“I should probably get an IUD, right?”
These past couple of weeks I’ve heard this question more than ever, as my friends and I struggle to come to terms with an impending Trump presidency and the implications it could have for our personal and reproductive lives. As NPR reported earlier this week, women in my city and around the country are seeking out the services of Planned Parenthood in droves, fearful they’ll be stripped of their reproductive options when Trump assumes the Presidency in January. The IUD is especially appealing for many women; it is a safe and long-lasting form of birth control that is currently covered by health insurance and lasts for 3-10 years.
I got an IUD almost a year ago, and as I prepared for the procedure I found myself anxious, and, well, ill-prepared. Although the internet is full of helpful infographics and charts describing the various benefits and drawbacks of different types of birth control, including the IUD, I had a hard time finding narrative accounts of what it actually feels like to get an IUD. I think part of the problem here is that, as with many things, there is no singular account that adequately represents the experience of most women. Some friends I know recount horribly painful experiences. Some felt hardly more pain than they do getting their annual flu shot. My goal here is to share, from my singular experience, the logistical, the physical, and the mental aspects of getting an IUD.
First of all, before we dive into it, I feel compelled to say that there are a lot of great reasons to get an IUD and to go to Planned Parenthood, but a feeling of obligation — of politically motivated obligation, no less — is the most troubling reason I can think of.
As an optimist, I feel hopeful that women’s most intimate decisions won’t fall into the hands of the patriarchy, whether it be the government, their employers, or the medical establishment, during Trump’s presidency. But do I feel confident enough that birth control will remain accessible and affordable? Do I feel certain that when birth control gets forgotten or fails, abortion will remain safe, legal, and available? Sadly, I can’t say I do.
There are a lot of worst case scenarios imaginable in the next four years that don’t fall too far afield of the rhetoric we’ve heard from Trump and Pence over the course of their hate-filled campaign; the possibility of a repeal of Roe v. Wade and the potential exclusion of birth control from the “preventive care” clause of the Affordable Care Act (not to mention the repeal of the ACA altogether) make me and many of my friends too nervous not to take matters into our own hands.
That said, let’s put looming political nightmares aside for a second, and focus on the IUD insertion itself:
1. Think About Which Type of IUD is Best For You
There are several kinds of IUDs — Paraguard (non-hormonal, lasts 10 years), Mirena (Progestin hormones, lasts 5 years), and Skyla (Progestin hormones, lasts 3 years) are the three most common types. There is no “best” kind — it’s a matter of personal preference. For some women, an IUD is a great way to achieve reliable birth control without hormones, and so Paraguard makes the most sense. I chose Mirena, because it’s known for creating lighter periods with fewer PMS symptoms. Some women who may want to have children in the near future prefer the shorter-lasting Skyla. It’s up to you!
2. Make An Appointment ASAP
You can call your local Planned Parenthood clinic or your primary health care provider, if you have one. Most doctors have experience inserting an IUD — it’s an easy, common, and safe procedure — but if your doctor doesn’t, he or she will be able to set you up with someone else in their network who has likely done literally hundreds, if not thousands, of these procedures before.
Some doctors or clinics may ask that you come in to discuss birth control options, and then schedule a separate subsequent appointment for the insertion. Either way, it might take awhile to get an appointment (especially with the flood of women preparing for the Trumpocalypse), and so best to make an appointment sooner rather than later. Think about making an appointment for a time when you’ll be able to take the day off work. I got my IUD inserted when I was visiting my parents over the holidays.
3. Before Your Appointment, Make a Plan
Assess your emotions: how are you feeling about the procedure? Are you nervous? Ask your healthcare provider to write you a prescription for one dose of Xanax if you’re afraid that your anxiety might be crippling. I have a terrible pain tolerance, and so I took half of one pill to miraculous effect– what would normally have been pretty traumatic anxiety was reduced to slightly nervous jitters. Either way, make sure you have a couple of ibuprofen to take before the procedure, just for basic painkilling.
