In uncertain times, getting an IUD can be like putting on your oxygen mask.
For women, the next four years are looking darker by the week. With a hundred thousand pussy hats still in the laundry, minority president Donald Trump surrounded himself with a posse of pasty, patriarchal mostly-religious conservatives and made his first moves to gut sexual and reproductive healthcare for women.
None of us know what kind of family planning services will be available a year from now, or how far away, or what they will cost, or who will have health insurance. Faced with these prospects, what should we do now to take care of ourselves and our teenage daughters?
Today, expensive IUDs and contraceptive implants are free, which is unlikely to be the case once conservative Republicans make changes to the Affordable Care Act. Some women prefer pills or the shot or implant, or another form of birth control, and no one method works for everyone. Even so, to get through the next four years an IUD may be the best option for many. Why? An IUD not only protects against pregnancy, it can literally save your life, especially if other health services like cancer screenings and prenatal care are being cut. And it lasts.
- “My IUD will last longer than your presidency” — so proclaimed a sign at the D.C. Women’s March, and it’s true. An IUD can be taken out at any point, with a fast return to normal rates of fertility. But if you aren’t ready for parenthood, or are busy loving on the kids you already have, a state-of-the-art IUD gives you up to 12 years of protection. There are two kinds of IUDs. Hormonal IUDs release a mostly-local micro-dose of progestin offer the benefit of lighter, less frequent periods. Copper IUDs offer long-lasting protection for women who don’t tolerate synthetic hormones. Despite what you may have heard, both are genuine contraceptives, preventing egg and sperm from hooking up.
- Get it and forget it. For those who care about other people and our world, the next four years are going to be stressful and sometimes depressing. We are going to need mental energy for taking care of each other and fighting back. There may be a lot we can’t control, but we can at least eliminate the extra stress of broken condoms or trying to remember daily pills (or all-day morning sickness from forgetting and having to double up). Once your body has adjusted to an IUD, you don’t have to think about it till the time comes for either a new one or a pregnancy.
- Lighter and fewer periods! There may be things you can’t control, but one thing you don’t have to put up with is miserable monthlies. Some women like having periods, but most would just as soon not spend 6.25 years bleeding, which is what the typical 456 menstrual cycles add up to. Now there’s no need to bleed unless you want to. After an initial adjustment phase, hormonal IUDs cut period cramps and bleeding by on average 90%, and a lot of women have no period at all. Is it healthy? Yup. In fact, reducing menstruation has a number of health benefits.When you eventually do want to get pregnant, it will make absolutely no difference whether you bled all those years or not.
- A penny saved. Daily pills and monthly periods are expensive. One journalist estimated that the average American woman will pay about $18,000 over her lifetime for menstrual supplies and birth control pills. That’s about $2000 between now and the time we can get someone into the White House who won’t grab us all by the pussy.
- Climbing the ladder. Painful periods, also called dysmenorrhea, are the number one health reason girls miss high school and young women miss work. In fact, a study in Italy estimated that 15 percent of the wage gap between men and women was due to “cyclical absenteeism,” literally caused by menstrual cycles. We women won’t be able to shatter the glass ceiling and fix the national wage gap this year like so many hoped just months ago, but the problem-period part of the gap is one you can take into your own hands.
- And then there’s pregnancy. In real life, the least effective IUD or implant works 20 times better than the Pill, or almost 40 times as well as condoms for preventing pregnancy. That’s an especially big deal when an unexpected pregnancy would be an especially big deal—like, say, when you’d have to immigrate to Canada to get paid family leave or affordable health insurance, and the rest of the safety net has been weakened to fund lifestyles of the rich and famous.
- A womb when you’re ready. We don’t talk about this much, but pregnancy takes a lot out of a woman’s body, and not just when she’s pregnant or right after. Up to a third of women who have had a baby leak pee occasionally. Scar tissue may make sex painful. A prolapsed uterus can create a feeling of pressure. And that’s just the ordinary stuff. When a woman feels ready to have a child, she bears these risks willingly, even gladly. But when the world is churning, the health costs of an unexpected pregnancy can feel particularly high. Truly reliable birth control puts you in control. It means better health for you going in and better health for your baby coming out, and less likelihood of needing that safety net.
- Making abortion obsolete trumps Pence. Look. We all know that the abortion fight isn’t about abortion. On the Pro side, it’s about being able to live the lives of our choosing and form the families of our choosing and bring children into the world with someone we love when we feel ready. It’s about stacking the odds in favor of our children flourishing. On the Anti side, some true believers are convinced that an embryo is a baby soul and killing it is murder. But just beneath the surface, most abortion foes want to force women back into a gender script that was written in the Iron Age and punishing those who deviate. That is why they obstruct sex ed and contraceptive access, which drive down abortion but give women greater autonomy. This means that if contraceptive technologies (like IUDs and implants and whatever is in the pipeline) make abortion obsolete, we get what we want, and they don’t.
- Live to fight another day. Hormonal birth control, including the IUD, has YUGE bonus health benefits. A hormonal IUD won’t help your acne like the pill does, but you do get less anemia, less pain, less endometriosis and—here’s a big deal—a 40 percent reduction in uterine and ovarian cancers. In fact, in some countries hormonal IUDs are being used to treat early stage cancers. Getting an IUD—if it’s right for you—is like putting on your oxygen mask first, because you can’t take care of anyone else if you don’t take care of yourself. So take care of yourself. And then, take care of the sisterhood by donating to Planned Parenthood, which is one of the easiest places to find a skilled, experienced practitioner who can insert an IUD same day, no charge—for now.
If you’re reading this, you probably won’t be among those hit first and hardest by the loss of reproductive health services. In one of their first executive actions, Trump and Pence targeted the poorest of poor women because they were the easiest to hit. They killed funding for International Planned Parenthood and any global health organization that so much as mentions abortion by re-instituting and expanding Ronald Reagan’s “Global Gag Rule.” Next in line? Probably poor American women who rely on Medicaid and Title 10 for birth control, then those working women who rely on Obamacare because paying out-of-pocket stretches a thin family budget to the breaking point.
But eventually they hope to get to all of us. Let’s be ready.
Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org. Her articles about religion, reproductive health, and the role of women in society have been featured at sites including AlterNet, Salon, the Huffington Post, Grist, and Jezebel. Subscribe at ValerieTarico.com.