There aren’t many groups that recent news in the United Sates hasn’t upset, and women are no exception.
Earlier this week, the Supreme Court ruled that so-called “crisis pregnancy centres” in California are not required to provide abortion information to patients. These often-unlicensed clinics usually pretend to be offering abortions or at least information on how to terminate a pregnancy, but when unsuspecting pregnant women visit, they are lied to, bullied and otherwise coerced into continuing their unwanted pregnancies. Sometimes they are given false information about the risks of abortion, the prevention of STDs, or the status of their pregnancy. Other times, they make it impossible to schedule the abortion that can allegedly be obtained from their clinic until it is too late for the women to terminate, or make the allegedly-available termination inaccessible to low-income women or those without reliable transport by requiring them to return again and again for assessments before signing off on the procedure. The law the Supreme Court struck down had required clinics to state if they were unlicensed, and had required clinics to make patients aware of options available from the state, including abortions.
Now comes the news that Supreme Court justice Anthony Kennedy will be retiring at the end of the month. Despite being a Reagan-appointed conservative justice, Kennedy was known as a swing-voter who was often a moderate voice in the Supreme Court thanks to key votes in cases regarding issues like marriage equality and reproductive rights. With his departure, Trump has an opportunity to nominate a far more conservative replacement, and naturally we can expect it to be the most awful choice possible. Women across the country are concerned, with good reason, that soon Roe v. Wade, the landmark case that struck down most restrictions on abortion, will be overturned or at least functionally dead.
After Trump’s election, many women feared that a combination of misogyny and pro-life zeal in office would form an attack on reproductive rights and make it more difficult for us to get not only abortions but also contraceptives. One of the major elements of Obama’s healthcare reform was to mandate that most forms of female birth control be covered by health insurance. Many feared (fear) that Trump will attempt to put and end to this, in line with the thinking of so many conservatives that the only purpose of birth control is to allow women to be promiscuous, ignoring the many who use it for health reasons and also the fact that there’s just nothing wrong with having sex. “Get an IUD,” became a common refrain, encouraging women to look into long-term contraception that wouldn’t be disrupted by the administration’s actions.
‘Get an IUD’ is more relevant advice than ever, and as someone who did just that almost a year ago, I thought I’d share a bit about my experience for anyone else who might be considering it.
There were several reasons I chose to switch from the pill (Junel Fe, for what it’s worth) to the (Mirena) IUD. One, yes, was political. While I hope to never find myself in a situation where I have to decide what to do about an unwanted pregnancy or a pregnancy that could be a health risk or even life-threatening, I definitely wouldn’t want to do so if the current administration succeeds in restricting and limiting our options. The IUD is one of the most effective forms of contraception, removing the user error and imperfect use that most often results in failure for other contraceptives like condoms and the pill.
Furthermore, as a freelancer, I was already paying a significant amount each month for health insurance; the prospect of potentially having to pay for birth control on top of that if the birth control mandate were repealed was not appealing. There have been times when I was living abroad when I’ve had to pay for my birth control out of pocket, costing me $20-30 per month, and it would’ve been even more expensive in the States had I not been covered. A small price to pay compared to the cost of a pregnancy, but still not something I would have wanted to do. My IUD cost me $55 total—50 dollars for a consultation appointment and five dollars for the pregnancy test they required before insertion.
The other reasons were more practical/personal. I’ve never had any issue with the pill—no major side-effects or problems remembering to take it or take it on time—but it’s still one more thing to remember to do each and every day. Add in traveling and time zones, not to mention that pesky menstruation thing (most people, including me, lose their period after a while on the Mirena), and the idea of a set-it-and-forget-it form of birth control starts to look more and more appealing. The Mirena is also good for six years, meaning the next time I’ll have to worry about it I’ll be 32. I still may not be ready to have children by then, but I almost definitely won’t be ready before, so it’s pretty convenient.
My IUD experience has been pretty easy. I made a consultation appointment with planned parenthood at the end of July last year, and in the first week in August I went back to have it inserted. It’s an extremely quick procedure; I spent more time in the waiting room than I did in the doctor’s office. It also hurts like hell. I want to be clear about that: the pain was 100% worth it, but it does hurt like a mother. First they numb your cervix with a local anesthetic; then they put a clamp (A CLAMP!!!!) on your uterus to hold in place while the IUD is inserted. It’s like your worst PMS cramp ever combined with a minor stabbing. Luckily, it takes about 20 seconds total, so it’s over fast.
Afterward, I had pretty bad cramps for the rest of the day. My mom had kindly taken the afternoon off from work to drive me to and from the appointment, and I would definitely recommend having someone to drive you home after if possible. If I remember correctly, I was able to go for a short walk in the park the next day, but it was probably a week before I could really exercise again.
My symptoms after that weren’t terrible: I had on-and-off cramps for the next few weeks, becoming more sporadic until they went away entirely after about two and a half months. I also had on and off spotting and bleeding during that time, along with my regular menstrual cycle. The spotting also went away after about two months, and a month or two later I also stopped getting my period. Since then, the only time I’ve had to think about my IUD is when I check it monthly to make sure it is still in place.
I can’t recommend the IUD enough, but I am also aware that it isn’t for everybody. I was personally deciding between the Mirena IUD and Nexplanon (the contraceptive implant) and decided on the IUD for several reasons: it’s longer-lasting (six years vs. three), it has lower hormone levels because it’s directly in your uterus instead of being released through your body (the implant goes in your arm), and the potential side effects of the IUD, while more serious, are less likely than those of the implant.
However, while I would definitely recommend that all people with ovaries who are or may become sexually active with people with testes consider LARCS (long-acting reversible contraceptives), you should definitely do some research to decide which option is your personal best choice. Planned Parenthood is, unsurprisingly, one of the best sources for information and education, and also a great place to go once you’ve made your decision. They often offer sliding scale payment if you’re not covered by insurance as well.
It’s difficult for me, for many of us right now, to feel optimistic about the state of women’s and reproductive rights in America. However, I am much more comfortable about my personal situation thanks to my IUD. I encourage other women and people with uteruses to consider their own contraceptive situation and look at ways to reduce their risk and feel more confident about their reproductive independence.