Before having D I'd always been on birth control pills. They're what everyone uses, right? They're like the default. While pregnant I started thinking about what other options there are, for when I'd need birth control again. Alarmed by my inability to remember, well, anything, I didn't want to depend on a pill that has to be taken at the exact.same.time.every.day to be fully effective. Other popular options like the patch or Nuvaring also didn't appeal to me that much-- I found it enough of a pain to have to get my pills refilled before having a baby (and I only had to go in once every 3 months thanks to our insurance provider, apparently this is very very rare) and needing to go run that extra errand with a young child just seemed like a hassle. I didn't really give the Depo shot much consideration, as I've known people who've had bad experiences with it, and you still have to go back every 3 months for a new shot anyway. None of the non-hormonal methods appealed to me at all, especially as they (sponge, cervical cap) become pretty ridiculously ineffective for a woman who's already had a child. We used condoms for this first year since I didn't want to be on hormones while breastfeeding (concerned about how they affect milk supply, along with the extra hormones getting into the milk itself. Since D's only nursing twice a day now I feel more ok about going back on a hormonal contraceptive), but I personally don't see condoms as a viable long-term solution for a married couple.
Then I started hearing about the IUD, which I'd previously written off, as so many of us have, due to negative hearsay. But then I saw this video, and started looking into it more. I found out that most of the negativity associated with IUDs are the result of one "bad egg", so to speak (the Dalkon Shield), that's been off the market for three decades. That they are incredibly effective, even more so that tubal ligation (according to the pamplet I got today, 0.1% failure rate vs 0.5%). That they are very common in many other countries, from Mexico to France to China. When I asked my ob-gyn about them at my annual check-up, she said that while only 10% of the general public use IUDs, closer to 80% of women in the medical field use them. And best of all, it's something that goes in and you don't even have to THINK about it (other than check that the strings are there every once in a while) until you decide you want to have a kid, or 5 years pass, whichever comes first. Oh, and that our insurance (Kaiser Permanente) covers the entire cost (can be about $500 or more otherwise), and even if I go in tomorrow to get it taken out again all I'll ever have to pay is my $15 co-pay for the visits themselves.
Yup, a grand total of $30 for 5+ year's worth of safe, effective, can't-possibly-forget-to-use-it-or-use-it-wrong, zero-effort birth control.
There are two types of IUDs on the market in the US, the copper (hormone-free) ParaGard which lasts for 10 years, and Mirena which uses a very low-dose of progestin and lasts for 5 years. There are some risks associated with their use, but they're pretty rare and about on par with those of other forms of birth control (I've been very lucky never to experience many side effects from the pill before, so don't expect the low dose of hormones from Mirena to mess with me much, either). I did recently find out that a friend of mine's brother was conceived in spite of an IUD, but hey that .1% has to come from somewhere, right? ; ) While Zach and I are deeply committed to giving D a sibling one day, we are in NO RUSH WHATSOEVER for that to happen anytime soon. So I decided to go with Mirena, had it put in this morning, and I'm pretty happy with this choice, at least so far. (BTW I decided against Paragard because I've never had an adverse effect to hormones and because of the 50/50 chance of stronger cramping and heavier flow during periods associated wth the copper IUD, whereas most Mirena users have lighter periods over time and many stop getting their periods altogether.)
The procedure to put it in wasn't too bad, a little uncomfortable but when you've gone through childbirth it kinda puts other pains like this into perspective (as an aside the exam room had a bunch of different diagrams and posters on the wall, one of them showing how big the cervix dilates, from 1 to 10cm, during labor. I couldn't keep my eyes off that 10cm circle thinking "Seriously? My body did THAT??"). I had some cramping, like bad period cramps, as she was inserting the IUD and they continued for about 20 minutes or so afterwards, and I felt the slightest bit lightheaded, but now I'm totally fine and it almost seems hard to believe that I have a little piece of hormone-coated plastic in my uterus.
I wanted to write about this to help bring this into the mainstream a bit. I'm not saying IUDs are the be-all and end-all of birth control, but they seem like a pretty great option to at least consider, and it does seem odd that while trying to reduce teen pregnancies we continue to use birth control pills and condoms (the two least-reliable, most subject to user error methods we've got) as our primary methods of contraception. I mean, no wonder half of all pregnancies in the US are unplanned, right? And who knows, I might end up having a horrible experience with this over time. Or I might love it and never go back. Either way, this is something I had never even thought about as an option before maybe a year ago, and now I'm using it and pretty happy about it, and I'm hoping to maybe bring this option to a few other women out there who might consider it for themselves. If anyone has questions about the IUD, about the insertion, side effects, etc, email me and I'll answer as best I can according to my own personal experience.
UPDATE 11/26/09: Just wanted to write an update, after 9+ months of use, to say that I am still very much happy with my IUD and have had no problems at all yet.