Caring For Our Bodies: What Was Old is New Again

I was inspired to write about the IUD (intrauterine device) after a visit with a new patient recently.

She was referred to me for surgical removal of an IUD that was placed in 1971.  It made me think reverently about how far healthcare for women has come.

When I was a young woman, considering what career I might want, I decided to go to medical school specifically to become an OBGYN. I was inspired by feminists and the civil rights movement, and I wanted to be a part of the progress that women have made and continue to make.

When I was a medical student, I was told by an ancient and wise doctor that the first IUD was a pebble that was placed in the uterus of a camel by nomads in the Middle East many, many years ago.  Of course, I believed it since it made sense that a foreign body such as a pebble could cause enough irritation within the uterus to prevent camel sperm from getting through.

However, after being a practicing physician for several years, I now think that the pebble story might have been a myth.

However, as a story goes, it proves the point that the first methods of preventing pregnancy helped build the world of today’s modern IUD.

An IUD or intrauterine device, is a device that is placed within a woman’s uterus to prevent pregnancy. The first known use of the IUD was in 1909 when Dr. Richard Richter of Poland claimed success in preventing pregnancy using an intrauterine ring.

Over the decades, there were many iterations of the IUD. There were silver versions and glass versions and 14k gold versions. In the past, these methods were generally reserved for only the wealthiest women. 

In the early 1970s, the Boston Women’s Health Collective was starting to publish “Our Bodies Ourselves” and radical changes were happening for women in the U.S.  In 1971, the IUD known as the Dalkon shield (a beetle shaped IUD with a braided string) was produced and soon it was implicated in several deaths and resulted in more than 200,000 lawsuits. The issues with the Dalkon shield seriously hurt the reputation of IUDs as women questioned their safety.  We still discuss the Dalkon shield with patients on a regular basis.  Globally, IUDs continued to be popular and make big strides.  But in the US, the birth control pill took over the contraceptive world, and cervical caps, diaphragms and sponges were manufactured….all less effective options.  Around the same time, a new type of IUD was created, taking on the modern T-shaped design we still see today.

Today, more and more women are interested in the IUD because it provides an effective, safe form of birth control. The IUD is now the most common form of contraceptive in the world! 

There are two main types of IUDs—progestin IUDs and copper IUDs. The progestin IUDs (such as Mirena, Liletta, Skyla, Kyleena) contain a small amount of progesterone-type hormone that keeps the lining inside of the uterus thin and gives lighter or nonexistent periods. In addition to contraception, it can also be a treatment for heavy periods.  The copper IUD (Paragard) is completely non-hormonal and works as an excellent contraception for women who cannot have hormonal contraception for medical reasons or for those who choose to avoid hormones.  The copper IUD can also be inserted as emergency contraception for up to 5 days after unprotected intercourse. 

An IUD is a long acting reversible contraceptive. So, you can “set it and forget it.”  IUDs are approved to be used for three to 12 years (depending on which IUD is chosen) and women of all ages are candidates, including women who have never been pregnant.  They are very effective (better than 99% effective) for birth control and have many advantages.  An IUD is long acting, is rapidly reversible, does not require regular compliance, has few side effects, is private and discrete, does not interfere with spontaneity of sex, is cost effective, and allows a women to be in control of fertility.

At Beebe Women’s Healthcare – Plantations, we have several FDA-approved IUD options, including progestin and copper/nonhormonal IUDs, and we make a special effort to provide same-day insertions for women who decide an IUD is for them. This makes it even more convenient!

In addition, our team is working on processes that will allow us to do IUD insertions immediately following childbirth in Labor and Delivery. This allows women to recover without the worry of an unexpected pregnancy.

Overall, the IUD can be seen as a huge victory for women’s health in the world and in Sussex County!

If you are considering an IUD as a contraceptive method or if you have questions about birth control options, call Beebe Women’s Healthcare – Plantations at (302) 480-1919.

This article originally appeared in the Sussex County Women's Health Journal 2018 and is re-published here with permission.