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SMNTY Classics: IUDs FYI · Stuff Mom Never Told You

0:05
Speaker 1: Hey, this is Annie and Samantha.
0:06
Speaker 2: I'm welcome stuff I never told you, obrection if I
0:08
Speaker 2: hurried you. So this is another classic inspired by your
0:20
Speaker 2: recent episode about gynecology, Samantha, because you mentioned in there
0:25
Speaker 2: that they Kristen Caroline, the past host told your story
0:30
Speaker 2: about getting it. Yeah, yes, and so I was like,
0:34
Speaker 2: I wonder what episode.
0:35
Speaker 3: That one is.
0:38
Speaker 2: I yes, I found that episode about IUDs and I
0:42
Speaker 2: was like, must be this one, correct, So I thought,
0:48
Speaker 2: you know, why not bring that one back so people
0:51
Speaker 2: kill can check it out?
0:53
Speaker 3: Perfect?
0:53
Speaker 2: Perfect, Well, please enjoy this classic episode.
1:00
Speaker 1: Welcome to Stuff mom never told you from houstuffworks dot com. Hello,
1:09
Speaker 1: and welcome to the podcast. I'm Kristen and I'm Caroline.
1:13
Speaker 1: And today we're talking about larking at a lark. Yes,
1:19
Speaker 1: not to be confused with LARPing. Let's go larking. We're
1:23
Speaker 1: talking about long acting reversible contraceptioning to make larking work.
1:30
Speaker 3: Oh right, right right yeah, And you and I have
1:32
Speaker 3: been historically evangelists for our larks. Our IUDs are intruderine devices.
1:40
Speaker 1: Which I so often accidentally call either IEDs or UTI's,
1:47
Speaker 1: both of which get a look.
1:50
Speaker 3: Uh dude, roommate when his girlfriend was getting an IUD
1:54
Speaker 3: texted me to say that she was getting an IED
1:57
Speaker 3: and I laughed, and I laughed and I said, I
2:00
Speaker 3: I think you mean i u D. And he said,
2:02
Speaker 3: I think you're wrong. I think she's getting an IED.
2:06
Speaker 1: I really hope not. It's not gonna go Well. If
2:09
Speaker 1: it is, Yeah, intermittent explosive devices that they i stand for.
2:14
Speaker 3: You could argue that it would prevent pregnancy.
2:18
Speaker 1: That that is true. That's one way to go about it.
2:23
Speaker 1: But IUDs are not the only thing we're going to
2:25
Speaker 1: talk about in the first half of the podcast. Because
2:28
Speaker 1: IUDs are not the only form of a long acting,
2:32
Speaker 1: reversible contraception. We've also got to talk about the implant
2:37
Speaker 1: and IUDs and birth control. Implants are considered really the
2:42
Speaker 1: gold standard of birth control. And this is according to
2:46
Speaker 1: both the American College of Obstetricians and Gynecologists as well
2:52
Speaker 1: as the American Academy of Pediatrics. So doctor people, doctor
2:56
Speaker 1: people in the know, doctor people in the know for
2:59
Speaker 1: human people of all.
3:01
Speaker 3: Ages, right exactly. And it turns out, according to these
3:07
Speaker 3: doctor people in the know, that both iud's and implants
3:10
Speaker 3: are just as effective as sterilization. But of course, they
3:15
Speaker 3: are reversible and not invasive. I mean, one could argue
3:20
Speaker 3: that it does hurt to get an IUD sometimes depending
3:25
Speaker 3: but they're recommended as first line contraceptives.
3:29
Speaker 1: And since two thousand and two, IUD use among American
3:33
Speaker 1: women has quadrupled, And anecdotally I've noticed in the past
3:40
Speaker 1: maybe two or so years, similar to the mainstreaming of menstruation,
3:46
Speaker 1: kind of the mainstreaming of IUDs, everybody's talking about iud's.
3:51
Speaker 3: Oh, mainstreaming of menstruation. Is that what everybody on Twitter
3:54
Speaker 3: is talking about when they do hashtag MSM.
3:59
Speaker 1: Don't I win?
4:00
Speaker 3: Don't we wish? Yeah, it turns out that ten to
4:05
Speaker 3: eleven percent of US women who are on birth control
4:09
Speaker 3: use IUDs, which is up massively from just about one
4:13
Speaker 3: and a half percent in two thousand and two. And
4:16
Speaker 3: it is worth noting side note that forty percent of
4:19
Speaker 3: gynecologists who use contraceptives use.
4:23
Speaker 1: IUDs according to Vox, and over at the Goupmaker Institute,
4:27
Speaker 1: we learned that just one point three percent of American
4:32
Speaker 1: women who use birth control use the implant. So how
4:37
Speaker 1: do these magical devices and contraceptive potions work?
4:43
Speaker 3: Well, Okay, you go out during a supermoon. Uh huh,
4:46
Speaker 3: and you howl into the phone to your gynecologists and
4:51
Speaker 3: make an appointment to get one of these devices, which
4:55
Speaker 3: work extremely well. Now, a lot of people say, oh, well,
5:02
Speaker 3: surely they're not that different in their effectiveness from the pill.
5:05
Speaker 3: But you've got to keep in mind that we are
5:07
Speaker 3: all in perfect people, and when we use the pill
5:11
Speaker 3: or the neuver ring or the patch with typical use
5:14
Speaker 3: as opposed to perfect use, those three things have a
5:18
Speaker 3: nine percent failure right right, And the birth control shot
5:22
Speaker 3: has a six percent failure rate. In other words, that's
5:25
Speaker 3: how many people will still get pregnant despite using those methods.
5:29
Speaker 1: So with that in mind, let's hop into how IUDs work.
5:35
Speaker 1: So there are two main types of IUDs. First up,
5:39
Speaker 1: we've got the original, the old copper IUD brand named Paragard.
5:45
Speaker 1: It can last for up to twelve years twelve years,
5:50
Speaker 1: and this to me is the one that does seem
5:52
Speaker 1: like magic because there are no hormones involved. They just
5:56
Speaker 1: insert this T shaped little little piece of uh copper
6:01
Speaker 1: into your uterus. But what happens is it essentially bathes
6:06
Speaker 1: our uterine linings in copper ions that create and I'm
6:11
Speaker 1: not exaggerating here. It really creates a sperm killing force field,
6:18
Speaker 1: although you can't expect heavier periods. But in exchange for that,
6:23
Speaker 1: that force field creates just a point eight percent failure rate.
6:29
Speaker 3: I am hoping that it also has like that movie
6:32
Speaker 3: magic sound effect when you have like some kind of
6:34
Speaker 3: force field.
6:35
Speaker 1: Of wom you know, wom, woom woom. Are those the
6:39
Speaker 1: sperm running into the force field?
6:40
Speaker 3: Yeah, h for sure. I'm bumping their little heads and
6:43
Speaker 3: being like, never mind, guys, let's get out of here.
6:46
Speaker 1: This also reminds me of those uh you know, those
6:48
Speaker 1: metal bracelets that people wear that are sold like in
6:51
Speaker 1: the back of magazines.
6:52
Speaker 3: Yeah, but those don't do anything.
6:54
Speaker 1: I don't think that those create sperm force field.
6:56
Speaker 3: Now, a pair reguard copper IUD can last you three
7:00
Speaker 3: presidential terms. I don't know why I would say anything
7:04
Speaker 3: like that, but I'm just saying three presidential terms.
7:09
Speaker 1: Yeah, two Trump and one Pence. Dear God, I think
7:13
Speaker 1: my uterus just actually withered up and died. Next up,
7:18
Speaker 1: we have the hormonal IUDs, same type of device T shaped,
7:23
Speaker 1: T shaped, little little piece of plastic that goes into
7:27
Speaker 1: your uterus. Brand names include the Marina which I have
7:32
Speaker 1: so do I. It lasts five years. There's also on
7:36
Speaker 1: the market now, Skyla, which lasts three years. And I
7:41
Speaker 1: just learned there are two others called the Liletta and Kylina. Yeah,
7:47
Speaker 1: and y'all, Kyleina is spelled k y l e e
7:51
Speaker 1: n A. And I'm just saying that Kylie Jenner is
7:53
Speaker 1: really missing a branding opportunity here. So with these hormonal IUDs,
8:01
Speaker 1: they use a hormonal called levanagestrel that thickens your cervical mucus,
8:08
Speaker 1: which is really the first defense as sperm travel through
8:12
Speaker 1: the cervix on their way to the uterus. So they're like, okay,
8:15
Speaker 1: let's try they get things up, slow it down. And
8:19
Speaker 1: on top of that, it thins out the uterine lining,
8:22
Speaker 1: which makes it super hard for the sperm to travel
8:25
Speaker 1: to and should fertilization happen, for implanting then to then happen.
