Sarah Anthony, a farmer and bookkeeper from Metchosin, B.C., experienced excruciating pain during the insertion of her IUD. She recalled crying out loudly during the procedure, prompting the doctor to caution her to be quiet to avoid alarming other patients. Anthony described the sensation as unnatural and distressing, feeling that her cervix was not designed to undergo such forceful manipulation.
IUDs, short for intrauterine devices, are small T-shaped contraceptives placed inside the uterus by medical professionals to prevent pregnancy. These devices, including hormonal and copper variants, alter sperm movement to impede fertilization, as explained by Planned Parenthood. The popularity of IUDs in British Columbia has surged following the province’s initiative to provide free contraceptives, championed by AccessBC.
During IUD insertion, healthcare providers employ a speculum to widen the vaginal walls, followed by a tenaculum—a clamp-like instrument—to stabilize the cervix. Subsequently, a specialized inserter is used to place the IUD through the cervix opening into the uterus. While some individuals tolerate the procedure well, others, like Sarah Anthony, find it highly distressing.
A study by AccessBC researchers Sara Sunderji, Anahita Seraji, and Victoria Greene identified three primary sources of pain during IUD insertion: tenaculum placement, cervical manipulation, and uterine contractions triggered by prostaglandins released during the procedure. The research also highlights additional sources of discomfort, such as speculum insertion and patient anxiety.
In response to the challenges faced by individuals undergoing IUD insertions, AccessBC has launched the “Not Just a Pinch” campaign advocating for improved pain management protocols. The group aims to ensure universal access to contraception and promote reproductive and sexual justice by addressing the issue of pain during IUD procedures.
AccessBC emphasizes that while some specialized clinics offer advanced pain management options, most British Columbians undergoing IUD insertions are advised to take over-the-counter pain relievers like Advil or Naproxen. According to Sunderji, the lack of comprehensive pain management for IUD patients reflects enduring gender biases within the medical field, where women are often expected to endure discomfort during gynecological interventions.
The campaign urges the province to establish guidelines for pain management during IUD insertions, implement billing mechanisms for pain control under the Medical Services Plan (MSP), mandate training requirements for healthcare providers, and ensure equitable access to pain relief services across all regions. In response to the initiative, the Ministry of Health affirmed its commitment to prioritizing reproductive healthcare access in the province, highlighting recent adjustments to the Medical Services Commission payment schedule to enhance compensation for IUD insertions, including a new fee for cervical block anesthesia to alleviate pain.
The ministry’s statement underscores its dedication to improving reproductive care accessibility and addressing the challenges faced by individuals undergoing IUD insertions in British Columbia.
