They told me to chew on a couple of tablets of Paracetamol in the hour leading up to the process. An over the counter drug you might also know as acetaminophen or Tylenol, available in every supermarket and pharmacy, and in most bathroom cabinets and bedside table drawers, Paracetamol is used to treat “mild to moderate pain.”
Pain is notoriously tricky to measure empirically. Different people have different tolerances, and even any one person experiences pain differently in an array of varied causes, situations and circumstances. Different bodies have different thresholds. There are always different factors at play. No measurement of pain can be truly objective, either. But I can say with utmost certainty that the pain that can typically accompany the process of IUD - intrauterine device - insertion usually demands far greater adjectives than the laughably tame “mild to moderate.” And yet two tablets of Paracetamol was all that I was running on when preparing for my own IUD insertion at the age of twenty (that, and a can of Heinz baked beans and a fried egg prepared for me by my best friend).
Before we go any further, I would like to specify upfront that I am speaking about my own personal experience here. I do not hope to - and am well aware that I am unable to - speak for everyone with bodies who have undergone this process. All I can do is offer up my own story for examination and consider what it may tell us about the larger systems at play, about the institutions that we entrust our safety, health, and sexual well-being to.
This is a difficult article for me to write. I don’t want to catastrophize, as I believe it would be a grave error to scare young people - or people of any age - away from seeking out the method of birth control , or a method of managing any given condition that contraceptives may be used for, that best suits them. And for me, that did happen to be the copper IUD. So I would like to say now, on the record: I have never once regretted getting an IUD. I once overheard a girl holding court at an inner city pub table, proclaiming over a cigarette, “My IUD is my favourite thing about myself.” And though her comment was tongue-in-cheek, I’m sure, I kind of know what she means. I love to sing the praises of my IUD to other young cisgender women, gathering around in awe, who are still on the cusp of deciding if they are ready for one or not. If, like me, you are catastrophically disorganized and chronically lazy when it comes to bodily maintenance, having an IUD is akin to a blessing. It’s in there, incandescent in all of its “over 99% effective” glory, and I never have to lift a finger when it comes to pregnancy prevention - not until it has to be removed, and in the case of the copper IUD, that’s after a five-year period . No more paranoia. No - for me - hormonal side effects, weight gain, weight loss, or acne flare-ups. No more waiting in line in your sweatpants at the nearest pharmacy, hungover and ashamed, fielding judgment and unwarranted high pricing. The first time I was able to say to someone in low lighting, “Don’t worry, I have an IUD,” I felt a stupid, blissed out euphoria not entirely dissimilar to the experience of dissolving in Molly sweats beneath strobe lighting.
So, yes, IUDs are largely a good thing, an important thing. Accessibility to acquiring one, if it is your choice to do so, is absolutely crucial. Fearmongering around birth control is dangerous, and a long convenient - and unfortunately effective - patriarchal tool. But I don’t want to be dishonest about the very real pain that I and many others had to endure in the process of gaining access to this method of birth control. The most common question with regard to the IUD that I am asked by people with a uterus who are weighing up different forms of birth control, which all have their cons (in the words of Jia Tolentino: “It Sucked, I Took It Anyway: A Universal Memoir of Young Female Adulthood”), is, Did it hurt? My honest answer is always, Like hell. I know I am far from the only person with an IUD who feels this way. And I think that it is vital to be honest with someone who is considering partaking in a potentially invasive procedure - especially as many of the women I’ve talked to who have IUDs feel that they were not sufficiently warned of the pain they might endure during the process. (The second most common question is, Would I recommend it? My honest answer is always, Yes, absolutely.)
An excerpt from a diary entry I wrote, dated August 10th, 2022:
I wanted to throw up from the anxiety for two straight days beforehand. I told the doctor this, white-faced, and she said that was understandable.
Another one:
The doctor made small talk while my legs were open in her face. The nurse held my hand and led me through breathing exercises. The doctor promised to take it all at my pace. I just wanted it to be over as soon as possible.
And truthfully it didn’t last long, even if it was the most painful experience of my life. After each step they waited till I was ready for the next one. It started off similar to the pain that can sometimes occur during sex or when I’m on my period - that aching tenderness - then expanded to fill my stomach, scrape at my insides. I slammed my hand down on the bed, gripping the sheet beneath me. I teared up - those panicky kind of tears.
I was very lucky that my doctors were lovely, gentle, and understanding, and that my parents were there to look after me once the procedure was over. (And in hindsight I feel stupid, because I forgot to book off work the day after, and for me, the insufferably heavy cramping lasted well into the latter half of the week. So this is a quick aside to remind you that if you are able to book off work for a few days after the insertion process, please do so.) And at the end of the day, even if the pain was excruciating, I survived it, and there’s no doubt that you would too.
But the thing is, we shouldn’t have to survive an everyday medical process. Safety and comfort within a medical context should be an inviolable human right, but rarely is for those with bodies coded as female.
While pregnancy requires more than one person to create, pregnancy prevention is largely considered to be a responsibility exclusive to the person who can themselves become pregnant. When I was first enjoying the diverse freedoms of having moved out of my parents’ house at age eighteen, I was constantly being asked by men I took home with me, What are you on? We were both equal participants in this act of intimacy, and yet I was the one who was expected to be on something. Mine was the body that was to be tampered with, to ensure his utmost ease and pleasure. And so for a while, furious that I was to be burdened with a sense of extreme responsibility that I did not want, I refused to be on anything at all as a form of convenient protest. When men asked me if I was on the pill , I would reply defiantly, No, are you? I didn’t want to deal with mood swings, abrupt hormonal shifts, spotting, weight fluctuations, skin problems, birth control prices that weren’t fully covered by Medicare. I didn’t want to have to deal with any of it, but it was my lot in life, as someone with a uterus, to eventually bite the bullet and Be Responsible and do something to prevent being fertilised against my will.
So I relented and got my IUD which I love so dearly. I did what was expected of me as a young, independent woman. And the powers that be do nothing to make undergoing this process easy to bear, despite the fact that it is expected of us. It is almost as if the pain is a punishing factor. Lying there legs akimbo on the leather bench at age twenty, bottom lip wobbling like that of a toddler in trouble, it truly felt as if I was being condemned by the medical system at large for pursuing my own sexual agency, for pursuing ease of mind, for ushering in a consequence-free wanton lifestyle. I was not to be given anaesthetic or rendered unconscious, though both options would have been easily doable for a system that has made leaps and bounds in technical progress. I was instead to be punished with the ultimate, wall-shattering penetration, punished with pain that is wholly unnecessary. It seems that bodies considered to be female are punished, discarded, mistreated, trivialised, by medical institutions at large, time and time again. I am tired of it, and my body is tired too.
I am grateful for the scientific progress that has allowed my body to be able to be furnished with that little copper miracle, my most cherished possession. What a relief, what a privilege, to be able to be lazy every day, knowing that it is there inside of me, suspended in my womb, protecting my peace of mind. I can be grateful while also believing that our bodies are worthy of a more gentle and understanding touch. So much is expected of the womb - would it kill the medical powers that be to try a little tenderness?
