The IUD, I’m beginning to learn, is a much maligned form of contraception. It got a terrible reputation in the US because of all of the furor surrounding the Dalkon Shield in the 1970s, however, the two modern versions of the IUD (ParaGaurd, aka The Copper-T, and Mirena, aka The Hormonal One) are actually safe, effective, more or less painless, and for many women, an ideal form of birth control. In fact, IUDs are one of the most popular forms of birth control in other countries—in most of Europe, actually.
Which is all well and good. In fact, great! Go IUDs. I will happily recommend them to all of my clients who want a no-fuss, highly effective, low cost (expensive at the outset, but cheap given that they last 5-10 years), low side-effect contracetive choice—especially my clients who have already been pregnant once. Nevertheless, tenaculums give me the heebies. The teeth of these gruesome little things are actually inserted into the tender flesh of the unsuspecting cervix, and then the instrument is gradually secured, one click at a time, followed by gentle traction in order to straighten out the axis of the uterus so that the IUD can be properly placed (and we spent most of the afternoon practicing this skill on models). And while I am well aware of the fact that supposedly the cervix has very few nerve endings, and antiseptic washes followed by anesthetic gels are applied before the tenaculum, and the entire procedure is done slowly and gently, one step at a time…even so: my initial reaction was a full-body grimace, and the mental thought of OUCH. Ouch ouch ouch. Poor cervix!
However, don’t let this bias you against IUDs! Insertion is not without its discomforts (usually cramping for the first few hours, which can be managed by a trusty dose of advil or motrin), but luckily, as a consumer of IUDs, you never have to watch the actual insertion process. As a student midwife, watching will probably be the least of it—actually using a tenaculum?? It makes my hair cringe just thinking about it (and the professors had the cheek to say, with eager, chipper voices “Hopefully you’ll get several opportunities to insert IUDs during your upcoming clinicals!”.) Yeah.
I. Can’t. Wait.