My mom told me not to get an IUD. Like many Americans, she had a lingering mistrust of the idea that traces back to the Dalkon Shield scare in the ‘70s and ‘80s. According to Mother Jones, the Dalkon Shield IUD was badly designed and drew bacteria up its strings, occasionally causing infections and even death.

Today, there are safe designs available (there are a few risks, but they all have a very tiny chance of happening), but still, only 6% of women who use contraceptives in the US choose an IUD [1]

Graphic provided by Guttmacher Policy Review

Use of contraceptive methods by type. Graphic provided by Guttmacher Policy Review

When you look at the statistics, you’d think IUD use would be much higher. According to the Center for Disease Control, IUDs are the number one most effective form of non-sterilization contraception, with a typical-use failure rate ranging between 0.2% and 0.8% (for reference, typical use failure rate for birth control is 9% and condoms is 18% [2]). Because lets face it, who actually remembers to take their birth control pill at the same time every day?

Maybe a barrier to IUD use is its reputation. The first thing anyone told me about an IUD is how much it would hurt. I Googled IUDs and what to expect, and immediately got blog results with titles like “No Pain, No Gain.” Several of my girlfriends advised me to expect “the worst period cramps of your life” for 24 to 48 hours. Yikes!

So when I walked into my GYN’s office to get an IUD yesterday, my palms were sweating and my heart was beating in my ears. Admittedly, the procedure itself didn’t feel great, but nowhere near as horrible as I was expecting. Once, I got a hairline fracture on my index finger from playing basketball, and it wasn’t even painful as that. I was sure to take ibuprofen an hour before the procedure, and used Cytotec the night before to soften my cervix to make the insertion easier. If your GYN doesn’t prescribe you anything like that before the procedure, don’t be afraid to ask!

When the procedure was over, after about 5 minutes of cramping and dizziness of medium severity, things started to feel more normal. The rest of the day I only experienced mild to medium cramping, no worse than an unpleasant period day. Phew! I had been gearing up to be incapacitated for two days straight.

The point is, I’m here to tell you that getting an IUD is not necessarily going to be terrible, and fear of the procedure shouldn’t be a barrier to getting one. Admittedly, everyone’s body is different, and everyone is going to have a different experience with the insertion and following few days. Some women really do experience the worst cramps of their lives. But not having to take birth control pills for the next five years? Worth it.

Affordability is another barrier, if you don’t have health insurance. New federal rules mandate that FDA-approved contraception, including IUDs, must be covered under health plans with no co-pays or additional fees. Thanks Obama! But if you don’t have health insurance, costs can be between $500 to $1000. That can be a lot of money for some one to front, even if it does last up to 10 years. Thanks again to federal changes, more people are covered by Medicaid in 2014, which does cover the procedure. Some Planned Parenthood clinics are also willing to charge you according to income.

I chose Mirena, a hormonal IUD that lasts 5 years. It’s supposed to lighten your period, or even stop it all together in some cases. You can also opt for ParaGaurd, which is a non-hormonal copper IUD that lasts for 10 years. ParaGuard generally increases cramping and bleeding during your period, and the few days following insertion can be slightly more painful than Mirena.

Access to effective and affordable contraceptives is basically the number one form of female empowerment. Delaying childbirth and smart family planning means that women can have the ability to finish their educations and establish a career. It fosters economic prosperity, more equitable romantic relationships (where women are less dependent on men for financial support), and gives rise to healthier communities.

So go forth and review your birth control options! Be safe and use effective methods. Educate yourself and help others do the same. Knowledge is power.

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