I inserted my first IUD today! I did it mostly on my own, with my preceptor checking my sounding and talking me through the procedure, and I was amazed by how simple it was. After learning all of the steps in school, and being tested on them during our IUD check-outs, it seemed like a much bigger deal than it actually was. And thankfully, there were no tenaculums involved. Instead, the clinic uses Allis tissue forceps in place of tenaculums, which was a little bit less intimidating. Basically, the prongs of the Allis are placed at the 11 O’Clock and 1 O’Clock position at the very top of the cervix, and then the axis of the cervix is gently straightened out for the insertion. Both the uterine sound and the IUD itself just slipped right in! I was amazed. Of course, it didn’t hurt that the woman we were inserting the IUD into had had six kids, and 2 previous IUDs, her last one in for 10 years. She was a big fan of them, actually, and was so gentle with me. Having had the procedure done two times prior to my insertion, she knew what to expect, and didn’t need much calming or reassuring—in fact, she was reassuring me! Funny how the one thing I was feeling particularly squeamish about ends up being one of the very first things I end up doing. And you know what? It really wasn’t that bad at all. I wasn’t as nervous as I thought I’d be. My hands weren’t even shaking—in fact, my preceptor told me that I had good hands during the procedure. What a compliment! She also mentioned that there are usually two or three IUD insertions a day to do at this clinic, and promised me that next week I’d do more. How exciting. I’m really looking forward to getting good at the technique, and feeling confident about it.
I only saw 4 patients, but two of them were annual exams, which were long and involved and fun. One woman was here because of the IUD, and one woman was here for a Depo Provera shot. I got to write a nice long SOAP note, and do full exams on the women. Lots of practice inserting speculums, and collecting specimens. We even looked at slides under the microscope again to determine that one of the women did indeed have a yeast infection. My preceptor was a lot of fun to work with today, too. She was the smiley one, and this time, instead of letting me go off on my own, she kept closer tabs on me, which I was really appreciative of. What a great day in Family Planning! I hope most of my clinical rotations are this much fun.
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