8:34
Speaker 1: And with those, unlike the copper IUD, you can expect
8:38
Speaker 1: lighter or in my case, TMI alert no periods. Yeah.
8:43
Speaker 3: I have actually had both of these, so I can
8:45
Speaker 3: speak to both of them. I started out with the scila.
8:48
Speaker 3: I was instructed or advised to get the Scyla because
8:51
Speaker 3: I am teens tiny inside and also have never given birth,
8:56
Speaker 3: and my gynecologist was like, the smaller one might be
9:00
Speaker 3: better for you. So I had that for three years
9:03
Speaker 3: and I still got a monthly period, but it was very,
9:06
Speaker 3: very light, very light. Now that I have the Marina,
9:10
Speaker 3: I no longer get a monthly period, which is awesome.
9:13
Speaker 3: I still do get PMS symptoms, my boobs get real
9:16
Speaker 3: big and sore.
9:18
Speaker 1: Hashtag humble brag, that's.
9:20
Speaker 3: Right, but yeah, but no period. It's awesome. And what's
9:25
Speaker 3: fabulous is you can really depend on these products. The
9:29
Speaker 3: Morena has a failure rate of just zero point two
9:32
Speaker 3: percent and the skyl Of failure rate is just point
9:36
Speaker 3: four percent.
9:37
Speaker 1: Now, let's quickly, though, take a mythbusting detour to clear
9:43
Speaker 1: up a little bit of misinformation, actually a lot of
9:45
Speaker 1: bit of misinformation that's out there about iud's because this
9:49
Speaker 1: is something anecdotally that I've run into in conversations with
9:53
Speaker 1: more conservative friends of mine in particular, and that I
9:56
Speaker 1: have a feeling a lot of listeners might have seen
9:59
Speaker 1: or heard or might just be worried about. IUDs are
10:03
Speaker 1: not abortifations, and this was something that came up in
10:08
Speaker 1: that Hobby Lobby birth control case that went to the
10:11
Speaker 1: Supreme Court. IU d's were one of the things that
10:16
Speaker 1: the hobby Lobby founders did not want to cover because
10:22
Speaker 1: of the misinformation, the fallacy that IUDs are essentially little
10:33
Speaker 1: abortion machines inside of us.
10:36
Speaker 3: Yeah, let's get something straight real quick. So, pregnancy is
10:39
Speaker 3: when a fertilized egg is implanted, right, But contraceptives prevent
10:44
Speaker 3: fertilization of an egg from happening, or they prevent the
10:48
Speaker 3: implantation of a fertilized egg, which therefore prevents pregnancy. And
10:54
Speaker 3: it turns out, and we talked about this on a
10:56
Speaker 3: long ago episode, the copper IUDs are actually a fabulous
11:00
Speaker 3: emergency contraceptive. Even when used up to five days after intercourse.
11:06
Speaker 3: Those copper IUDs can prevent fertilization and possibly implantation, but
11:11
Speaker 3: they do not disrupt implantation. Therefore, there is a difference there.
11:18
Speaker 3: There is a line between preventing a pregnancy and disrupting
11:23
Speaker 3: a pregnancy. So, like Kristen said, the idea that an IUD,
11:27
Speaker 3: whether it's hormonal or copper, can lead to abortion is
11:32
Speaker 3: again a complete fallacy.
11:34
Speaker 1: Yeah, and this information too is coming from the American
11:38
Speaker 1: College of Obstetricians and Gynecologists. We're not just We're not
11:42
Speaker 1: just reciting NSNBC headlines here, folks, hashtag msn I don't know,
11:47
Speaker 1: I'm trying to do a callback. So that's the situation
11:51
Speaker 1: with IUDs. We also got to shout out the implants.
11:57
Speaker 1: The brand names are implan On next plan On, and
12:02
Speaker 1: implants are really what they sound like. They are thin
12:07
Speaker 1: plastic match sticks sized progestin dispensers essentially, and progestin is
12:13
Speaker 1: a synthetic form of the hormone progesterone, and these little
12:18
Speaker 1: match sticks are implanted in your upper arm. They last
12:22
Speaker 1: up to four years, and they work by stopping ovulation
12:27
Speaker 1: and again thinning that cervical mucus.
12:31
Speaker 3: Yeah, and so when you use an implant, you can
12:33
Speaker 3: expect spotting in the first six months or a year,
12:37
Speaker 3: but one out of three women who have the implant
12:39
Speaker 3: stop having a period all together. And you know, as
12:42
Speaker 3: we've gone along, the failure rate has dropped and dropped
12:45
Speaker 3: and dropped to the point where now if you get
12:48
Speaker 3: an implant, the failure rate is just zero point zero
12:52
Speaker 3: five percent, which is fantastic.
12:54
Speaker 1: Yeah, I mean, it was a while back and I
12:57
Speaker 1: forget what exactly it was about iud's that you and
13:01
Speaker 1: I were raving about as we do on social media,
13:06
Speaker 1: and there were a few people who helpfully piped up saying, hey, hey,
13:09
Speaker 1: I d's are actually not the most effective, because in fact,
13:14
Speaker 1: it's implants, which I'm even after all the research we've
13:18
Speaker 1: done for this episode, I've walked away still not quite
13:22
Speaker 1: clear on why implants are as rare as they still
13:27
Speaker 1: are today. So if anyone has any intel on that,
13:31
Speaker 1: please give us a shout. And all of this might
13:35
Speaker 1: sound too good to be true, right, I mean, we're
13:38
Speaker 1: just putting these like little match sticks and a little
13:41
Speaker 1: T shaped what's not inside our bodies and our utes
13:45
Speaker 1: are on lockdown? Yeah, y'all, I mean, yeah, that is
13:50
Speaker 1: That is the delightful truth.
13:51
Speaker 3: Yeah, it's really not too good to be true, which
13:54
Speaker 3: warms my freaking heart because so often I feel like
13:57
Speaker 3: we talk about things that are But we're going to
14:01
Speaker 3: cite some research coming out of Colorado that would be
14:05
Speaker 3: fabulous to send to people in your family who perhaps
14:09
Speaker 3: might have quibbles with either birth control itself or contraception
14:14
Speaker 3: and providing it to teens, or the issue of having
14:18
Speaker 3: birth control and contraceptives paid for. And we're going to
14:21
Speaker 3: have all of these sources over at stuffmon've never told
14:23
Speaker 3: you dot com on our source post for this episode,
14:26
Speaker 3: so you can, you know, send those links onto your family.
14:31
Speaker 1: So what happened in Colorado is a number of years back,
14:35
Speaker 1: they received a substantial private grant to fund a program
14:40
Speaker 1: which they launched offering low income teens and young women
14:44
Speaker 1: free IUDs. And what happened is that due to this program,
14:51
Speaker 1: between two thousand and nine and twenty thirteen, Colorado's teen
14:56
Speaker 1: pregnancy rate dropped forty person And also this is important
15:02
Speaker 1: to underline for conservative family members as well, people who
15:09
Speaker 1: are opposed to abortion in general. In addition to the
15:13
Speaker 1: teen pregnancy rate dropping forty percent, literally plummeting, the abortion
15:19
Speaker 1: rate also dropped forty two percent. And in addition to that,
15:24
Speaker 1: people who are not too keen on taxpayer dollars going
15:29
Speaker 1: to subsidize single motherhood food stamp enrollment also dropped by
15:35
Speaker 1: around twenty five percent between twenty ten and twenty thirteen.
