Thursday, November 10, 2011

To Have an IUD or Not to Have an IUD (And then, which type?)

Desembarazarme’s recent post about IUDs here got me thinking. IUDs definitely are more popular. Not so much the ParaGard, but Mirena is. Women are often asking for it and providers are generally – in my experience – urging women to use it. I hope, too, that as long-term birth control methods become more available, that our community doesn’t swing their biases towards one method over another (but , this does seem to happen). The thing is, no method is the savior of all birth control for all women. We’re individual, unique people and different methods fit our needs: including abortion as birth control.

I’ve talked about my very own personal choice to not use hormonal birth control for over 15 years. With my current partner, we combine natural family planning with withdrawal and Plan B to control pregnancy. It’s worked for us. I’ve only become pregnant when I’ve wanted to. Despite this, I’ve actually been considering an IUD for years. When I recently discussed this with my Gynecologist and explained to him my reasons for considering the IUD, he told me that Mirena “is the birth control of choice for female OB/GYNs…even for themselves…so that tells you something,” and admitted that he’d recommend it over the ParaGard (which contains no hormones, but generally causes heavier, longer periods and cramps).

The doctor at my clinic loves the IUD, too, and inserts them immediately following an abortion for many of our clients. Many of our clients soon have them removed, though, because there is “nuisance” bleeding for a few months with the Mirena (which has a small level of progesterone) and then no period at all. (Some of us like to have our period to feel more certain we’re not pregnant, even though you can have bleeding and still be pregnant.) Personally, I’m still a bit on the fence about it and since it does cost so much money, I find it hard to just “play” with the method and see if it will work for me, only discover it doesn’t, after forking out over $500.

What do you guys think?

P.S. If you want the recipe for the IUD cookies (they are super cool!), then check out this blog here.


  1. How does your clinic manage the cost of IUDs? Are they only inserted when patients pay out-of-pocket for the additional expense?

    As far as I know, NAF won't fund them, and I've been told by docs that insurance won't let you bill for two procedures on the same day (that was for an explanation for why IUDs weren't being inserted post-partum at a given hospital).

  2. Hi there. I love to see that there are conversations about IUDs happening. I am also fairly uncomfortable with hormonal birth control ( my mom was part of that group of women that got breast cancer from the HRT drug Prempro), and I also just don't feel good in my body on artificial hormones.

    I chose to have an IUD when I was in my early 20's, when I was a single mom. I had to BEG the Dr to give it to me, promising that I didn't want any more kids. How patronizing, right!? But I did get it.And I kept that one for about 5 years. The insertion itself is not really all that much fun ( kind of like intense menstrual cramps for a few minutes) but it is over pretty quickly. The day of the insertion is pretty crampy, but overall not a huge deal. I did have it removed, and chose to get pregnant- which happened easily the very next month. When I was 3 months postpartum with my 2nd kid I had another IUD inserted. I have now had my 2nd IUD for almost 4 years.

    Like you said, no birth control method is perfect, but given our options, the IUD is pretty great. I rarely notice it, I almost never think about it (except to sing its praises), and it effects my partner maybe once in a while, but we just change positions and that is that. I love that my birthcontrol is safe, non-hormonal, reliable, and a no-brainer- I don't have to maintain it in any way. I have the paragaurd, and it will last for 10 years. Also- removal is really fast, easy and painless.

    Downsides: for the first year or so the string is a little stuff, but it softens up over time and becomes more flexible. ( it is kind of like a fishing line).
    My man does feel it sometimes, but it is not terrible or painful, just kind of annoying.
    My periods are sometimes a bit more crampy, but not anything awful- seriously.

    I love having an IUD- I will tell anyone and everyone about how great I think it is. It allows for spontaneity as well as the ability to get pregnant (if you want!) immediately after removal. I think it as close as we are going to get to a perfect method of BC ( except the crazy price tag.)

    My one bit of funny advice- if you do get one- what really helped me was to have an orgasm as soon after insertion as possible. It is a kind of uncomfortable time, but having an orgasm seems to allow it to settle into place and let your uterus chill out a little bit and stop cramping.

    Good luck with your choice! I am happy to talk about it further with anyone!

  3. I got an IUD in July and I love, love, love it! My situation is a bit different as my insurance covered it so I only had to pay for the office visit (I know how extremely fortunate I am). Also I have a Paraguard as I didn't want any hormones (although it is worth noting that the hormones in Mirena are supposed to be non-systemic meaning they stay in the uterus and don't affect the body as happens with pills). My IUD experience was very easy. I had my insertion during my period, which was then very heavy and crampy. Since then my periods have been longer and texturally different but not enough to bother me. I stayed on the fence about the IUD for a long time and now wish I hadn't waited so long. I do understand the financial concern though especially because I know they don't work out for everyone.

  4. Please do give it a chance/try, IUDs work well for many, many women! So many of us LOVE our IUDs - 160 million women worldwide can't be wrong!

    If you need moral support try IUD Divas, a Live Journal community that's all about IUDs.

    Also check into whether or not your state's Medicaid will cover it and if you qualify. Texas Women's Medicaid Program paid for both of my IUDs (first one expelled due to incorrect placement) and the second one has been GREAT for yrs! I LOVE the ability to plan my family, live without hormones and have a normal cycle with my copper IUD.

    Also has a monthly pay system setup, so if you can't afford the hefty 300-500$, you can arrange it with them to pay monthly!

    Good luck either way :)

  5. Wow! What a lot of IUD love! Thank you - each of you - for your thoughts and your experiences, not to mention support. I did do a google search on Mirena side effects and everything that came up was pretty scary. It nearly put me off getting an IUD.

    After all this support (from you) and advice from friends - some of them co-bloggers - I have decided to book an appointment. :)

    MamaC, thank you for the advice on having an orgasm quickly after insertion. It makes a lot of sense that it wouled help ton settle it into place.

  6. Benedict - thanks for your question. I'm not sure if NAF subsidizes the cost of IUDs or not. Our clinic does bill private insurance and the reimbursement for it directly after abortion is good. I am sure you can bill insurance for more than two procedures in a day. Lots of people get different tests done in the same day...or consider women getting an epidural, followed by c-section. Each procedure is covered.

    Our state medicaid also pays for IUDs. Many of our patients have Medicaid.

  7. i had an IUD (Mirena) placed in 2009. I was actually going to get a tubal ligation but my Doc said the Mirena IUD would alleviate my endometrial pain. But its been wonderful. I still get my period (which eases my anxiety) but it is incredibly light. I'll get it again if I don't get my tubal afterwards.

  8. Pretty sure there is an issue with MEDICAID paying for it -- or at least that is the problem with getting a tubal ligation at the same time as a c-section, for example -- because in the bad old days there were too many cases of doctors exercising biased pressure on "certain kinds" of women (usually poor or disabled) to agree to be sterilized after giving birth, often obtaining their "consent" while they were drugged for labor or not really obtaining it at all!

    NAF doesn't pay for post-abortion IUDs as far as I've ever heard -- they just don't have the funds for that. But the Ryan training program in family planning does. If you have a clinic near a teaching hospital, that could be a good option.

  9. Best website for Q&A re: iuds, hands down.


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