If you have a womb and, at some point, have hoped against placing a baby in it, chances are you will have heard some birth control horror stories.
And for many, interuterine devices (IUD), or the coil, make for the most terrifying tales of all.
There was my relative, who said having hers fitted “was like (her) C-section recovery” (her anaesthesia had worn off by the time she’d gotten stitches). There was a friend who compared hers to being “stabbed.“
Thankfully, not all IUD fittings are like this. Some women, like Davina McCall in her most recent documentary Pill Revolution, find getting the coil “uncomfortable,” but not agonising.
And it feels important to note among this discussion that contraception is getting harder to access in the UK, reproductive rights seem to be regressing right now, and birth control in general has been an unquestionable net positive for women worldwide.
Still, access to the (highly effective) method of contraception shouldn’t come at the cost of so many women’s suffering – 17% of women who haven’t given birth, and 11% of those who have, experience “significant” pain.
Surely, there has to be a way to manage the IUD fitting process better than that.
So, why is it so bad?
The Faculty of Sexual and Reproductive Healthcare acknowledged in 2021 (FSRH) that too many women experience significant pain during an IUD fitting, and said that “We are calling on the UK government to ensure these experiences are recognised and addressed in the new Women’s Health Strategy for England.“
And while the FSRH said that women should “always” be offered pain medication during an IUD fitting, this hasn’t historically been the case – and many people report professionals not following the FSRH guidelines today.
Comedian Alison Spittle, whose show Wet focuses on her “traumatic” experience with an IUD fitting, told HuffPost that the experience was “the worst pain in her entire life.“
She says that “In the letter, you’re told to take a few painkillers before and you’re free to go in the afternoon.“
However, after experiencing an “agonising” fitting – which she stresses she doesn’t blame the “competent” medical pros for – she “could not imagine returning to work” in such severe pain.
It makes sense. While most women are told to take ibuprofen or paracetomol before the procedure, there’s very little evidence this does anything at all.
NHS strains are felt in sexual health services, too
Simphiwe Sesane, a contraception and sexual health nurse consultant at MSI Reproductive Choices, told iNews that while she always works hard to keep her patients pain-free, there may be huge discrepancies in training and staffing elsewhere.
“With any guidelines, there can be a delay in people being trained up, especially with things like the (anaesthetic) injection,” she said.
She added that not every place will have a specialist who’s trained in IUD fittings, and that some medical settings won’t carry anaesthesia on-site.
Gynaecologist Prof Lesley Regan recently talked to The Guardian about what she calls NHS “silos,” where reproductive health falls through the cracks.
“Contraception has got to be everybody’s business and up until this moment it’s been nobody’s responsibility and no one’s been accountable for it,” she says.
Here’s hoping the health system manages to catch up to their ten-year-old guidelines sometime soon...