15:40
Speaker 1: And that's just looking at the teen pregnancy rate. Pretty
15:44
Speaker 1: Much the same thing happened for single women under twenty
15:47
Speaker 1: five who hadn't completed high school who also qualified for
15:51
Speaker 1: this free IUD program. And money wise, do you understand
15:59
Speaker 1: the impact back onto taxpayers. Each dollar a state health
16:06
Speaker 1: department spends on long acting birth control IUDs or implants
16:12
Speaker 1: translates to five dollars and eighty five cents of Medicaid savings,
16:17
Speaker 1: and Medicaid covers seventy five percent of teen berths. And
16:21
Speaker 1: these are a lot of percentages and numbers that have
16:23
Speaker 1: all tossed out, but TLDR, these IUDs literally changed these
16:30
Speaker 1: young women's lives because the highest teen pregnancy rates were
16:35
Speaker 1: in the lowest income communities, as is often the case,
16:40
Speaker 1: not just in Colorado but across the United States. And
16:43
Speaker 1: the New York Times talked to one woman in particular,
16:46
Speaker 1: who I believe she was one of the women who
16:50
Speaker 1: was under twenty five and hadn't completed high school, and
16:55
Speaker 1: she talked about how due too being able to set
16:58
Speaker 1: and forget this contraception, it allowed her to really set
17:05
Speaker 1: up the life that she wanted for herself, you know,
17:08
Speaker 1: coming out of very disenfranchised circumstances. So Colorado has been
17:14
Speaker 1: a standout example of the power of these long acting
17:20
Speaker 1: reversible contraceptives because by the way, that forty percent drop
17:24
Speaker 1: in teen pregnancy rate is far and away faster than
17:28
Speaker 1: any other states drop in teen pregnancies. Sounds great.
17:33
Speaker 3: I mean, how could anyone not support this?
17:37
Speaker 1: Because people get squeamish when it comes to young women
17:43
Speaker 1: and the government subsidizing birth control, Republicans often aren't fans
17:51
Speaker 1: of it.
17:52
Speaker 3: So yeah, and so this is according to an article
17:55
Speaker 3: about this from Colorado's in PR station. Despite the success
18:00
Speaker 3: of this program, when that private grant money began to
18:03
Speaker 3: run out, the state's GOP ended up blocking a bill
18:08
Speaker 3: to pay for the program with tax money, but they
18:12
Speaker 3: were able to push through two point five million dollars
18:16
Speaker 3: in the state budget for it.
18:18
Speaker 1: Yeah, and I'm just curious to know from the foundation
18:22
Speaker 1: that delivered that first substantial grant that got the program
18:26
Speaker 1: off the ground, if it's possible that this can happen
18:30
Speaker 1: in other places. But again, this is just a real
18:35
Speaker 1: world example of how these things can really work and
18:38
Speaker 1: not just work for you know, college educated, employed, middle
18:43
Speaker 1: class white ladies like you and me, Caroline. But y'all,
18:49
Speaker 1: it's not all candy and roses. I don't actually know
18:53
Speaker 1: that any of it is candy and roses. Although you
18:56
Speaker 1: your IUD doesn't get you roses, no, just carnations. But
19:03
Speaker 1: as a lot of people listening who are probably yelling
19:08
Speaker 1: at their phone or however they're listening to this podcast
19:11
Speaker 1: right now, all is not perfect when it comes to
19:14
Speaker 1: iud's and implants because every body is different, and we're
19:20
Speaker 1: going to get into some of those not so fun
19:21
Speaker 1: facts when we come right back from a quick break.
19:37
Speaker 3: Yeah, okay, so you might imagine that when you are
19:41
Speaker 3: inserting something, inserting birth control into your body, whether it
19:44
Speaker 3: is an IUD into your uterus or an implant into
19:48
Speaker 3: your arm, it's not the same as just popping a
19:51
Speaker 3: birth control pill or wearing a patch. These things can hurt,
19:57
Speaker 3: but we've got to get you the rundown right of
19:59
Speaker 3: what happens when you're getting them. So when it comes
20:01
Speaker 3: to an implant, uh, you get an area on your
20:04
Speaker 3: upper arm numbed, and then the insertion is basically like
20:08
Speaker 3: getting a really big shot, she says, casually, pretending as
20:14
Speaker 3: though she does not pass out when she gets shots.
20:17
Speaker 3: And the insertion, though, is generally faster and anecdotally a
20:22
Speaker 3: little less painful than getting it removed, because getting it
20:25
Speaker 3: removed involves an incision to remove it from underneath your skin. Now,
20:30
Speaker 3: that's pretty straightforward. And it's not that IUD insertion and
20:33
Speaker 3: removal is not straightforward. There's just several more steps when
20:37
Speaker 3: it comes to an IUD.
20:38
Speaker 1: Yeah, because instead of putting it in your arm, you
20:40
Speaker 1: gotta get all the way up to your ute. So,
20:44
Speaker 1: and yes, ute is my preferred term for uterus, because
20:48
Speaker 1: why not. So the way that IUDs get inside of
20:54
Speaker 1: us is Unfortunately, it wouldn't be cool if we could
20:56
Speaker 1: like swallow them and they're just like, no, no, no, I'm
20:59
Speaker 1: in your uterus. Nope, that's not how our bodies work.
21:02
Speaker 1: So gynecologists, well, first you gotta go. You gotta get
21:06
Speaker 1: in the stirrups, all right, So you're in the stirrups.
21:08
Speaker 3: You're on a horse.
21:09
Speaker 1: You're on a horse. You gotta find some stables. No, really,
21:14
Speaker 1: you're in the gynecologist room. You're in your stirrups, and
21:20
Speaker 1: the gynecologist is going to use something called a tenaculum
21:23
Speaker 1: clamp to straighten your cervical canal. And they describe the
21:29
Speaker 1: discomfort with this as a pinch. Yeah, Caroline's laughing, because
21:36
Speaker 1: it is quite a pinch. Okay, it's it's quite a pinch.
21:39
Speaker 1: Think about think about a pap smear. They're not comfortable. Now,
21:44
Speaker 1: double or triple a pap smear. You're getting close. So
21:48
Speaker 1: after they straighten your cervical canal, they do something called
21:53
Speaker 1: sounding the uterus, which is a term brand new now
22:00
Speaker 1: to Caroline and me, and sounding the ute is our
22:03
Speaker 1: new battle cry.
22:04
Speaker 3: Yeah, imagine me with a conk shell, but it's actually
22:06
Speaker 3: a uterus.
22:08
Speaker 1: Whenever you want to gather nasty women everywhere, you sound
22:13
Speaker 1: the ute. Actually sounding the uterus, though, is when the
22:17
Speaker 1: doctor inserts a straw sized rod into the uterus to
22:21
Speaker 1: measure its size and angle. And this is really good
22:24
Speaker 1: because they got to figure out the right size for
22:28
Speaker 1: the right sized iu D and the right place to
22:31
Speaker 1: put it so it stays in place, et cetera, et cetera.
22:35
Speaker 1: So so that's how sounding the uterus works. Not to
22:38
Speaker 1: be confused with our battle cry of sounding the ute.
22:41
Speaker 3: Oh okay, well, uh so then your doctor will remove
22:46
Speaker 3: the measuring rod and pop in another rod that actually
22:49
Speaker 3: contains the IUD. Christens making a face, girl, I know,
22:53
Speaker 3: and it's because of.
22:53
Speaker 1: Pop in I think, just popping it in.
22:56
Speaker 3: Hey, hey, guys, just popping in there. Just popping in
22:59
Speaker 3: with I'm Skyla good In Metscha or Kylina. You can't
23:04
Speaker 3: talk right now, okay, okay, no, because I'm screaming. We're
23:09
Speaker 3: scaring people. We'll give you the low down here in
23:11
Speaker 3: just a second. But so that that second rod comes
23:13
Speaker 3: on up and it has the IUD in it, and
23:16
Speaker 3: the doc positions it in your cervix, sticks it in there,
23:22
Speaker 3: and it's hanging out like the kitten in the hang
23:25
Speaker 3: in there poster in the bottom of your uterus, right
23:30
Speaker 3: at your cervix.
23:31
Speaker 1: Just but it does not feel like claws or inside
23:34
Speaker 1: inside of you. You don't once it's in there.
