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IUDs: The Other Side of the Speculum


I’m a single, white, sexually-active young woman with no significant medical history and I want an intrauterine device (IUD).  Yet after four months of trying to get an IUD, I still have an empty uterus.  At the end of my last visit to the doctor, I turned to my friend exasperated and exclaimed, “Why does this have to be so hard?!”

The truth is that obtaining affordable long-term birth control often is too hard.  As someone studying to be a health care provider, I know that limiting factors include cost, access to trained health care providers, and common IUD myths and misinformation.  My story is just one example of the headaches and hang-ups that many women have to face when getting an IUD.

Let’s start at the beginning. In early June, I called my school’s student health department to schedule an IUD placement.  The secretary gave me the name of the physician whom I would have to independently schedule with because he required an initial visit to “discuss my birth control options.”  Options?! I thought to myself.  As if an IUD couldn’t possibly be what I really wanted? I emailed the physician, and after some persuasion on my part, he agreed that given my recent work at a women’s health clinic, I could forgo the counseling session and simply “get ‘er dun.”  He then penciled me in for August, over two months later!  As the only physician in a 20+ physician office trained to place IUDs, his schedule was quite busy.

On the day of the visit, I was very excited.  Not having to think about birth control again until after I finish my clinical training was extremely liberating.  I entered the exam room with a friend, and a nurse followed us in.  However the nurse didn’t introduce herself.  In fact, she didn’t even look at us.  She simply proceeded to look for something in every cabinet in the exam room and then exited empty handed. My friend and I were alone again.  I would have laid down on the exam table, but I wasn’t given a sheet or gown. Finally, the physician came in and looked bewildered that I wasn’t legs up, ready to rock and roll.  He awkwardly introduced himself, gave me a sheet and instructed me to undress.

Once I was sitting on the exam table, I thought the doctor would review the procedure with me. But he completely forgot!  He did not review how the IUD insertion would work, until I politely reminded him.   He handed me a clipboard and I signed on the dotted lines.  Then, I shimmied down the table and put my legs in the stirrups.  Suddenly, the physician’s nurse realized she forgot something  from outside and opened the door wide, forcing me to snap my legs shut so that the whole hallway didn’t get a full view of me half-naked!

When we resumed, the doctor did not do a bi-manual exam, which I learned this summer is a necessary part of the IUD insertion protocol to help clinicians determine how a woman’s uterus is positioned.  Instead, he just started right away with the metal tools.  Speculum, tenaculum, ringed forceps, and dilator. (Ouch!) After expanding my cervix with a series of dilators in progressing size (arguably very painful), he reached for the IUD insertion device.

I took another deep breath, and the doctor successfully placed the IUD.  As he removed the instruments, though, I heard him say, “Oh crap.”  He had gotten the IUD’s strings caught in his instruments and pulled it out of me! And because my school’s pharmacy doesn’t keep IUDs in stock, the doctor told me they would have to order another IUD.  And I would have to wait for another visit. And so here I am, 3 months later, still waiting…



Thank you to 4000 Years of Choice for the artwork featured in this post

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