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When Women & Girls of Color Share Our IUD Stories

iud

 

So, I got an intrauterine device, or IUD, and I had it inserted at Planned Parenthood of New York City (PPNYC).

Given everything that happened in 2015 regarding the continuous attacks on women’s reproductive health and rights, (also also being a member of PPNYC’s Activist Council), it meant a lot to me to have my IUD inserted at Planned Parenthood. Several hours after I left the health center, I briefly announced it on Twitter, Instagram, and my personal Facebook profile what I had done.

What happened next included reading and interacting with friends and family members on their own experience with getting the IUD, some common myths and misconceptions (that even I held for a long time) about the device, ways to deal with the anxiety and the cramps (the heating pad is your new best friend), and resource sharing.

Contrary to popular belief, many women and girls don’t often make reproductive healthcare decision in a vacuum. We consider our options and how they can potentially fit into our lives. We consult with our friends, families, classmates, colleagues, doctors, and even our spouses and partners. In the end, we try to equip ourselves with the knowledge and resources necessary to make an informed decision.

Sharing your story is powerful, and nothing’s more powerful than sharing a personal story about birth control. Here is what led me to choose the IUD.

(…and if you’re into long stories, you’re in for a treat!)

A Little Background

I was on the pill for a year. Despite the annoyances with weight fluctuations, I never had many major problems remembering to take it. I enjoyed knowing exactly when my menstrual cycle would begin (always on a Saturday), and I never utilized my heating pad (which often wasn’t the case for years prior). My cramps would go as quickly as they came, takes to Advil. Before, it would sometimes take hours for the heating pad and the Advil to do their magic.

At some point during 2013, I started contemplating getting an IUD. Like many women, I saw the Mirena ads on TV years back, but I always remembered one Mirena commercial in particular stating, “candidates for Mirena have had a child, are in a stable relationship…,” which took me out of the running as I am nulliparous (a woman who has not given birth).

But then I saw this: The American College of Obstetricians and Gynecologists released a committee opinion in 2007 that long-acting reversible contraception (LARC) may be beneficial for adolescents who are currently and not currently sexually active. This became a game-changer, because I’m nowhere near my adolescence.

Along with Mirena, I researched ParaGard, and the newest (at that time) FDA-approved Skyla. Knowing that IUDs have significantly fewer hormones compared to the typical birth control pill, and that the hormones are concentrated in your uterus as opposed to coursing throughout your body was intriguing.

Fast forward to 2015, and the IUD was becoming an ever-present thought. I liked the idea of “set it and forget it” (which you don’t really forget it, but I’ll discuss that in a bit), of not having to make sure my phone alarm goes off at 9pm every night, or searing frantically when I would take the pill out of the packet only for it to fly out of my hand and roll into a crevice (or, worse, down the sink drain).

A Little Research

But in spite of the benefits of the IUD, I started to look more into the LARC methods in general. Assistant Professor Jenny Higgins of the University of Wisconsin-Madison’s Department of Gender and Women’s Studies has shared that increased use of LARC can significantly reduce the rate of unintended pregnancy , especially for young women. Higgins also argued that LARC can reduce both the social and financial consequences of unintended pregnancies. The financial aspect made sense to me because, without health insurance, my pills cost around $90 a month. That’s roughly $1,080 a year. Without insurance, an IUD could cost around the same (including insertion in most cases), but (depending on which IUD you choose), the IUD is good up to 12 years.

However, one thing that gave me pause was how and who the LARC methods was being marketed to. While Skyla is marketed more to nulliparous women and ParaGard is marketed towards women who want a non-hormonal IUD, there has been concern that LARCs—which also include the implant Depo-Provera , NuvaRing, and the patch—are being marketed to certain demographics, particularly low-income women of color, as a method of reproductive coercion.

Higgins stresses providers “keep in mind the ways in which socially disadvantaged clients, particularly women of color, have endured legacies of social injustice that will affect the way they experience LARC promotion.” And by legacies of social injustice, she means non-consented sterilizations and coerced abortions. In fact, between 1991-1993, lawmakers in several states introduced measures that would have coerced women convicted of child abuse or drug use during pregnancy, or women on welfare, to use a LARC method for financial incentive.

Adding to this, Dorothy Roberts, scholar and author of Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, says, “Birth control has been pushed on low-income communities of color not as means of ensuring reproductive freedom but as “a way of reducing populations that weren’t valued.” Roberts also mentions evidence that unconscious bias can affects health care providers’ birth control recommendations to their patients. Even if it doesn’t, Roberts says that how a provider approaches birth control methods can leave Black and Latina women feeling pressured to chose a LARC method.

Aimee Thorne-Thomsen, Vice President of Strategic Partnerships at Advocates for Youth, also said in a October 2015 Feministing article : “There is a context that already exists in many communities of color and low-income communities around the country, and some of that is medical mistrust based on real, lived experiences,”  Thorne-Thomsen also says that a model of counseling that focuses on what makes sense for the patient, rather than focusing solely on pregnancy prevention, is preferred.

A Lot of Encouragement

I went on websites like Bedsider and IUD Divas, reading the good and the bad about women’s insertion experiences, post-insertion experiences, myths about the IUD an of the procedure itself,  how they’ve felt about their IUD of choice. The general consensus: All bodies are different and one’s experience is completely unique to one’s body.

I also read about the possibility of the IUD expelling itself, how people have fainted during insertion, and those Mirena lawsuit ads. I asked friends I knew who spoke openly about it either to me or to the world about their IUD experience (as my friend Alison Turkos did when she live-tweeted her IUD insertion).