23:37
Speaker 3: No, yeah, no, no, and and it does it does
23:40
Speaker 3: hurt there. There is a lucky minority for whom this
23:45
Speaker 3: procedure feels like nothing more than a perhap smear followed
23:48
Speaker 3: by some minstrel cramps. Uh. My friend Samantha is one.
23:52
Speaker 1: Of those people.
23:53
Speaker 3: She uh literally went running the same day, went back
23:57
Speaker 3: to work. Yeah, A Christen's making a face.
23:59
Speaker 1: Do I know?
24:01
Speaker 3: Samantha has always had incredibly severe menstrual cramps. She is
24:07
Speaker 3: used to a higher degree of pain than that with
24:10
Speaker 3: which I was accustomed, and so I warned her about
24:13
Speaker 3: the horrific pain that I went through, and she proceeded
24:16
Speaker 3: to make fun of me, probably for about the next
24:18
Speaker 3: year or so. For the middle group of people, it's
24:24
Speaker 3: a moderately painful, yeah, not really painful process.
24:27
Speaker 1: That's most of us. For most people, it's going to
24:29
Speaker 1: be moderately painful.
24:30
Speaker 3: For the rest of us, including your friend Caroline Irvine here,
24:33
Speaker 3: it is severely painful. I absolutely don't want to discourage
24:39
Speaker 3: anyone from getting this procedure done. I think it's important
24:43
Speaker 3: to have really effective birth control, and iud's are incredibly effective,
24:47
Speaker 3: as we have already laid out for you. That being said,
24:50
Speaker 3: I was not one of the lucky ones who had
24:52
Speaker 3: low to moderate pain. I was one of the ones
24:54
Speaker 3: who literally tasted color. I developed apparently circumstantial sinis desia
25:00
Speaker 3: during the procedure. It hurts so badly I threw up.
25:03
Speaker 3: I almost passed out. I made the bad mistake of
25:06
Speaker 3: taking no pain medicine, not even like a tile in all,
25:12
Speaker 3: and it was a nightmare. But the thing is, like
25:14
Speaker 3: they give you the night before you take a medicine
25:18
Speaker 3: that dilates your cervix so that your cervix is open
25:21
Speaker 3: so they can more easily stick the ID in. Then
25:24
Speaker 3: ideally you will take some type of pain medication, and
25:27
Speaker 3: if you are highly, highly anxious or scared, they might
25:31
Speaker 3: prescribe you like a low dose of valume or something
25:33
Speaker 3: along those lines. I will say, and I think this
25:37
Speaker 3: is important to say because I just told this to
25:39
Speaker 3: a friend and colleague the other day, and this is
25:42
Speaker 3: what convinced her after all this time of being afraid
25:44
Speaker 3: to go get this procedure done. When I went to
25:48
Speaker 3: have my Skyla removed so that I could get my morina,
25:53
Speaker 3: the removal felt like nothing.
25:55
Speaker 1: I mean it did.
25:56
Speaker 3: It felt like a pap smear. It was uncomfortable, but
25:59
Speaker 3: not bad. And the insertion of the marina was a
26:03
Speaker 3: little bit more uncomfortable than a perhaps mirror, but I
26:07
Speaker 3: wasn't I didn't taste color. We'll just say that it was.
26:10
Speaker 3: It was really fine. And I don't know if that's
26:12
Speaker 3: because my cervix was like, oh, hey, you, we've seen
26:15
Speaker 3: your kind here before, or if maybe my tail and
26:20
Speaker 3: all was really kicking in that day. But I think
26:24
Speaker 3: it's important to acknowledge that, yes, this can be a
26:26
Speaker 3: very painful procedure. It is very helpful to have someone
26:29
Speaker 3: a partner, a friend, a parent, someone go with you
26:32
Speaker 3: in case you do need to be driven home. But
26:35
Speaker 3: I just really want to hammer home that I don't
26:38
Speaker 3: want you to avoid this procedure just because your pal
26:41
Speaker 3: Caroline throughout the first time.
26:44
Speaker 1: Yeah, And if you're nervous about pain and have a
26:47
Speaker 1: low pain tolerance, just tell your doctor and uh, they'll
26:50
Speaker 1: prescribe you something. And if anything, definitely take the they're
26:54
Speaker 1: gonna prescribe you probably regardless, like the horsepill, ibuprofen. Yeah,
26:59
Speaker 1: so just take that. And even if you don't have
27:01
Speaker 1: someone who can drive you, I survive both times driving myself,
27:07
Speaker 1: so we can do it. Because also the great thing
27:10
Speaker 1: is it is discomfort for I mean in the rest
27:14
Speaker 1: of the day you're crampy, But then you have birth
27:17
Speaker 1: control for five years if you have the marina, which.
27:20
Speaker 3: Is a presidential term plus a year.
27:23
Speaker 1: Yes, which is good, which is good to know. I
27:27
Speaker 1: think my marina right now, I'm on my second one
27:30
Speaker 1: and it should last me right up through the end
27:34
Speaker 1: of Trump. So happy for that. We also don't need
27:38
Speaker 1: to talk about possible side effects after you get this
27:44
Speaker 1: thing implanted, whether it's the IUD or the implant. And
27:49
Speaker 1: this info is coming from Planned Parenthood Vox and again
27:54
Speaker 1: the American College of Obstetricians and Gynecologists. So typically with
27:58
Speaker 1: iud's the main side effects you're going to have are
28:02
Speaker 1: some unpredictable menstrual spotting and bleeding. At first, I experienced this.
28:09
Speaker 1: I'll just leave it at that. You may also experience headaches, nausea, depression,
28:16
Speaker 1: and breast tenderness. Speaking to the depression aspects, IUDs were
28:22
Speaker 1: implicated in a recent study that went viral about birth
28:26
Speaker 1: control and female mental health, and it was particularly like
28:33
Speaker 1: strongly correlated to women getting IUDs and then later getting
28:39
Speaker 1: on antidepressants. Again, there's some correlation causation issue there, but
28:43
Speaker 1: just something to keep in mind if you struggle with
28:47
Speaker 1: mental health that it's just something again to just talk
28:49
Speaker 1: to your doctor about. Right.
28:50
Speaker 3: And again, personal experience. Obviously my experience is not everyone's.
28:54
Speaker 3: But I had been on the pill specifically yaz or
28:58
Speaker 3: Yasmin for you years, about a decade before I went
29:01
Speaker 3: on an IUD, and I never had never, never had
29:06
Speaker 3: PMS with the pill, and I now on an ID,
29:09
Speaker 3: I do get PMS, and that's again that's not going
29:12
Speaker 3: to be the same for everyone. But I noticed that
29:14
Speaker 3: that was something that changed for me. So things on
29:16
Speaker 3: an IUD versus the pill versus no birth control whatsoever,
29:21
Speaker 3: they're not necessarily going to be the same.
29:23
Speaker 1: And with implants, the major side effects sited include change
29:28
Speaker 1: in sex drive. You might see a discoloring or scarring
29:32
Speaker 1: of the skin over the implant site. You may also
29:35
Speaker 1: experience headache, infections, or pain in the arm, although that's
29:38
Speaker 1: very rare, nausea, sore breasts, weight gain. I mean, honestly,
29:43
Speaker 1: these are side effects that you see with a lot
29:46
Speaker 1: of hormonal birth controls. And there are some worst case
29:51
Speaker 1: scenarios though that I know, some stuff Mom never told
29:54
Speaker 1: you listeners have experienced because you all have told us
29:57
Speaker 1: about them, specifically IUD expulsion. And this is probably the
30:02
Speaker 1: most common scary story that you hear when you're, you know,
30:07
Speaker 1: talking two friends about iud's because for about three to
30:12
Speaker 1: five percent of people who get them in the first year,
30:17
Speaker 1: your uterus might be like ha, now girl, Kylie, go
30:23
Speaker 1: back to to Cabo. You know, they don't live in Cabo.
30:26
Speaker 1: Calabases calabases. I know that, and I'm ashamed of that,
30:30
Speaker 1: but that's likely because the gynecologists didn't insert it correctly.
30:35
Speaker 1: If you're concerned about this though, watch out for cramping
30:40
Speaker 1: because that that might be a sign that your your
30:43
Speaker 1: uterus is not happy, and they're also in much rarer
30:48
Speaker 1: cases perforations that can happen. Your IUD can actually puncture
30:53
Speaker 1: your uterine wall, which could potentially harm your bladder and
30:57
Speaker 1: intestine and if left untreated, lead to hemorrhaging and sepsis.
