes compared to what we’re currently looking at in our immediate future.
