Getting a Copper IUD Part 2: The Procedure

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What it’s like to get an IUD (not that bad).

…continued from Getting a Copper IUD Part 1: Choosing Birth Control

“That was it”?

I was lying vulnerably on an examining table with my feet in stirrups and my hands over my eyes, taking exaggerated but shaky breaths when my gynecologist told me it was over. By it, I mean “a copper intrauterine device (ParaGard IUD) placement.”

She had assured me the discomfort would only be mild before the procedure, but afterward, there was a tinge of surprise in her voice. “Wow, you did really well.” Maybe she simply expected the worst because I entered the room with jitters and a case of alarmingly high blood pressure. Either way, it was retroactively disconcerting, but I was glad for what felt like a lifetime of build-up to finally resolve. For once in my sex life, anticlimactic was good.

So rewind to October 2017. I had just moved to Raleigh, NC, and I made an initial consultation appointment with a gynecologist; I had a placement appointment scheduled two weeks out. I am fortunate enough to have a job that provides health insurance with 100% birth control coverage, but I was willing to pay anything. I had saved enough money to pay upfront and in-full if necessary.

The two weeks before my appointment dragged on forever, but what started as excitement quickly turned to fear as the weekend before the procedure passed.

There were risks: uterine perforation, expulsion of the IUD, fainting after the procedure, heavy bleeding and cramps, anemia, the 1% chance of pregnancy, Pelvic Inflammatory Disease, migration, etc. I read first-hand accounts from women who said they “saw stars” or “never experienced pain like that again” during their insertion. I have a high threshold for pain, but I almost canceled the appointment more than a few times due to my nerves. Then, my rational mind would again take the wheel. I have wanted this for over a year. Suck it up. If it’s torturous, it will only last five minutes. I will be protected for 10 or more years. I do not want a child and do not foresee wanting a child in the future. I want bodily autonomy.

I noticed a new feeling starting to emerge: empowerment. I don’t necessarily like that word when it is co-opted by companies that use “feminism” as a way to market their products or by people who want to reduce feminism to “ individual choices” that are only available to the privileged few, but in this case, I felt it genuinely.

The day arrived, and I sat alone in the waiting room, bouncing my legs nervously. I scanned the room and saw a handful of pregnant women and doubled down on my course of action. For as blindly as I went into finding a gynecologist, I really lucked out. She was upfront about the risks but was totally relaxed about the procedure and the IUD itself. She places IUDs every day, and even has one herself.

I sat on the examining table and she sat in front of me on a stool while she explained how the procedure would go:

  1. A speculum—the instrument used during a Pap smear—is inserted.
  2. The cervix is cleaned.
  3. The cervix is opened and clamped by a tenaculum so that it remains open.
  4. The depth of the uterus is measured using a uterine sound so that the doctor can see exactly where to place the IUD.
  5. The IUD is prepared and put into the insertion tube.
  6. The IUD is pushed into the uterus by a plunger inside the tube.
  7. The instruments are removed, the strings are cut, and that’s it!

I only felt pain when my cervix was opened, but it was that of a slightly worse-than-usual period cramp. If you’ve ever had a Pap smear, you know that it’s difficult to describe the sensation of manipulating the cervix. For me, it has the texture of a scrape but feels more like a pinch.

The speculum and tenaculum combination pinched but I was more discomfited by the picture my mind’s eye painted of my cervix being held open than how it actually felt. I did get a bit faint. My high pain threshold doesn’t preclude vasovagal wooziness from so much as a routine blood draw.

I will be honest with you. I did not feel anything when the IUD was inserted. I put my hands over my eyes and took deep breaths in anticipation of the pain, but I didn’t even know it was happening. I have light periods with mild to no cramping, which may contribute to the lack of pain I felt, but I also attribute it to my gynecologist’s experience with IUD placements. I shook her hand, laid on the examining table for about half an hour, and rescheduled my follow-up appointment.

Afterward, I drove myself back to work despite planning to take the rest of the day off. So far, I occasionally get a tinge of a period cramp and a drop of brown and/or bloody discharge, but I find myself jokingly wondering if my gynecologist actually put an IUD in.

I do feel a rush of wooziness when I imagine a t-shaped device in my uterus, and for some reason, I keep expecting the sensation of a tampon. I’ve had sex once, and it did cause some cramping. It wasn’t anything unbearable though. I can’t attest to the long-term effects because it has only been 48 hours. This post is restricted to the placement procedure and immediate effects of the procedure.

My account is not meant in any way to discount the women who experience pain during and after the procedure, but the Internet is chock full of terror-filled narratives. I am here to tell you that getting an IUD will not necessarily cause unbearable pain or any pain at all. I liken it to a prolonged Pap smear with slight period cramps.

My gynecologist showed me how to check for the strings and instructed me to abstain from unprotected sex for three weeks (or, you know, forever if I’m not being unequivocally monogamous). Those were the extent of her aftercare recommendations.

Otherwise, I went about my day as planned and am now looking forward to a pregnancy-free ten years.

Talk to your gynecologist about an IUD if you have even the slightest interest in one. If you decide to go through with the placement, remember what my dad always says, “expect the worst, hope for the best, and take anything in between.” And next time you hear a screaming baby at a restaurant, you will be able to breathe a sigh of relief.
Even if you can’t—or don’t want to—take hormonal birth control, you are not powerless to take 100% control of your sexual health. The strategic sexual disempowerment of my upbringing permeated every aspect of my life to the point of my not even realizing. It’s about more than sex; it’s about claiming complete ownership of my body for the first time. Taking control of my sexual health has given me a new lease on life. For me, it’s that important.

Header image illustrated by Marcy Gooberman

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