Getting an IUD

2009 November 18 at 11:59 AM (2009, birth control & IUD, me)

I had an IUD put in about two and a half weeks ago. In the process of deciding what form of birth control would be the best for me, I found out that while almost all of my female friends have used oral contraceptives (the Pill), none of them had used an IUD. This meant that the Mayo Clinic and Planned Parenthood overviews of IUDs were my only sources of information, and although they were informative and helpful, I would have liked to have been able to ask people what their experiences had been. Relying on anecdotes is unscientific, but it’s reassuring to hear them, and they make me feel less alone in struggling to decide what the best form of contraception is for me. It’s reassuring to talk about these things and have conversations: “I’ve had an IUD, and I’ve had these concerns, and I was fine,” or “I’ve had an IUD, and I’ve had these concerns, and I wasn’t fine, and this is what I did.” So here are my experiences with the IUD.

Motivation: C asked if we could have sex without condoms. Once I worked through some rape-related trauma that was triggered by that idea, I thought it would be nice, too. C was remarkably supportive throughout. He also listened to me while I freaked out about various BC methods and reiterated that it would be ok if I didn’t feel comfortable with using any of them, and we could stick with condoms. Men, here’s a clue: be more like him.

Deciding on a method: I didn’t want to use the Pill because remembering to take it every day would have been annoying. A forgets it all the time, and I initially scoffed at her forgetfulness. Then I remembered that during the spring, I would occasionally forget whether or not I’d taken my daily Claritin, so maybe I shouldn’t be casting stones about forgetting to take medication.

I was on the Nuva Ring for a month while I was waiting to get the IUD inserted. It slipped right in and it didn’t hinder sex. Based on one month’s observation, it also improved my cramps and PMS. For the first couple weeks, I had a hard time adjusting to the idea that this little thing that I couldn’t even feel hanging out inside me was going to keep me from getting pregnant, but I gradually got over that mental block. It helped that I could stick a finger in my vagina and check that it was still there (it never fell out, but I worried nonetheless).

The IUD has three primary benefits for me: (1) cost; (2) longevity; (3) ease. I think that insurance is covering my IUD, but even if it doesn’t, the cost of the IUD will be about the same as two years of co-pays for oral contraceptives or the Nuva Ring (this is an assumption based on my co-pays for other prescription medications). The Mirena IUD, which contains progestin and is the hormonal IUD, lasts for five years, making it cheaper over the long run. For those five years, I don’t have to go to the pharmacy every month or three months to refill a prescription; remember to take a pill every morning; or worry about a Nuva Ring popping out. The IUD is in there, and I don’t have to worry about getting pregnant for the next five years. The IUD comes in a hormonal form (Mirena) and a non-hormonal form (ParaGard, the copper IUD), and I chose the Mirena because a side effect of ParaGard is worsened cramping.

Insertion: After my first appointment with the ob-gyn, when we discussed birth control and I decided on a Mirena IUD (a hormonal IUD), the ob-gyn said that he would insert the IUD when I began my next period. Dr. F had also done my annual pap smear at that appointment, and he wanted to wait for the results before proceeding with the IUD. If my results were abnormal, which happened last year, then I would need a colposcopy and possibly additional testing, so Dr. F wanted to get the pap smear results and get any necessary procedures done before inserting the IUD. This delay also gave me time to get tested for HIV before having the IUD put in. Dr. F offered an oral contraceptive or Nuva Ring sample to use in the meantime, and I chose the Nuva Ring.

When my next period rolled around, I called Dr. F’s office and made an appointment to have the Mirena inserted. At the appointment, Dr. F applied some local anesthetic to my cervix, which I hardly felt. He checked the position and location of my uterus and said that it would feel like a cramp. Did it ever–it was an instantly induced cramp, ugggggh. Dr. F then inserted the IUD, gave me a tampon, talked about common side effects (cramping, light spotting), and said that he would check it in a month to make sure everything was alright. The entire process took all of 15 minutes, from taking my pants off (full disrobing wasn’t required) to walking out the door.

Overall, the procedure was easy. I am in my mid-20s and have never had children, and Dr. F didn’t ask about my relationship status, whether I’d had children, or whether I planned to have children. When I said that I wanted to try birth control, he rattled through a list of common options, including the IUD. Dr. F is an elderly, white, male ob-gyn, and entirely professional, i.e. executed his duties without ideological blathering and gave me the birth control that I requested. As Keori recently wrote, this is not always the case when it comes to IUDs.

