Image credit: Wikimedia Commons/the author

I Inaugurated My Uterus With an IUD Because Trump Is President

Trump has vowed to take away the ACA, so I decided to get birth control that would outlast him.

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Jan 20 2017, 3:00pm

Image credit: Wikimedia Commons/the author

I was sitting in my doctor's office about a week after the 2016 US Presidential election, about to get a physical, anxiously swinging my feet and kicking my heels against the chair. My doctor, a youngish no-nonsense sort of woman, was enduring my usual barrage of neurotic health-related questions when I looked right at her and said: "Do you think I should get an IUD?"

"I think that's a great idea," she said.

For over a decade, my contraceptive history has been pretty uncomplicated—same pill, same partner. Boring. But with the incoming president vowing to dismantle the Affordable Care Act—the legislation that had saved my ass back when I was a freelancer—and defund Planned Parenthood, I started to feel like the pill wouldn't be enough to guarantee my reproductive autonomy.

Suppose I lost my job, or had to quit? Suppose I decided I wanted to go back to freelancing? While much of our health coverage is still in the hands of the state and our employers, anything can happen in four years. If I took the incoming president at his word, my safety net was in danger of disappearing. So I made an appointment.


As many people who've taken it are well aware, the birth control pill is a pain. It's the right choice for some, but what hormones do to your body is no joke. And for oral contraception to be maximally effective, you have to take it at the same time every day, which is a lot harder than it sounds. I can't count how many times I didn't realize I was out of pill packs, and had to scramble to get a refill before the month was out, or how many times I forgot to take it, or left it in my other bag, and had to take two the next day.

"At least I wouldn't be pregnant when I didn't want to be."

But it was a pain I was willing to put up with, because at least on paper, it's easy. And even as IUDs swing further into favor here in North America, becoming equally or perhaps more effective than the pill at preventing pregnancy, there's a gut reaction to the idea of having a foreign object hanging out in your deepest junk all the time. Especially when you're a wuss who has trouble submitting to a Pap smear, like me.

A Mirena IUD. Photo: Mirena

For those unfamiliar, the IUD (literally, "intrauterine device") is dramatically different than an oral contraceptive, and nowhere near as medieval as it might sound. It's a tiny plastic or copper T-shaped device that lives in your uterus. Hormonal IUDs, like the one I was getting, work by slowly secreting a hormone that thickens your cervical mucus, preventing sperm from getting past the goalie.

An IUD lasts years at a stretch, from three to twelve depending on the type, and the one I chose for myself (Mirena) involves only one hormone versus the two in the pill I was currently taking. Fewer hormones = less bullshit. Plus you can get it taken out whenever you want, and you're basically immediately fertile again. With so many advantages, the IUD is also a statistical favorite of female OB/GYNs. If these women trusted IUDs enough to use them on themselves, it seemed like a ringing endorsement.

There was only one catch

I wasn't alone in my fears about losing long-term contraceptive coverage after the election. My doctor told me she was amazed by how many young women were asking her about getting IUDs in the immediate national hangover. This gave me more affirmation that I wasn't just making a sloppy choice under pressure: my sense of urgency was real and well-founded.

Before the Affordable Care Act, birth control was expensive. IUDs cost hundreds of dollars, but the ACA qualified all birth control and reproductive health as preventative care, making IUDs free. Free. Without the ACA—which Trump has vowed to annihilate as soon as he can—and without job-based benefits, I'd be paying out of pocket for my birth control. This is costly at best, and unfeasible at worst. Plus, I'd have to go to the doctor to get a prescription, and pay out of pocket for that visit too.

In short, this was clearly the best way to "get a lady who isn't ready to be a mother through the next legislative term as unpregnant as possible," as Erin Gloria Ryan wrote for The Daily Beast. One OB/GYN wrote straight out, for Cosmopolitan: "If you've been considering an IUD but have been putting off making the appointment, get to your doctor ASAP."

Don't get me wrong: if I lost my health insurance and the ACA or a similar option was no longer around to cover me, I'd still be screwed, for a million other reasons. But at least I wouldn't be pregnant if I didn't want to be. I entered the hospital that day with the facts, medical counsel and some confidence.

There was only one catch: getting an IUD inserted motherfucking hurts.


The Tuesday before the inauguration was IUD-Day. The hospital had delayed my appointment twice, and I was anxious to get it over with. The clock was running out.

I'm not one to be shy about intimate stuff, or hold back on details, so basically every woman and half the men in my life knew what was about to go down. But everyone—coworkers, friends, family members—actually wanted to know about it. I heard it again and again. "Tell me how it goes, I'm thinking of getting one too."

So I texted my best friend: "Today's the day. Getting a contraption shoved through my cervix."

I Slacked my coworkers: "gonna keep my socks on for the lols," "im so bad at peeing in cups," etc.

I tweeted:

After half an episode of waiting room NCIS and some dicking around in the exam room, taking selfies with a chart of the female reproductive system, a young doctor came in and explained the procedure to me, showing me exactly what would be going where. She showed me the insertion device, basically a wand with an IUD at the tip of it. Krang it up there, push a button, and it releases the IUD. Bam.

"It'll be short," the doctor promised me. "Five minutes. Maybe as little as three."

The nurse patted my thigh and told me to take deep breaths

Several minutes later, I was bottomless (I did keep the socks on), cold, and anxious. Two doctors and a nurse came in and started to prep me. I was really nervous at this point and started yammering: "Can you guys give me a Xanax?" "When will they develop a male birth control?" "Can I cuss?"

"You can definitely cuss."

The pain was unlike anything I've ever felt. I saw stars. I had no local, no topical anaesthetic, nothing to prepare me except a few Ibuprofen that did nothing. I dug my nails into my belly flab and unleashed a stream of expletives that was only interrupted by pure cavewoman yowling. The nurse patted my thigh and told me to take deep breaths, which I managed a few times before returning to hyperventilation.

Then it was over, and the relief was so immense I almost collapsed.

They made me hang out on the table for a while to make sure I wouldn't vomit or pass out. My boyfriend drove into the city to pick me up, our dog in tow. I went home, ordered cheese fries and a strawberry milkshake, and watched Law & Order for several hours straight.


A few days later, I feel great. I feel like a cyborg. I feel, literally and figuratively, impregnable. This is not to say that everyone should get an IUD—it's obviously a very personal decision, and not right for all uterus-havers out there. But the hordes of people marching for women's causes both in Washington and worldwide don't trust the coming administration to protect their interests, and neither do I.

So right now, the IUD was probably my safest bet. Because once you have it, no one can take it away from you.

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