A woman’s choice in birth control is not only a deeply personal one, but often a political one, too. This was made infinitely clear to me at the end of 2016, when in the wake of the presidential election, women flocked to health care providers seeking long-acting reversible contraceptives (LARCs), like IUDs (intrauterine devices) and implants.
In the months following Donald Trump’s election, the number of doctor’s visits related to IUDs increased by 19%, according to data collected by athenahealth. Researchers noted that this was the first time in five years that the volume of IUD-related medical visits had increased in November and December. They speculated that this jump might’ve been a direct response to the 2016 election: Trump had vowed to repeal the Affordable Care Act (ACA), which required insurance companies to cover contraception without a copay. (In other words, the ACA guaranteed women access to genuinely affordable birth control. And Trump’s plan to repeal the ACA threatened to thwart that access.)
For those of you who aren’t familiar, IUDs are T-shaped devices that are implanted into the uterus to prevent pregnancy over a period of several years. Some IUDs—like the Skyla, Kyleena, Mirena, and Liletta—use the hormone progestin to prevent pregnancy. These IUDs can last between 3-7 years. Other IUDs, like the Paraguard, are crafted from copper, a material that renders your uterus a hostile environment for sperm. Copper IUDs last 12 years, and tend to be a great option for those who are unable to use hormonal birth control. Though IUDs can be used for periods of 3-12 years (depending on the type), they can be removed at any time. For instance, if you get a copper IUD and decide you want to have children three years later, your doctor can remove it, and you’ll be good to go. (This is why IUDs are classified as long-acting reversible contraceptives—not simply long-acting ones.) In addition to offering security and flexibility in equal measure, IUDs are one of the most effective forms of birth control around. Hormonal IUDs are 99.9% effective at preventing pregnancy, and copper IUDs are 99.2% effective, according to the American Sexual Health Association. (Compare that with oral contraceptives, like the pill, which are 92-97% effective.)
At the end of 2016, IUDs offered women a kind of security—one that was, frankly, in short supply. With one simple procedure, women could ensure that they had access to contraception for the next 3-12 years (or, perhaps more aptly, the next 1-3 presidential terms). No matter who the president was, which health care laws were overturned, or what anti-abortion bills made their way to Congress, these women could rest assured knowing their contraceptive situation was within their control. They had 3-12 years worth of long-acting contraception if they wanted it, they had the flexibility to get off that contraception at any time, and they didn’t have to spend a small fortune to get that access. In a political moment where so much felt out of control, power over something so seemingly simple—so straightforward, so human—counted for a lot.
Of course, there are many less obviously political reasons someone might seek out an IUD. I opted for the method at the start of 2016 after several years of failing to remember to take my pill every day. This was a recipe for disaster, and when the cost of my birth control increased (albeit marginally), it was one I could no longer tolerate. I’ve now been on the Mirena for nearly four years, and I cherish the opportunity to have a long-acting contraceptive I don’t have to pay any attention to. There are no pills to take daily, no patches to replace weekly, no rings to swap out monthly—just annual gynecology check-ups that I’d be attending anyway.
Intrigued by this intersection of the private and the political, I asked the internet at large one question: Why did you decide to get an IUD?
“I had been on the Pill, but I always worked jobs with odd hours and would forget to take it.”
“I had been on the pill in college and for a while after, but I always worked jobs with odd hours and would forget to take it. I also had a hard time remembering to pick up new pill packs from the pharmacy every few months. I tried the ring for about six months, but it made me feel super emotional, and I was put off when an ex-boyfriend mentioned that he could feel it when we were having sex. I got the Mirena IUD so that I wouldn’t need to worry about any logistics for five years, and I’m really glad I did!” —Christine B.
“I was having trouble getting my birth control prescriptions filled.”
“I got my first IUD about three years ago. (And I got my new one a few months ago.) Before that, I’d been on birth control for about six years, and I was having trouble getting my prescriptions filled. I liked that the IUD worked for a full three years, and that it took a different approach to hormones than other kinds of birth control.” —Valerie S.
“I’d just gotten married, and we’d decided not to have kids for a little while.”