Side effects: Cramping. Bleeding. After the procedure, I took 2 ibuprofen. The cramps were awful, but no worse than the ones I usually get before a period, which respond to ibuprofen. These cramps did not. Over the next few hours, I took a total of 8 ibuprofen and spent a lot of time in the bathroom wishing for the cramps to stop. After a few hours, they did.

The cramps have returned every day, although not as fiercely as the first day. They get better and worse; every time I think that they’re improving, they get worse a few days later. Fortunately, they always respond to ibuprofen.

The bleeding is more annoying than the cramping, right now. “Light spotting” is a misnomer for what’s going on; the blood drips out in spurts, much like the way menstrual fluid does, enough to thoroughly stain my underwear and get on my pants. I have to use either a tampon or a pad, because I got tired of scrubbing at the blood stains. The bleeding is probably also causing anemia and fatigue; my iron count is low to begin with, and ever since I got the IUD, I’ve been tired almost every day. Walking up the slightest incline makes my legs ache and I feel sleepy all the time. Like the cramps, there are good days and bad days. A couple weeks ago, C and I were on our feet all day traipsing around MoMA and the Ferry Building, and I was fine. Today, I needed a nap, felt better for a few hours, felt fatigued again, and had to take the bus home from work instead of walking. Being tired makes it difficult to concentrate, think, or stand up for long periods of time.

The IUD hasn’t significantly affected sex. There’s usually blood mixed in with the semen and lubricant, which makes cleaning up immediately after penetrative sex more of a priority than it was when I was on the Nuva Ring. The fatigue means that a couple times, I’ve been tired to have sex. The tips of the IUD’s strings poked C once, but he doesn’t usually feel them (I don’t feel them inside me at all, except with fingers). The IUD is effective immediately if inserted within seven days of starting your period, so C and I could have had celebratory sex after my appointment with Dr. F, but I think I felt too crappy for that and so we put it off for the next day.

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I Write Letters: on Stupak and Health Insurance Reform

2009 November 12 at 3:02 PM (2009, DNC, Pres. Barack Obama, Rep. Nancy Pelosi, birth control & IUD, i write letters, reproductive rights)

Feel free to copy or alter and send to Speaker Pelosi and your elected officials. Find your senators here, your representatives here, and the White House here.

Dear Speaker Pelosi [Senator Boxer / Senator Feinstein / Senator Reid / President Obama],

Thank you for your leadership on health insurance reform. I appreciate the hard work you’ve put into this issue; however, I am concerned that the recent Democratic compromises over women’s medical rights will jeopardize the health and lives of millions of women, with the impact falling the hardest, as ever, on women who are poor, who are disabled, who are of color–in short, women who are part of the most vulnerable groups that health insurance reform was supposed to help, not hurt. I request that in conference, you amend the bill to (1) remove the Stupak Amendment; (2) put gynecological wellness exams and birth control on the list of services that health insurers must cover.

The Stupak Amendment would drastically limit a woman’s ability to access a legitimate medical procedure, one that one in three American women[1] will have in her life. By expanding the Hyde Amendment and banning any plan purchased with any federal subsidy from covering abortion services, the Stupak Amendment dramatically raises the financial cost of having an abortion. The amendment does not include exceptions for the mental or physical health of the women or severe fetal abnormalities (e.g. anencephaly, a cephalic disorder that makes it impossible for a fetus to survive after birth). The amendment will force many women carry pregnancies to term, even if they can’t afford to raise the child; even if the pregnancy will destroy their mental or physical health; even if the fetus suffers from disorders that will make it impossible for it to live past birth; even if they miscarry and the dead fetus remains inside the womb.[2] In short, the Stupak Amendment will deny women the right to make decisions about what they do with their own bodies, a right that is granted to children, to men, and even to corpses.

As for gynecological wellness exams and birth control, these are vital parts of womens’ health care. The current health insurance reform bill cover pap smears and mammograms, but that is insufficient. Access to STI counseling, pelvic exams, domestic violence screening, and birth control are necessary if women are to be healthy, informed, and protected.

The founders of our country declared that among the unalienable rights of men are “Life, Liberty and the pursuit of Happiness.” If the principles of the Declaration of Independence are to hold true for all people and not for men alone, then you must ensure that health insurance reform does not come at the sacrifice of womens’ rights to their bodies, their freedom, and their health.

Sincerely,
PD

[1] Guttmacher Institute, Facts on Induced Abortion in the United States, July 2008
[2] For an example of the far-reaching ways in which limiting abortion access will affect women, see Robin Marty’s post at RH Reality Check, Will the Stupak Amendment Affect Insurance Coverage for Miscarriages? I Think So.

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