“It’s easy to forget, amidst the current threats to restrict access to contraception, that for much of their lives, women still face the dilemma of which type of birth control to use. My friends and I are no different: More and more of us are now choosing intrauterine devices, those hormone-emitting or copper-wrapped plastic wonders that I hadn’t paid much attention to until about a year or two ago, when I decided to switch to an IUD. After one albeit painful appointment to get the tiny instrument inserted, I no longer have to remember to take a pill or worry about needing to re-up my supply every month or before traveling; lucky for me, my insurance paid for the whole shebang. (My colleagues Kate Sheppard and Stephanie Mencimer both wrote about recently landing on this option, too.)
As it turns out, we’re in the minority.Although long-lasting reversible contraceptive methods (LARCs) like IUDs are pretty popular in Europe (27 percent of Norwegian female contraception users have one) and China (41 percent!), only around 8.5 percent of women in the United States choose these as their birth control method, among the lowest of any developed country, according to a recent report by the Guttmacher Institute. But while at least half of my girlfriends now have IUDs, some of them have had to jump through hoops and even lie to convince their doctors to prescribe them one. Why has it been hard for young women in the United States to get their hands on this type of birth control?
The American stigma against IUDsalmost certainly traces back to a scare in the ’70s and ’80s surrounding the Dalkon Shield IUD, a poorly designed device that wicked bacteria up its string and sometimes resulted in infections, septic miscarriages, and even death. (Mother Jones reported on it back in a 1979 issue.) In the years after the controversy, reported Adam Sonfield of the Guttmacher Institute, “the media trumpeted a series of studies linking the Shield and other IUDs to pelvic inflammatory disease and subsequent infertility.” IUDs sincehave been reengineered and deemed safer, but physician and consumer mistrust has lingered.
In the meantime, women in other parts of the world—where the Dalkon Shield scare had less impact—have chosen IUDs in large numbers. The graph below reveals how popular its usage is in parts of Europe.
Additionally, in his recent report on changes in contraceptive use (PDF), Guttmacher’s Dr. Lawrence Finer also noted that 41 percent of Chinese women use either the IUD or an implant, another type of LARC. The United Nations, which tracks global contraceptive usage for women who are married or cohabiting, discovered in 2011 that women in less-developed countries were nearly twice as likely to use IUDs than women in Europe and North America. Dr. Kabir Ahmed of the United Nations Population Fund has a theory about this: “Oral contraceptives aren’t as popular among lower-literate populations because these women don’t want their husband to know they are taking anything.” IUDs and implants easily are kept secret. Women in more-developed countries, he explains, don’t need to hide anything and might be more likely to choose the pill because it would allow them to change their minds more quickly…”