T H E O T H E R C O N T R A C E P T I V E
Why we should restructure how we think about IUDS.
An intrauterine device, commonly abbreviated as an IUD, is a long-acting form of birth control with a high success rate and an unwarranted negative connotation. Most people associate IUDs with high risk and high pain, when neither are accurate assumptions. In fact, Planned Parenthood notes that IUDs are 99.9% effective for up to 12 years with mostly minimal side effects. The Centers for Disease Control and Prevention (CDC) backs this evidence, and cites IUDS as being closer in effectiveness to sterilization than to the pill, patch, or injectable. Unfortunately, only approximately 10% of women who use contraceptives in the US opt for IUDs, while the rest instead select methods which leave room for inconsistency, such as the pill. The Guttmacher Institute reports that 41% of unplanned pregnancies occur due to inconsistent use of a birth control method. IUDs eliminate the possibility of irregular use and offer a great solution to the question of how to have safe sex.
When the original mainstream IUD, the Dalkon Shield, was pulled from the market in 1974 after several instances of infection and death amongst users, women in the US became fearful of the idea of long-acting birth control. Those in the medical field, however, continued to research and improve the devices. One can notice the very visible differences between modern IUDs and their predecessors.
Given improvements made to the device's design and insertion process, Planned Parenthood now reports that “serious problems are really rare” and that most can be solved by simply removing the IUD if necessary. An IUD can be effective for anywhere between 3-12 years but requires no commitment of the woman who uses it; she can take it out at any time she deems appropriate (with the assistance of an ob/gyn). The IUD offers a convenience that is simply unmatched by other forms of birth control.
In my personal experience with a hormonal IUD, I have found it to be life-changing. I have never considered, nor would I ever call, condoms a useful form of birth control. People should be taught from a young age that condoms are a means of preventing STDs, but not of securely preventing pregnancy. Women who plan on partaking in sexual intercourse with men should always have a more reliable method of contraception. And, more importantly, they should feel empowered and encouraged to do the research required to make an informed decision that suits their individual situations.
I, like most teenage girls, did not feel that way at all when I first had sex. I went to see a gynecologist who gave me no information and instead wrote me a quick prescription and sent me out the door. I knew that there were other forms of birth control available, but they simply were not discussed amongst my family, friends, or doctors, and I did not know how to begin asking about them. I felt as though my health had been taken out of my control, and I was angry. Thus, my research began.
I studied both hormonal and copper IUDs. Hormonal IUDs use small amounts of progestin to thicken cervical mucus, lessen the lining of the uterus, and prevent ovulation. Copper IUDs weaken sperm and make it more difficult for them to survive once released into the cervix. Both IUDs can potentially have negative side effects including cramps or irregular bleeding. And yet, both remain two of the most protective forms of birth control on the market.
When one goes in for her appointment, the IUD, whether copper or hormonal, will be inserted by a gynecologist who will first use a speculum to open the vagina, then measure the length of the cervix to determine where to place the IUD, and then, last but certainly not least, proceed with IUD insertion. Two small strings will remain external (these are used to periodically check that the IUD is in its correct place, but will not hinder any sexual activity or be noticeable to a partner.) This is an extremely fast process, but that said, it is not necessarily pain-free. I decided that five minutes of pain and some post-procedure cramps would be worth it for years of protection against pregnancy and little-to-no long-term side effects.
I also decided that the IUD was more practical financially. Most healthcare providers cover the cost of the IUD. If not, the average cost of the IUD and procedure range from $500 to $900. Compare that to the cost of the pill, which, estimated to be roughly $30 a month (without insurance), will amount to about $1,080 over the course of 3 years. That does not include any other doctor visits or checkups, or the costs associated with the higher risk of unwanted pregnancy which could result in an abortion that would cost anywhere between $500 to $2,000 and potentially severe emotional trauma.
There is no denying the fact that the financial hindrance that birth control imposes upon women is an issue that should be improved in the upcoming years, especially as population continues to increase and women in lower-socioeconomic regions struggle to maintain reproductive rights.
Although I do not feel ready to offer an argument for how to solve the problem on a global scale, I believe that the first step to solving the absence of adequate reproductive education and healthcare access in the US is to have an open and honest conversation that is inclusive of all available contraceptives. Girls must feel encouraged to speak about their experiences and desires without judgment. A woman who demands safe-sex is not weak, but one who paves the way toward a more stable society and positive self. She increases the likeliness that another woman will obtain a more comprehensive background of birth control options and, as a result, uplifts her.