Time to Give a Neglected Contraceptive a Little More Love


An article in Obstetrics & Gynecology takes a fresh look at the emergency contraception we often forget about—IUDs. The authors of the article, who surveyed women who came to family planning clinics in Pittsburgh for emergency contraception or pregnancy testing, found that few of the women knew much about IUDs.

I, for one, am not surprised by their ignorance, since I didn’t know that IUDs could be used as emergency contraception until I happened to read it on Planned Parenthood’s website two weeks ago. There are two kinds of IUDs available in the United States; the copper kind, which is effective for up to twelve years, is the one that’s also effective in preventing pregnancy if inserted up to five days after unprotected sex. 

At that point, I wondered, Why would you go for such a long-lasting contraceptive when you’re just looking for emergency contraception?  

But this makes a lot of sense. Though some women who seek emergency contraception may have had a one-time malfunction, many others may be looking for a form of contraception that works for them.  

The women surveyed in Pittsburgh were primarily low-income, and IUDs are an economically wise choice. Depending on how long you’re planning on using contraception, it could work out to be cheaper than the Pill. And if the IUD is free from a family planning clinic, the benefits are even clearer. A woman with other things on her mind doesn’t need the extra worry of where her next pill pack is coming from and who’s paying for it, especially when contraception funding is in danger. 

Why don’t more women use IUDs or even know about them? Perhaps getting one seems like a big production, or maybe the idea of a copper device in your uterus is frightening. The article’s central argument is that IUDs should be less of a hassle:

"Efforts therefore should be made to expand education about and access to IUD insertions for women seeking either emergency contraception or pregnancy testing, with consideration given to the development and evaluation of same-day insertion services," Schwarz and associates conclude.

In an ideal world, women would visit reproductive health clinics before they needed emergency contraception. In the same world, Americans would visit doctors before, or rather than, visiting the emergency room. But until preventative health care is a reality for everyone in this country, emergency care is where many people first see a doctor. In light of this, clinic doctors and nurses should view an EC visit as an opportunity for sensitive outreach. And if a woman never visited a clinic before, because she’s working two jobs or she has three kids at home or she had to get a ride from a friend, is she going to come back for a second visit?

For some women, a certain level of convenience is not a luxury—it’s a necessity. And the IUD has always been an important option for women who can’t tolerate birth control pills or who’d rather not use hormonal birth control because of family health history. Bravo to this report for pointing to a neglected contraceptive choice that may be, for many women, just what the doctor ordered.

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