I specifically wanted to hear more from women of color who, despite concerns over LARCs, chose the IUD. I watched one woman’s (currently) 12-part video series of her Skyla experience. Even with the understanding that every body is different, it meant a lot for me to hear from other women of color on why they chose this form of birth control. For some, the desire to not give birth anytime soon, to use something that is reversible, to be on low amounts of hormones (or none at all) while still being protected against unintended pregnancies were just a few reasons why they chose the IUD.

I took my last pill on October 3, 2015, contacted Planned Parenthood of New York City, and scheduled my appointment for later that month…and chickened out, requesting to schedule the appointment for the following month.

The November appointment came…and went with me rescheduling for December 12, 2015. Why? I was nervous. I began to think that taking a pill every day isn’t that bad, and the hormones weren’t affecting my mood. But the expectation of the insertion was a lot worse compared to what actually happened.

…And The Day Came

I got dressed in some comfortable sweats, made a light breakfast, filled my water bottle, and took 800mg of Advil about 30 before getting to the clinic.

I won’t go into the ins and outs of the PPNYC clinic itself, but I will say that, with the security measures in place, I felt safe and confident knowing that anyone who wasn’t supposed to be there wouldn’t be getting in.

I was seen early, and met with a health counselor after taking a pregnancy test. My heart was set on getting Skyla because it’s a short time frame (3 years). When making my appointment, I was told that ParaGard and Mirena were the only options available. But when I arrived at PPNYC, I settled on ParaGard. We discussed my options, and I switched to Mirena. I made the switch because even though I liked the idea of a non-hormonal IUD option, I didn’t want to risk having longer and heavier periods with cramping. (Though the fact the copper surrounding the ParaGard is toxic to sperm still fascinates me.) After signing patient consents and consenting to have the Mirena inserted and taking an HIV test (which wasn’t related to the IUD in any way…just a standard part of routine healthcare), I met with my provider.

Normally, I recommend speaking to your provider prior to scheduling an IUD insertion appointment. Because I was between providers after leaving my former provider’s practice, my IUD was inserted by a PPNYC whom I had met about five minutes before my procedure.  I ended up lucking out , because my provider was incredibly nice, thorough, answered all my questions, and even shared her own experience with her IUD that she had inserted 3 years go.

You can watch this handy animated video on how Mirena (or any IUD) is inserted (or you can watch it in real time.) But here are the steps your provider wll take to insert your IUD:

Your provider will place a speculum into your vagina and clean the vagina and cervix with an antiseptic solution to prevent infection. Your provider will hold your cervix and straighten out your cervical canal before inserting the IUD using a narrow applicator tube. Once the IUD is inserted, the application tube is removed and the arms of the t-shaped device open.

My procedure took less than 10 minutes, and that included my provider leaving to find someone when I asked her if there was someone to hold my hand (She couldn’t find anyone, and I ended up not needing that kind of assistance).

After my provider was done, she wiped me off and the area around me, and asked for me to continue lying down to avoid fainting . Remember when I mentioned that the expectation of the insertion was a lot worse compared to what actually happened? Well, my provider clamping down on mu cervix was the worst part, and that lasts all of 3 seconds. Then I felt about 15 seconds of period-like cramping as the “arms” of the Mirena stretched out into place. After I felt I was ok to get up, I got dressed and my provider walked me to the waiting area. I left the clinic on my own, took the subway, and made it home safely.

A Little Advice

Don’t go into your IUD insertion appointment blinded. I’ve added some links through this post, and I hope that you take the time to read them as they can help you decide if the IUD is right for you.

Write down any question you have about the IUD insertion (or put them in your phone). Don’t be afraid to ask because it’s your body. Including asking about the actual insertion procedure or how often to check the IUD string, ask your provider how often s/he inserts the IUD in any given week or month. This may be useful as you can see what IUD are most requested and that your provider is proficient and efficient in inserting it.

Birth control is covered under the Affordable Care Act. Call your provider’s office in advanced of your appointment to make sure your insurance covers the appointment, the insertion, the co-pay, and the removal. Verify everything with your actual healthcare insurance company as well.  If you have insurance and are still expected to pay out of pocket, call the National Women’s Law Center at 1-866-745-5487 or email NWLC at coverher@nwlc.org. If you don’t have insurance, you may qualify for free birth control. Call Bedsider for free birth control info at 888-321-0383 and they can help you out.

While an IUD can be inserted at any time, it is often advised to get it inserted while on your period, as your cervix is lower and softer for your provider to access.

A Reflection

As of today, I’ve had daily light spotting, sporadic discharge, and almost daily cramp since my insertion. While that’s annoying, I’m confident in my decision to get the IUD. My provider told me that it can take up to 3 months for my body to adjust to having the IUD. She have me a Mirena information guide, along with the lot number of my Mirena and recommended I return in about 6 weeks to have the string of the Mirena check to make sure it’s still in place. Next week, I have my 6 week post-insertion check up. I’m looking forward to the cramping ceasing and to (hopefully) one day be period free for the duration of my Mirena’s life.

I felt that it was important for me to share my IUD experience. We all don’t have access to the people we need in order to make informed reproductive health decisions, and I hope my story adds to the voices of many women and girls (especially women and girls of color) who have an IUD, regardless of which one they decided to get. As I’ve mentioned, every body is different and will respond in various ways to having an IUD inserted.

Now that I have an IUD, I am open to speaking with other women and girls of color about my experience, the concerns over LARCs, and how we can raise our voices to work bring more awareness about reproduction coercive tactics that prevent women and girls of color from making the best reproductive healthcare decisions for us.  No one birth control method is perfect, and what will work for you may not work for someone else. While the IUD was the best choice for me, it may not be for you. Talk with your provider about each birth control option available and how each one may fit into your daily routine. Be honest with yourself. It’s your body.

RAISE YOUR VOICE: Share your IUD experience in the comments below. 

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