31:02
Speaker 1: But that sounds awful, it is awful, Take heart, It
31:05
Speaker 1: is very very very rare. It is about zero point
31:10
Speaker 1: one percent expulsion rate chance with.
31:13
Speaker 3: That, and these are just more even more reason to
31:18
Speaker 3: make sure that you stick to your follow up appointment.
31:21
Speaker 3: Usually your gynecologist will request that you come in about
31:24
Speaker 3: a month after the fact to just make sure that
31:27
Speaker 3: everything is where he or she left it. Basically, that's
31:31
Speaker 3: how my doctor put it. Another worst case scenario involves
31:36
Speaker 3: a slightly elevated risk of pelvic inflammatory disease in the
31:40
Speaker 3: first twenty days after you get your IUD inserted, and
31:44
Speaker 3: when it comes to implants, incorrect insertion can cause discomfort
31:49
Speaker 3: and ineffectiveness, and in the very very very super rare
31:53
Speaker 3: case of pregnancy with one of these long acting reversible contraceptives,
31:59
Speaker 3: you do have an element risk of ectopic pregnancy. When
32:02
Speaker 3: I put the call out on Twitter to let people
32:04
Speaker 3: know that we were going to be talking about this
32:06
Speaker 3: and they were welcome to send us their questions, their concerns,
32:09
Speaker 3: we did have one listener who said, yes, I was
32:12
Speaker 3: one of those people who had to endure an ectopic pregnancy.
32:17
Speaker 3: So the risk is there, and again it is very small.
32:21
Speaker 1: Now in terms of who shouldn't get one of these,
32:25
Speaker 1: especially for iud's people with untreated STIs, no, because insertion
32:32
Speaker 1: can promote pelvic infection. Also, a good gynecologist is probably
32:38
Speaker 1: going to make sure that you're tested before going anywhere
32:41
Speaker 1: near insertion. Speaking of pelvic infection, not surprisingly if you
32:45
Speaker 1: have a recent history with those not going to be
32:48
Speaker 1: a good idea. People with untreated cervical or uterine cancers,
32:51
Speaker 1: and with the implants, people with breast cancer are advised
32:55
Speaker 1: against getting them. And speaking of STIs, it is worth
33:01
Speaker 1: emphasizing that even though it these these wonderful things dramatically
33:08
Speaker 1: reduce our chances of getting pregnant, they do nothing to
33:10
Speaker 1: reduce your chance of contracting st I. So you know,
33:16
Speaker 1: don't throw away your condoms folks. And we should also
33:19
Speaker 1: mention when it comes to having sex with IUDs that
33:24
Speaker 1: at the bottom of these little T shaped devices there
33:27
Speaker 1: are some strings that hang down, just a little tiny strings,
33:30
Speaker 1: And if your sexual partner is like I think I
33:35
Speaker 1: can feel the string, that's probably okay. It's it's not
33:39
Speaker 1: terribly surprising, especially for digital penetration. But you might also
33:45
Speaker 1: want to monitor your string because if you can't feel
33:49
Speaker 1: them at all, because you can actually yourself reach up
33:55
Speaker 1: and probably feel them, and if you can't feel them
33:57
Speaker 1: at all after the first few months, you might just
33:59
Speaker 1: want to call your doctor to see if you need
34:01
Speaker 1: to come in, just to ensure that it hasn't been
34:04
Speaker 1: knocked out of place or that it's been expelled. I've
34:07
Speaker 1: actually called my doctor before because a partner way back
34:12
Speaker 1: when was concerned about feeling the strings, and it was fine.
34:17
Speaker 1: It was totally fine. You know, just always pick up
34:19
Speaker 1: the call, pick up the call and phone your nurse practitioner. Perfect.
34:26
Speaker 1: So now we know what these things are today and
34:29
Speaker 1: how they work and how effective they are, it's time
34:34
Speaker 1: to get into the more fascinating story of how they
34:38
Speaker 1: came to be. And we're going to do that when
34:41
Speaker 1: we come right back from a quick.
34:42
Speaker 3: Break and as we get into this history of the IUD, specifically,
35:01
Speaker 3: we want to go ahead and give a shout out
35:03
Speaker 3: to Chikako Takashida, whose dissertation Negotiating Acceptability of the IUD,
35:09
Speaker 3: Contraceptive Technology, Women's Bodies and Reproductive Politics is a major source.
35:15
Speaker 3: It's a very well, as you might imagine, it's a
35:17
Speaker 3: very in depth dissertation. Does that even need to be said?
35:19
Speaker 3: It's full of Chuck's chock full of great information.
35:22
Speaker 1: Good job.
35:24
Speaker 3: But basically, iud's have been around for a really long time.
35:28
Speaker 3: But as we kind of touched on at the top
35:31
Speaker 3: of the podcast, American women are really just now coming
35:35
Speaker 3: around to it. It's much more common overseas in Europe
35:40
Speaker 3: than it is here, and a lot of that has
35:42
Speaker 3: to do with some horror stories that we have and
35:48
Speaker 3: some terrible things that we endured in the nineteen seventies
35:53
Speaker 3: thanks to this thing called the Dalkon shield. You also
35:57
Speaker 3: have issues in the way, hurdles like in shurance not
36:00
Speaker 3: covering this device, which can be four hundred dollars or more,
36:04
Speaker 3: and just general lack of awareness. I mean, I spoke
36:06
Speaker 3: with some friends after I got my IUD inserted who
36:09
Speaker 3: were still under the impression that IUDs were as dangerous
36:14
Speaker 3: as the Delcon shield was back mid century. And so
36:17
Speaker 3: we will get to that, but let's take a trip
36:21
Speaker 3: down IUD memory lane first.
36:23
Speaker 1: Yeah, so just important to note Europeans, by no means
36:29
Speaker 1: the first folks to figure out that that putting a
36:31
Speaker 1: physical barrier between your vaginal canal and your uterus can
36:36
Speaker 1: prevent pregnancy. Since ancient civilization, we have used pessories, we
36:43
Speaker 1: have used cervical caps, we have used all sorts of
36:47
Speaker 1: things similar to iud's with a similar kind of strategy
36:52
Speaker 1: in mind of really blocking the sperm from reaching dim eggs.
36:59
Speaker 1: But in the late nineteen twenties, even though a doctor
37:03
Speaker 1: in Japan tenray Ota was doing the exact same kind
37:07
Speaker 1: of research and development at the exact same time, German
37:11
Speaker 1: Ernst Grafenberg, he of g spot fame.
37:14
Speaker 3: Yeah, I always forget that, even though we talked about
37:16
Speaker 3: him extensively in our Clitteracy episode.
37:18
Speaker 1: Oll Ernst. So doctor Ernst is a doctor g cited
37:24
Speaker 1: as the inventor of the modern IUD, and his was
37:28
Speaker 1: a small ring made of silkworm gut and coiled silver
37:33
Speaker 1: that was inserted into the uterus and the cultural climate
37:37
Speaker 1: in Germany was perfect for Graefenberg to get his proto
37:46
Speaker 1: IUD on the map because a sex reform movement was afoot,
37:50
Speaker 1: and he presented as a male doctor his device as
37:56
Speaker 1: scientific hashtag credibility.
38:03
Speaker 3: But they weren't very effective and they cause a lot
38:06
Speaker 3: of infections. Turns out silkworm gut not perfect. And once
38:12
Speaker 3: we get into the nineteen sixties, interest in iud's is
38:18
Speaker 3: reignited thanks to the Population Council, which had been established
38:22
Speaker 3: in nineteen fifty two, and they do remain the number
38:26
Speaker 3: one developer of IUD and Lark technology. They were actually
38:31
Speaker 3: initially looking for a pregnancy vaccine and considered the pill
38:36
Speaker 3: too expensive and user dependent, but there are layers there
38:42
Speaker 3: to that idea of it being too user dependent.
