Quick Hit: Why don’t more American women use IUDs?

Y’all already know that I am an IUD evangelist. While more American women are jumping on the bandwagon these days–8.5 percent of female contraception users in the US now choose long-lasting reversible contraceptive methods like the IUD and implant–we still seriously lag behind other countries.
IUD usage in different countries
At Mother Jones, my colleague Maddie Oatman reports on why it’s “been hard for young women in the United States to get their hands on this type of birth control”–and how that could be changing thanks to no co-pay birth control and a growing awareness among doctors that the IUD can be a good option for women of all ages. Check it out.

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6 Comments

  1. Posted September 26, 2012 at 4:21 pm | Permalink

    Years ago IUDs were more popular, but then there were a series of disasters among women who used them. Ectopic pregnancies, emergency surgeries, women blew out tubes, some could no longer have children. After that, many women decided not to take the risk.

  2. Posted September 26, 2012 at 5:09 pm | Permalink

    I had an IUD for about 8 months and it was one of the worst experiences of my life. I got the Mirena when I was 28 and was in excruciating pain, like needles stabbing my abdomen and even worse when I was ovulating. A good friend of mine got one at the same time and she had a similar experience. After the second time I had to go to the hospital for an ultrasound to check that something wasn’t punctured, I got it pulled. I would have loved for it to work, but when they say it’s better for women who’ve had children, I think they’re right.

  3. Posted September 26, 2012 at 7:19 pm | Permalink

    I am 28 and when I was 22 for several reasons I decided that my form of birth control needed to be not something that could break (condoms) or something that I could forget to take ( birth control pills) or that made me feel awefull (both). After investigating all my options I decided to get an IUD and scheduled a free (due to qualifying for support) appointment at my local PP. While waiting for my appointment, like you, I turned into an IUD “evangelical”. I was SO happy to learn about this new form of birth control that seemed less cumbersome, to have less side effects as hormones, and was just as effective as the most effective forms I had already heard of and used. I was telling all my friends to go get it and espousing about it at every bar or party conversation I could. Then I got the IUD and I had really really bad cramps. But whatever, I was told those would go away. Then I had spotting…which is an understatement. But still no pregnancies and no having to buy things at the pharmacy or pop pills….so I continued to be a walking IUD add to anyone in earshot. I had a follow up appointment with my gynocologist and was cleared to go. This went on for three months. I had severe cramping and basically non-stop bleeding. Then the bleeding stopped and I thought “Great, it’s working!”. A little latter I realized I was pregnant. A whopping eight weeks pregnant. The IUD had obliterated any measurable regular cycle I had along with a fear of pregnancy therefore, I had no tell tale early signs that I would have used to clue me in (like a missed/late period or feeling ill…feeling kind of nauseous was the new normal) I had to go to the emergency room and have the IUD immediately removed and then latter have an abortion. Both of which were traumatic. Since then several of my friends have gotten IUDs and sworn by them. But as peer educators and educators it’s important that no one prosthelytize about any form of birth control. It is a problem when a shockingly low numbers of people know about some of the options. But IUDs are not perfect. No form of birth control is risk free. And what risk you are willing to take is a highly personal decision. I wouldn’t hype up any forms as much as the importance of making an informed decision. IUDs lead to a higher risk of ectopic pregnancy, which is life threatening, and can lead to raising the odds of future wanted pregnancies being ectoptic. IUDs can be painful. And for some they just plain fail. And that failure rate may be less then with condoms and birth control pills…but that is hardly heartening to the person who it does fail on.

  4. Posted September 27, 2012 at 9:43 am | Permalink

    So, I read the mother jones article and Oatman’s points are well taken, although I think she missed an even greater complexity. From my limited experience, many young women with out children have a hard time finding a Dr. to give them an IUD for the reasons listed such as the many misconceptions of health related issues, essentially. But, it’s deeper than that. For women without children, it is harder to get the IUD inserted all the way into their body, therefore, they have to be given medication to dilate their cervix, but many affordable health clinics aren’t authorized to provide these women with that kind of medication. As I understand it, the medication needs to be administered through an IV and many clinics, such as the Planned Parenthood in my town, not only do not perform abortions, but also are limited as to the health care they can provide. They cannot hook someone up to an IV, therefore, they can implant and IUD, but it’s extremely difficult for them to have success at the IUD implanting properly in a woman who has never had children.

    So, the problem for young women is very multi-faceted. Many Dr.’s have misconception or judgments about whether a young women, single or not, without children should be allowed to have an IUD. This makes it very difficult for them. But even when they find a clinic that will, such as PP, these women often have a difficult time due to the needs of their bodies in order for the IUD to insert properly.

  5. Posted September 27, 2012 at 11:07 am | Permalink

    I was interested in this method a couple of years ago and did some online research and met with my doctor about it. I was very scared about the possible side effects and complications I learned about, and I was also told it is recommended that only women who have already had a child should use it (which I have not). I’m on the daily pill, which also has many negative aspects. It is a shame women are (for the most part) the only ones who sacrifice their bodies and bank accounts for contraception that benefits both parties in a relationship.

  6. Posted September 27, 2012 at 1:46 pm | Permalink

    There are a some misconceptions on this thread that I wanted to address:

    1. The old IUDs (Dalkon Shield) did have a lot of problems and scared a lot of people away from IUDs. But those problems are drastically reduced with today’s IUDs, which are very safe and very effective. Not to say, of course, that there are no side effects or complications–just that it is a completely different situation now than it was in the 1980s.

    2. Regarding the risk of ectopic pregnancy on IUDs: The risk is only increased if you look at people who are already pregnant, which is anyway a tiny proportion of people who use IUDs. An IUD does not increase your absolute risk of ectopic pregnancy. It does mean that if you become pregnant while using one, it is somewhat more likely to be ectopic than if you were using another method, or no method.

    3. Anyone with a uterus can get an IUD, whether they have given birth or not. Generally Mirena is recommended for those who have not yet given birth, because the small amount of progestin it releases helps to reduce side effects. The Paragard (copper IUD, no hormones) can be difficult to tolerate for people who have not given birth. Side effects such as pain/cramping and heavy bleeding can be tough for people who have them, but they do tend to resolve after several months. (Of course it’s hugely variable what kinds of side effects, if any, different people experience.)

    4. You do not need an IV for cervical dilation to insert an IUD. Some providers will give you pain medication ahead of time, or some will inject anesthetic directly into the cervix. The experience varies, but insertion can be painful for a few seconds.

    The upfront cost of an IUD has until just recently been several hundred dollars, which can be prohibitive, but many of the people I know in medical fields use them and are extremely happy with them. I think that with IUDs now being free under the ACA, they’ll become more popular.

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