IUDs: Your Right to Humane Medical Treatment

It came to my attention last year via Instagram that women are rarely, if ever, offered local anesthesia or other pain medications when they get an IUD (intra-uterine device) placed in the United States. As a woman who has never had an IUD I really had no base understanding of what the process is like, or whether or not it warranted pain management.

Then women started recording themselves getting IUDs and posting them online. A lot of the videos that circulated included screaming, crying, begging for the doctor to stop and doctors very actively and verbally dismissing and ignoring these women's pain. Sometimes even mocking them after the procedure.

So really quick- the process of having an IUD placed includes having a speculum inserted in the vagina to open the vagina so the doctor can visualize the cervix, clamping the cervix with a tool called a Tenaculum which has two sharp prongs to pierce the cervix and hold it in place, using a cervical sound to open the cervical opening, inserting another instrument into the cervix and uterus to measure the uterus, then inserting a tube that holds the IUD to release the IUD in the uterus.

And even though nerve-filled flesh is being pierced and the cervix is being stretched open when its natural state (outside of birth and labor) is to be pretty tightly closed to protect the uterus... Doctors in the U.S. rarely offer any anesthesia or other pain medications. And even though most doctors understand that at least some of their patients can experience severe pain during this procedure, it seems as though it is overlooked because OTHER patients report just mild discomfort. Doctors also tend to rate their patients pain as much lower than the patients self-report, which may be another reason why studies have in the past failed to understand patients' pain- they're only asking doctors what the patients pain level was. They aren't asking the patient or including any follow up.

But this isn't the way it needs to be. Men and male bodied people receive local anesthesia for procedures like vasectomies and may even receive paid time off or the suggestion to take a few days off of work.

Women and female-bodied people often endure painful medical procedures with no pain management and no time off or no suggestions to take time off. Most women are sent home from an IUD placement with the advice to take some Advil and "take it easy" despite the fact that some women pass out from the pain in the office, throw up, or spend days to weeks in pretty excruciating pain.

Did you know that many gynecologists today haven't received comprehensive education on the nerve networks of the vulva, clitoris, vagina, or cervix? There are a lot of doctors still today that don't believe that the cervix has any nerve endings... Despite the science that tells us there is indeed, and despite the fact that women feel both pain and pleasure via their cervixes.

I don't write all of this to scare you or to convince you that you shouldn't get an IUD. Though what you have read so far is pretty scary... I write this because I want you to walk into an office (or preferably call an office first) and understand your rights and advocate for yourself.

You can always:

• call your doctor, or a new one, and ask what pain prevention methods they offer for IUD placements or removals

• not see any doctor or office that refuses to offer women pain management

• specifically ask for a local anesthetic and require that the doctor wait until the medication has fully taken effect

• request anxiety management medications

• request that your doctor talk you through the entire process and tell you what they are doing BEFORE they touch your body

• bring a trusted friend, family member, or ask for a nurse to be by your side to help advocate for your needs and comfort

• make it loud and clear that your comfort and dignity are the top priority

• leave an office and refuse services if the doctor isn't treating you with respect, honoring your wishes or taking your concerns seriously

• report any doctor or office that has belittled you, or treated you poorly

IUD placement or removal doesn't need to be painful. You are deserving of respect; you deserve to have your concerns heard and addressed. You deserve pain management. IUDs are extremely reliable forms of birth control and if it's the option that feels best for you, the concern of how painful the procedure may be should not be something that gets in the way of women/AFAB seeking medical care.