38:45
Speaker 1: Yeah, so essentially what's happening are mostly a lot of
38:49
Speaker 1: white dudes making a lot of classist and racist assumptions
38:54
Speaker 1: about how poor women, especially women of color, both in
38:57
Speaker 1: the United States and in developing countries, simply not be
39:00
Speaker 1: trusted with their own reproductive health. So they are more
39:05
Speaker 1: fans of the set it and forget it type of contraception.
39:10
Speaker 1: And I didn't do much deep digging on the population Council.
39:16
Speaker 1: But in general they I mean, their name kind of
39:18
Speaker 1: says it all. Really they are, I want to say,
39:21
Speaker 1: an NGO still around whose mission is population control, you know,
39:30
Speaker 1: and especially focusing in on developing countries and low income areas.
39:38
Speaker 1: This does start to intersect, especially around this time, with
39:42
Speaker 1: eugenicis philosophy, and again just a lot of classism and racism.
39:48
Speaker 1: But nonetheless they were the pioneers, the scientific pioneers of
39:52
Speaker 1: the IUD, and in nineteen sixty two they hosted the
39:56
Speaker 1: first international conference on the IUD.
40:00
Speaker 3: I bet they had great swag, all the goodie bags
40:03
Speaker 3: full of silkworm gut. How do I get through all
40:07
Speaker 3: what's at the bottom.
40:09
Speaker 1: It's just cigars, because it's just all it's all dudes. Really,
40:13
Speaker 1: I mean, like in this paper at least, I only
40:15
Speaker 1: read about dudes doing this scientific research. And that's like
40:19
Speaker 1: another little question mark in my brain of you know,
40:25
Speaker 1: what what is what is really? What is really the intent?
40:29
Speaker 1: But anyway we'll get we'll get into the more feminist
40:33
Speaker 1: lens that people have looked at this R and D
40:36
Speaker 1: through in just a second.
40:37
Speaker 3: Yeah, but a question mark was one was not one
40:41
Speaker 3: of the shapes of early IUDs, but there were several others.
40:46
Speaker 3: Early iu d's were rings, bows, loops, coils. All of
40:50
Speaker 3: these different shapes were patented. And you even had this
40:54
Speaker 3: crazy straw looking thing, this loop, that became the go to.
40:58
Speaker 1: Yeah, the lip is became what they thought was going
41:03
Speaker 1: to be the key to population control in developing nations
41:08
Speaker 1: in particular. And listeners, imagine your head. How the IUD
41:13
Speaker 1: today is very small, It's t shaped. The lip is
41:20
Speaker 1: loop is just this zigzag back and forth and back
41:24
Speaker 1: and forth.
41:25
Speaker 3: That looks it's really there to confuse the sperm more
41:28
Speaker 3: than anything.
41:29
Speaker 1: You think, So it just it looks incredibly painful. But
41:35
Speaker 1: and I'm so glad that it is not the current design.
41:39
Speaker 1: In nineteen sixty nine, though, Population Council affiliated Chilean scientist
41:45
Speaker 1: Jack Zipper, who has the best name of this podcast
41:48
Speaker 1: so far, Jack the Zipper, Jack the Zipper Hold. Jack
41:51
Speaker 1: the Zipper discovers the anti fertility effects of copper. He
41:57
Speaker 1: was doing some research on fertility in rabbits and realizes, hmm,
42:01
Speaker 1: this copper is a really effective contraceptive. Hello, proto parreguard
42:07
Speaker 1: copper IUD.
42:08
Speaker 3: Woom, that's the force field again.
42:10
Speaker 1: The sperm forest field.
42:12
Speaker 3: Yeah, but when you hit the nineteen seventies and eighties,
42:17
Speaker 3: there's a bit of a drop off because of the
42:21
Speaker 3: nightmare that was the Dalkon Shield disaster. So this scary
42:26
Speaker 3: looking thing which can look like a cartoon eye with eyelashes.
42:32
Speaker 3: It can also look like a bacterium or some kind
42:35
Speaker 3: of fishing lure, depending on which way you hold it.
42:40
Speaker 3: It was used by nearly three million women, and not
42:45
Speaker 3: only did it sometimes fail to prevent pregnancy, but it
42:48
Speaker 3: injured about two hundred thousand women. It caused infertility, and
42:53
Speaker 3: fifteen women died.
42:56
Speaker 1: Fifteen women died in the process of miscarriage because of
43:00
Speaker 1: this Dalkon shield. And the thing is I had known
43:03
Speaker 1: about the Dalcon shield by name for years, but researching
43:06
Speaker 1: for this episode was the first time I actually saw it.
43:09
Speaker 1: And seeing is believing. Y'all google Dalcon Shield d A
43:14
Speaker 1: L K O N because how ugh it It just
43:20
Speaker 1: looks very It just looks very painful because there are
43:23
Speaker 1: these little like protrusions off of it, and it just
43:26
Speaker 1: looks like it would cut you up. But surprisingly, it
43:30
Speaker 1: wasn't this frightening looking evil eye design that caused all
43:35
Speaker 1: the problems, but likelier, the thread that served as just
43:42
Speaker 1: a bacterial infection canal, instigating all of these pelvic infections
43:47
Speaker 1: that led to so many problems as a result, especially
43:52
Speaker 1: in the eighties, as the company that released the Dalcon
43:57
Speaker 1: shield was just flooded with lawsuits and Sheer company is
44:00
Speaker 1: just moonwalk away. They're like, nope, we are out of
44:04
Speaker 1: the IUD game. But that's the US.
44:09
Speaker 3: Yeah, overseas, same game was not happening. China, for instance,
44:16
Speaker 3: in nineteen seventy nine establishes its one child policy, So
44:19
Speaker 3: basically the propaganda and the policies that were being pushed
44:22
Speaker 3: were like, hey, you've had one child, go with an IUD.
44:25
Speaker 3: Oh hey, you've had to be sterilized.
44:29
Speaker 1: So that's that right. But there was, you know, as
44:33
Speaker 1: all of this Dalkon shield nightmare was happening in the US,
44:38
Speaker 1: China was definitely on the forefront of developing the IUD,
44:43
Speaker 1: which in nineteen seventy nine, when the program was kicked off,
44:48
Speaker 1: they had gone to the Population Council and had been like, hey,
44:51
Speaker 1: what are y'all working on? We need something? Oh yeah,
44:54
Speaker 1: this IUD thing. So it was fascinating to see how
44:57
Speaker 1: all of this globally is starting to weave together back
45:03
Speaker 1: to the United States. In nineteen eighty eight, after a
45:06
Speaker 1: couple years where IUDs were nowhere to be found in
45:10
Speaker 1: the US, the Paraguard the copper IUD was made available
45:14
Speaker 1: to American uteruses once again, and in the nineties the
45:19
Speaker 1: Marina which Caroline and I have was developed in Europe
45:24
Speaker 1: and became super popular quite quickly. Twenty three percent of
45:28
Speaker 1: French women on birth control today, for instance, use IUDs.
45:32
Speaker 1: Twenty seven percent of Norwegian women on birth control use IUDs.
45:37
Speaker 1: All of this to say that IUD use in the
45:40
Speaker 1: US at what ten eleven percent right now is still
45:44
Speaker 1: so much lower than use abroad.
45:48
Speaker 3: Well, yeah, and I mean the FDA was watching for
45:50
Speaker 3: about a decade what was happening in Europe, essentially making
45:53
Speaker 3: sure that there was not going to be another Delcon
45:55
Speaker 3: shield nightmare of death and injury and unexpected regnancy. And
46:01
Speaker 3: so I was actually ignorant of that fact that the
46:07
Speaker 3: Marina and it's like weren't even available until the new millennium.
46:13
Speaker 3: I kind of just had thought that they had been
46:16
Speaker 3: around for and they have been around for longer, but
46:18
Speaker 3: I mean available especially with insurance.
46:21
Speaker 1: Yeah, I mean, and for a while too, even when
46:23
Speaker 1: they were made available again, most doctors wouldn't allow women
46:27
Speaker 1: who had been pregnant before to use them. They were
46:31
Speaker 1: all sorts of concerns, understandably, you know, because fifteen women
46:35
Speaker 1: died hello, But there were a lot of concerns around
46:40
Speaker 1: whether they were truly safe. And it turns out yes
46:43
Speaker 1: they are. But interestingly, as we learned from a Time
46:46
Speaker 1: magazine piece, when the Marina was first marketed in the US,
46:50
Speaker 1: it was targeted at moms, basically being like, we know,
46:54
Speaker 1: y'all don't have time to take a pill every day,
46:57
Speaker 1: you're busy with your kids.