Ask yourself: How will you get to and from the clinic? Can you get a ride with a friend or family member? Can you hang out in the clinic until you feel OK to drive home? Are there comfortable public transit options, or will you be able to get an Uber or cab? I brought my mom with me to the appointment, and she chatted away with the nurse, held my hand through the procedure, and drove me home with a stop at my favorite bakery on the way. I may have a slightly unusual relationship with my mother, but I would recommend bringing a friend if that will make it feel less scary to you. Maybe you’re completely unfazed by this whole thing and can tackle it solo — and that’s totally normal, too.
4. It’s Time For the Insertion!
Although the procedure itself takes no longer than five minutes (likely less), you should allow for about an hour at the clinic, and take a couple ibuprofen while you’re in the waiting room. Just like any doctor’s visit, you’ll begin by filling out some basic insurance information and waiting around for your turn. Once you’re in the room, the doctor will talk you through the procedure. If she doesn’t, you have every right to ask about what’s in store — or of course, not to hear it, if it freaks you out and you’d rather just have it done with.
She’ll have you take off your clothes below the belt, and you’ll lie down with a paper over your bottom half and put your legs in the stirrups, just like a normal gynecological exam.
The insertion has a few steps to it; first, the doctor may numb your cervix to access your uterus. To me, this felt uncomfortable, but not unbearable. I had been practicing yoga in the weeks leading up to the insertion, and I focused on my deep breathing, which gave me somewhere to channel my nerves. I actually began to sing Adele’s “Hello” (embarrassing, I know, and hilarious for the nurse in the room) but for me the singing was a way to make sure that I wasn’t forgetting to breathe.
Next, the doctor will measure your uterus and dilate it slightly in order to slide the IUD into place. This was where the pain really kicked in for me. To be completely honest, it was the worst pain I’ve felt in recent memory, perhaps ever. The pain was acute and internal and searing. The good news, though, is that this part only lasted about 15 seconds! And you can do anything for 15 seconds. Finally, the doctor will insert the IUD and get out of there, which was about another 30 seconds of pain, but a more moderate pain — totally bearable at that point. I just about got to the chorus of “Hello” (with a few screams interjected into the lyrics) by the time the whole thing was over and done.
I had some unpleasant, but not painful, cramps for the next 15-20 minutes, and my body temperature was a bit up and down. I felt a little faint, and so I kept lying down until I was able to sit up. My mom drove us home, we stopped to get some baked goods, and after about thirty more minutes, I felt more or less back to normal. I went home, turned on Netflix in bed, and fell right asleep. I woke up about three hours later to a text from my friend’s little sister who wanted to play Just Dance, and I went over to her house and jumped and danced around for a full hour, and felt completely fine!
Despite what you might hear, it’s OK to exercise and even to have sex as soon as you feel ready to do so. And no, you won’t be able to feel the IUD during sex. Again, the procedure itself and the recovery time are different for everyone, but there’s no prescribed bedrest or abstinence rule.
That said, the immediate efficacy of an IUD depends on the type and on when during your cycle it’s inserted, and so in some cases it’s best to use a secondary form of birth control (like condoms) for the first week or so. Make sure to ask your doctor about the timeline of your protection. Some doctors also may ask you to come in for a follow-up about a month later to check that everything is going well and to trim the strings if needed.
One Year Later
I’m really happy to have gotten an IUD. After eight years of worrying about remembering to take pills or to mark my NuvaRing dates on the calendar, having an IUD feels safe and, most importantly, easy. I spotted for about six months, which was slightly annoying. But now I have about one day of a light period every month, and I can’t feel my IUD at all, ever — it’s hard to beat.
In the end, my IUD cost $0 (thanks, Obama!), about one minute of real pain, and about 20 minutes of discomfort. I came away with peace of mind, and the knowledge that I don’t have to rely on anything or anyone to make decisions about my reproduction for the next five years.