“I got an IUD when I was 25. At the time, I was on the pill. But I decided to make the switch, because I’d just gotten married and we’d decided not to have kids for a little while.” —Vanessa B.
“After one too many midnight runs to the pharmacy to get plan B, my boyfriend asked me to look into other options.”
“I never used any sort of hormonal birth control before getting my IUD. I relied solely on condoms throughout all my relationships. After one too many midnight runs to the pharmacy to get Plan B, my boyfriend asked me to look into other options. (It only takes one broken condom to really shake you up!) I’d always been hesitant about getting on birth control. I used to be a professional ballet dancer, and I’d heard such horror stories about weight gain and other unexpected side effects. After hearing my concerns, my doctor suggested an IUD—due to its effectiveness and its low dose of hormones. While the procedure to get my IUD inserted was awful—some of the worse cramping I’ve ever experienced—I love my IUD now. I don’t have to worry about taking a pill every day, and I’ve experienced little to no side effects.” —Kimberly G.
“I got scared about what reproductive health care might look like under the new administration.”
“I got an IUD in July 2017. At the time, I wasn’t on any form of hormonal birth control—I was just using condoms. I got scared about what the reproductive health care landscape might look like under the new administration, so I figured I should get a form of long-acting contraception while I could.” —Heidi V.
“There was no way I was going back to the hormonal swings of the pill.”
“I’ve had an IUD for about 16 months now. Prior to getting pregnant with my firstborn, I’d tried several different kinds of birth control pills. After being diagnosed with PCOS and suffering two years of infertility to get pregnant, however, I knew there was no way I was going back to the hormonal swings of the pill. I’d gone through enough of that in my infertility treatments! The IUD has been a much more stable experience overall.” —Chrissie J.
“The IUD came highly recommended by one of my friends.”
“I’d been dating someone for about five months when he brought up the topic of birth control and realized I wasn’t using any. I’d previously been on the pill, but it had a horrible effect on me, so I stopped using birth control altogether. After talking to my partner, I decided to re-explore my options. The IUD came highly recommended by one of my friends, so I talked to my gynecologist about it and got one.” —Shauna W.
“I was fairly sure I was done having children.”
“I got my IUD after my third baby, because I was fairly sure I was done having children at that point. Before that, I’d used birth control. But I generally recommend that women get an IUD if they don’t plan on having a baby for at least a year.” —Hilary E.
“Unfortunately, I’m one of the women who experienced bad side effects from the pill.”
“I got my first IUD in 2010, and have replaced it twice since. (I was worried it wouldn’t be covered by insurance after Trump got elected, so I replaced it in late 2016.) I’d been on the pill since I was 14—my mom put me on it to manage my cycle and lessen my cramps. Unfortunately, I’m one of the many women who experienced bad side effects, like pain during sex. (Being on the pill for 15 years also impacted my testosterone levels.) My situation got pretty bad—I didn’t have sex for years—but I was lucky to find a specialist who recommended that I try an IUD and prescribed the right mix of medication/treatments I needed to resolve the issue. It changed my life! I currently use the Mirena IUD, and even though it’s hormone-based, I don’t have any of the negative side effects I experienced when I took the pill.” —Abby W.
“A friend of mine told me she used an IUD and loved it.”
“I got a copper IUD eight years ago, when I was 25. I’d previously been on the pill for a few years, but I noticed it was giving me terrible mood swings. My partner and I began using condoms, instead, but it just felt a little sterile—and there was always the concern that one might break. A friend of mine told me she used an IUD and loved it, so I made the switch!” —Emma S.
“I’d heard the hormonal IUD could make your periods much lighter.”
“I got my IUD my junior year of college, in November 2017. I’d previously taken the pill for a couple years on and off, and I also wasn’t on any kind of birth control for a while. I decided to make the switch because I’d heard the hormonal IUD could make your periods much lighter or go away completely for a number of years. This was important to me, because my period cramps were always very painful and disrupted my life. The hormonal IUD has been amazing for me. I have had no periods for almost three years, and now I get very light ones. The insertion was a bit painful, but it was very quick. Getting a hormonal IUD was one of the best decisions I ever made.” —Tash D.
*Responses have been edited and condensed for clarity.