46:59
Speaker 3: Well well yeah, I mean there is that side of
47:01
Speaker 3: it of like you don't have time to worry about
47:04
Speaker 3: your birth control. But there's also the side of like,
47:06
Speaker 3: we are specifically marketing to moms over single women. We
47:10
Speaker 3: don't want to promote this birth control to single women
47:16
Speaker 3: and have people just willing nilly ditch condoms, for instance,
47:20
Speaker 3: or think that they can just have unproductive sex forever.
47:23
Speaker 1: Unproductive sex. Unproductive sex, yeah, as in not having kids sex.
47:29
Speaker 1: But that's the case today, I mean, thankfully, Like are
47:32
Speaker 1: people are all about id's and I wonder if that
47:35
Speaker 1: is at all correlated to like the growing population of
47:40
Speaker 1: female obgyns, just just a thought. If anyone knows, let
47:46
Speaker 1: me know. So, what's not to love about all of
47:51
Speaker 1: this technology? Well, there are some feminist scholars who have
47:56
Speaker 1: interpreted their development and use, particularly as it relates to
48:01
Speaker 1: the Population Council and their implementation in developing countries and
48:07
Speaker 1: promotion among poor women in particular, as coercive and even violent.
48:14
Speaker 3: Yeah, we read a lot in the dissertation about sort
48:19
Speaker 3: of this history of forcing women to be either sterilized
48:24
Speaker 3: or to have some type of contraceptive to limit expanding families.
48:30
Speaker 3: Whereas here in the West we tend to view it
48:32
Speaker 3: as a way to control our lives. In a lot
48:36
Speaker 3: of countries, regions like Indonesia or India, it's viewed more
48:41
Speaker 3: as almost punishment, as a way to control women.
48:45
Speaker 1: Well China, hellow, I mean that's like state propaganda right there.
48:50
Speaker 1: I mean they refer to it as state imposed fertility control,
48:54
Speaker 1: where it's not you know, white women like jumping up
49:00
Speaker 1: in the air choosing our choice, but rather the government
49:03
Speaker 1: choosing your choice for you. And again going back to
49:06
Speaker 1: those you know, classiest and racist elements of you know,
49:10
Speaker 1: let us let us choose on your behalf. This set
49:13
Speaker 1: and forget it kind of thing, because you probably don't
49:16
Speaker 1: have the wherewithal to do for yourself. So and this
49:22
Speaker 1: was an area, these these biopolitics, feminist biopolitics, were something
49:26
Speaker 1: that I hadn't read before, and I'm curious to read
49:31
Speaker 1: more about also because a lot of that information and
49:36
Speaker 1: that perspective was coming out more in the late nineties
49:40
Speaker 1: early two thousands, And I'm curious to know whether there
49:44
Speaker 1: is still a similar sentiment now that iud's are more
49:49
Speaker 1: common and more affordable in the US in particular, but
49:54
Speaker 1: there are also still a lot of barriers to use,
49:58
Speaker 1: especially in developing countries, even though it is recommended by
50:02
Speaker 1: the World Health Organization because increasing iuduse could be a
50:08
Speaker 1: major boon to maternal health and of course managed population control. Still,
50:15
Speaker 1: as of twenty fifteen, according to NPR, sixty one percent
50:19
Speaker 1: of women in developing nations have unmet family planning.
50:23
Speaker 3: Needs right and so many of them, more than fifty percent,
50:26
Speaker 3: get pregnant within two years of having the previous child.
50:32
Speaker 3: The important aspect of that stat being and many do
50:36
Speaker 3: not want to Many want to wait, and the World
50:38
Speaker 3: Health Organization does urge people in general to wait to
50:44
Speaker 3: i guess let their bodies recover essentially, especially if you've
50:47
Speaker 3: had a traumatic childbirth. But some of the hurdles that
50:51
Speaker 3: people are up against are things like menstrual taboos and
50:55
Speaker 3: very real sterilization fears, because we do have this his
51:00
Speaker 3: street globally of forcing women, particularly women of color, to
51:05
Speaker 3: be sterilized.
51:06
Speaker 1: And Jill Philipovic a couple of years ago wrote a
51:09
Speaker 1: terrific in depth piece for Cosmopolitan about the situation of,
51:16
Speaker 1: or the challenge really of getting IUD access to women
51:20
Speaker 1: in rural India because they tend to opt for the
51:24
Speaker 1: pill over the paraguard. When it comes to iud's being sent,
51:31
Speaker 1: you know, through nonprofits and NGOs, it's usually going to
51:34
Speaker 1: be the copper IUD because it is much cheaper than
51:37
Speaker 1: the hormonal version, as you might imagine, And in these areas,
51:43
Speaker 1: the pill is chosen because what the paraguard. Remember that
51:48
Speaker 1: one of the major side effects is heavier periods, And
51:53
Speaker 1: if you are in a developing area, you might already
51:57
Speaker 1: have entrenched menstrual taboos. But I mean, if you're on
52:01
Speaker 1: your period because of that, you can't do anything really,
52:04
Speaker 1: I mean, it like puts you out of commission. And
52:07
Speaker 1: they literally cannot afford to do that right exactly.
52:11
Speaker 3: And you've also got the issue of the difficulty of
52:15
Speaker 3: insertion even right after childbirth. And you know, another benefit
52:20
Speaker 3: of course of the paraguard is it can remain in
52:23
Speaker 3: for so much longer, so there isn't the every three
52:27
Speaker 3: years or every five years. Even there's that nice ten
52:30
Speaker 3: to twelve year stretch where you can just I mean,
52:33
Speaker 3: you can just set it and forget it. Not to
52:35
Speaker 3: sound globe, but there have been developments. There is this
52:41
Speaker 3: new easy to use quote unquote IUD insert or developed
52:44
Speaker 3: by Population Services International, which I feel like these names
52:49
Speaker 3: need to be improved. Doesn't Population Services International sound like
52:53
Speaker 3: something out of nineteen eighty four.
52:55
Speaker 1: I think they're related to the old school Population Council.
52:58
Speaker 3: Well, all right then, but this new inserter could make
53:03
Speaker 3: IUDs more accessible and on top of that lowered the
53:07
Speaker 3: chances of getting IUD related infections. The expulsion rates are
53:12
Speaker 3: still comparable to those in the US right now.
53:15
Speaker 1: Yeah, and those easy to use inserters are super important
53:19
Speaker 1: in those areas where you aren't going to have just
53:23
Speaker 1: you know, a buffet of trained obstetricians and perfectly sterilized
53:28
Speaker 1: areas and instruments to use, and apparently the existing inserter
53:36
Speaker 1: that tends to come with a mariner or paraguard is
53:39
Speaker 1: really flimsy and kind of hard to use if you
53:41
Speaker 1: don't really know what you're doing.
53:42
Speaker 3: Yeah, it's not as long as as would be ideal.
53:45
Speaker 3: And they mentioned I think this was still from Philipovic's article.
53:48
Speaker 3: Right she she mentions how right now in the study,
53:54
Speaker 3: when IUDs are inserted with these these new inserters that
53:58
Speaker 3: have been developed, the doctors leave the strings long still
54:02
Speaker 3: after childbirth and want you to come back like a
54:05
Speaker 3: week or two later. But even that is still a
54:08
Speaker 3: barrier to overcome. Researchers and developers still want to get
54:11
Speaker 3: it down to no, we just we do just set
54:15
Speaker 3: it and forget it, and that we do insert it
54:18
Speaker 3: and you go back to your life, You go back
54:20
Speaker 3: to your village or wherever, and you don't have to
54:22
Speaker 3: worry about coming back to find a healthcare provider to
54:25
Speaker 3: trim those IUD strings.
54:26
Speaker 1: And most often that does happen right after childbirth. You know,
54:31
Speaker 1: they come in to have the baby and like a
54:34
Speaker 1: lot of women choose to then get a tubal ligation.
