With the nomination of Judge Brett Kavanaugh to fill Justice Anthony Kennedy's seat, President Trump is following through on his campaign promise to stack the Supreme Court with conservative justices less than halfway through his first term. Among the numerous immediate threats this poses are the ones to reproductive justice issues. In the first week after the 2016 election, Planned Parenthood reported a 900 percent spike in patients seeking intrauterine devices (IUDs) for birth control, but while the the popular device is a long-term birth control option that’s often free (at the moment), it isn't the right choice for all bodies. So here are other options if an IUD is not something your doctor recommends for you.
Most of the reporting around issues of access to IUDs in recent years have focused on health care providers and their dated understanding of the device. In the 1970s, a popular IUD model called the Dalkon Shield caused 17 deaths and was linked to Pelvic Inflammatory Disease (PID), which can cause infertility. Following a massive class action lawsuit, the Dalkon Shield obviously stopped being manufactured. Although science has progressed since then and safe IUDs are back on the market, many health care providers have yet to catch up. There are countless stories of doctors erroneously telling patients that IUDs are only a good option if a patient has already given birth — because demonstrating fertility in the past means a patient won't sue them later if they learn they're infertile after having an IUD implanted.
Luckily, patients are learning to advocate for themselves and doing much of their own research to circumnavigate the problem of bad training and lack of education on behalf of health care providers. But there are some legitimate medical reasons not everyone can get an IUD. It's not a good fit for every size and shape of uterus and cervix, for example. Furthermore, folks who already have PID or other untreated pelvic conditions like chlamydia, or those who are prone to pelvic infections may not be good candidates for an IUD either. So what are the options if an IUD is out of the question? There's no shortage of them.
1
Birth Control Implant
The contraceptive implant has the same "set it and forget it" appeal of IUDs, although it doesn't last quite as long. The implant is about the size of a matchstick and it gets inserted into a patient's arm at a doctor's office. It then releases a steady dose of hormones into the bloodstream for up to four years, according to Planned Parenthood. Patients don't have to do anything else after the procedure, so it's a good option for folks who have trouble with remembering to take oral contraceptives.
2
Birth Control Shot
The depo shot (aka Depo-Provera) is a progestin injection patients get once every three months at their doctor's office. Again, it's a low-maintenance option that doesn't require remembering to do something every day or every time you have sex. It's slightly less effective than IUDs and implants, but it's also slightly more effective than vaginal rings, patches, pills, condoms, diaphragms, sponges, and cervical caps, according to Planned Parenthood.
3
Breastfeeding
Admittedly, this only applies to a small slice of birth control seekers, and it only works for about six months, but lactational amenorrhea method, or breastfeeding consistently every four-to-six hours is as effective as the pill at preventing pregnancy, according to Planned Parenthood. This is because breastfeeding halts ovulation, which stops your period and makes getting pregnant nearly impossible. Importantly, pumping won't keep this natural process going, so you have to actually be able to nurse every four-to-six hours, according to the CDC.
4
Birth Control Rings And Patches
The birth control ring (NuvaRing) and the birth control patch are two hormonal options that are equally effective. The ring is inserted vaginally at home and needs to be replaced every month. The patch, meanwhile, sticks onto the belly, upper arm, butt, or back and releases hormones transdermally for a week, necessitating weekly replacement, plus one week off for your period.
5
5-7. Diaphragm, Cap, & Sponge
All of these options are hormone-free, for patients who prefer not to mess with their hormone levels artificially. However, they all need to be inserted every time you have sex. The diaphragm is a soft silicone cup used best with spermicide applied to to it, which gets inserted vaginally before sex and covers the cervix, discouraging fertilization, according to Planned Parenthood. Cervical caps work much the same way, but are a slightly different shape, which may work better for some bodies. Caps can be left in longer (up two days), but are slightly less effective than diaphragms.
Sponges are newly back on the market in the United States and work similarly, except they come pre-soaked in spermicide, and they can be worn for a full 24 hours after insertion for a whole day of protection, regardless of how many times you have sex. Sponges are the only option of the three available over the counter, no doctor's visit required.
There you have it — plenty of other options if an IUD isn't right for you. Talk to you doctor about what makes the most sense for you.