54:37
Speaker 1: For instance, you can then get an IUD inserted. But
54:42
Speaker 1: here in the US even there's still some mistrust around iud's.
54:47
Speaker 1: Of course, there are horror stories because of you know,
54:51
Speaker 1: people we might know or have heard about who have
54:53
Speaker 1: had to deal with those very painful expulsions or even
54:57
Speaker 1: rare perforations. And since though the election of Trump and
55:07
Speaker 1: even more troublingly, former Indiana Governor Mike Pence as Vice president,
55:13
Speaker 1: IUD searches have skyrocketed, skyrocketed, my friends, I am not
55:19
Speaker 1: That is not hyperbole. You can see it. You can
55:21
Speaker 1: see it in the Google because people are worried about
55:25
Speaker 1: the repeal of the Affordable Care Act and the possible
55:28
Speaker 1: repeal of Roe v. Wade and out of pocket hormonal
55:33
Speaker 1: IUDs can run you eight hundred dollars. So there have
55:38
Speaker 1: been a lot of women ever since that happened, ever
55:42
Speaker 1: since November ninth, who have said get an IUD. Yeah.
55:48
Speaker 3: Well, I mean I posted the question on Facebook of
55:50
Speaker 3: how many of you out there are thinking about this?
55:54
Speaker 3: Are in line or on the phone with your doctor
55:56
Speaker 3: to get your contraceptives of whatever kind taking of? And
56:01
Speaker 3: I mean the response was overwhelming from women of all
56:03
Speaker 3: ages and backgrounds saying I'm on the phone with my doctor.
56:07
Speaker 3: I'm calling I'm going to planned parenthood. One woman literally
56:10
Speaker 3: responded from her doctor's waiting room saying that she was
56:13
Speaker 3: getting it taken care of.
56:15
Speaker 1: Yeah. So, I mean, this conversation is more relevant than
56:19
Speaker 1: ever before, and even though we were only able to
56:23
Speaker 1: offer just a tiny snapshot of a more global perspective,
56:30
Speaker 1: it does go to show how again, reproductive rights are
56:35
Speaker 1: very intersectional issue and affect different people in such different ways,
56:41
Speaker 1: in the same way as birth control does. So perspectives
56:48
Speaker 1: that you can share insights, questions, send them to us.
56:53
Speaker 1: Mom staff at HowStuffWorks dot com is our email address.
56:56
Speaker 1: You can tweet us at mom Stuff Podcasts. You can
56:59
Speaker 1: directly tweet and follow me at Kristin Conger.
57:04
Speaker 3: And me Caroline Irvin at the Caroline IRV.
57:08
Speaker 1: And we've got a couple of messages to share with
57:10
Speaker 1: you right now.
57:14
Speaker 3: Per well, actually, to be honest, we just have one
57:20
Speaker 3: letter to read and it's from Allison. So. Allison saw
57:24
Speaker 3: on social media that Kristin and I were gearing up
57:27
Speaker 3: to do an episode on iud's and she, a fellow
57:31
Speaker 3: IUD evangelist, had to write in. She says, I'm not
57:35
Speaker 3: a medical professional or IUD salesperson. However, I am the
57:38
Speaker 3: owner of one set of lady parts, my Lady Parts.
57:43
Speaker 3: Alison writes. When I started college, I was prescribed the
57:47
Speaker 3: pill for irregular MINSI since back in my day you
57:50
Speaker 3: couldn't get it covered if it was just for stopping babies.
57:53
Speaker 3: And to make a long story short, the hormonal birth
57:55
Speaker 3: control really made me sick, serious depression, weight gain, moodswingsh
58:00
Speaker 3: and debilitating cramps. One time, I remember handing my roommate
58:04
Speaker 3: my car keys while I curled up on my floor
58:06
Speaker 3: after class, telling her to just take the car where
58:09
Speaker 3: she needed to go. I can't sit up. I took
58:11
Speaker 3: it four more years because I don't know doctors are
58:13
Speaker 3: smarter than me. I was not living my empowered truth. Eventually,
58:18
Speaker 3: I eschewed hormonal birth control altogether because my side effects
58:21
Speaker 3: were so bad. But I met an Englishman in two
58:24
Speaker 3: thousand and nine and I needed to get birth control
58:26
Speaker 3: stat After talking to my amazing lady obgyn who sets
58:30
Speaker 3: my heart alight, and doing a little research, I told
58:33
Speaker 3: her I wanted to try the IUD even though I
58:36
Speaker 3: am nella Paris. I wanted to try the IUD for
58:39
Speaker 3: a variety of reasons, but most importantly, I wanted something effective,
58:43
Speaker 3: easy to use, and easy to reverse. Oh that, and
58:47
Speaker 3: it was covered by my insurance one hundred percent. Only
58:50
Speaker 3: my regular appointment COPE would apply. This was before the
58:53
Speaker 3: legislation for covering birth control was passed, so my doctor
58:57
Speaker 3: and I talked about it, and because I had a
58:59
Speaker 3: bad reaction to hormonal birth control, she recommended doing the
59:02
Speaker 3: paraguard the copper id. We giggled when she said that
59:05
Speaker 3: she liked that one because she likes to imagine the
59:07
Speaker 3: heads of the sperm popping off when met with the
59:09
Speaker 3: inhospitable uterine environment the copper creates. Did I mention she
59:14
Speaker 3: sets my heart alight because she does. We talked about
59:17
Speaker 3: how it would work, that it would be good for
59:19
Speaker 3: ten years, and if I wanted to take it out,
59:21
Speaker 3: she could do that anytime, just come in. When I've
59:24
Speaker 3: told friends about the insertion process, I've described it like
59:26
Speaker 3: sticking a straw in your huha then shooting a dart
59:29
Speaker 3: into your uterus. But it didn't really hurt. I did
59:32
Speaker 3: have cramping and a tinge of regret that I only
59:34
Speaker 3: took four hundred milligrams of ibuprofen. The weirdest thing was
59:37
Speaker 3: I got dizzy, uh and the nurse brought me an
59:40
Speaker 3: apple juice box that they kept there for the kids
59:42
Speaker 3: and let me lie down for ten minutes. I advocated
59:45
Speaker 3: the IUD to my best girlfriend after she had two
59:47
Speaker 3: children fourteen months apart her she and her husband decided
59:51
Speaker 3: their family was complete, at least for now. She wanted
59:54
Speaker 3: to know about my experience, and she talked to her
59:56
Speaker 3: obgyn and decided the marina was for her. I will
1:00:00
Speaker 3: pretty much talk to anyone about my ID if they ask,
1:00:03
Speaker 3: and have called out IUD deniers for just being lying
1:00:05
Speaker 3: liars like those who say it's an abortifacient. Anyway, Englishman
1:00:09
Speaker 3: and I got hitched in twenty fourteen, and I have
1:00:11
Speaker 3: four more years of effective, safe and fabulous birth control
1:00:16
Speaker 3: that I can decide at any time to keep or
1:00:17
Speaker 3: take out having children. It's not something we want to
1:00:20
Speaker 3: do maybe ever, and that is cool with my paraguard
1:00:23
Speaker 3: because she's just in their chill and popping the heads
1:00:25
Speaker 3: off sperm. Thank you so much for listening to my
1:00:28
Speaker 3: story time. I've listened to you both for a few
1:00:30
Speaker 3: years and appreciate so much your candor and the important
1:00:33
Speaker 3: topics you discuss. Please let me know if you have
1:00:35
Speaker 3: any questions I can answer. And Alison signs her letter
1:00:40
Speaker 3: unicorns and empowerment and what a fabulous way to end
1:00:44
Speaker 3: a letter. Thank you so much, Alison.
1:00:47
Speaker 1: And thanks to everyone who's written into us moms stuff
1:00:50
Speaker 1: at HowStuffWorks dot com is our email address. And speaking
1:00:55
Speaker 1: of email, y'all, in light of the post election hot
1:00:59
Speaker 1: mess happening, I've started a little tiny letter, a little
1:01:04
Speaker 1: tiny letter how redundant is that if you'd like to
1:01:07
Speaker 1: check it out and subscribe, It's called the Do Better
1:01:10
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1:01:15
Speaker 1: Slash Kristen, which is c R I S T E
1:01:21
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1:01:28
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1:01:31
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