Advocates are demanding better pain management for IUD insertion in BC

When Sarah Anthony, a farmer and bookkeeper in Metchosin, BC, had an IUD inserted, the pain was unbearable.

“I was screaming so loudly in pain that the doctor told me to keep quiet or I would scare other patients,” she said.

“I just remember that feeling, like my cervix wasn’t meant to be open like that.”

IUDs, or intrauterine devices, are small T-shaped devices inserted into the uterus by a medical professional to prevent pregnancy. There are hormonal IUDs and the copper IUD, which alter the movement of sperm cells so that they cannot reach the egg. Planned Parenthood,

IUDs have become more popular in B.C. after the province made some contraceptives free, according to AccessBC, a group that campaigns for free birth control.

When IUDs are inserted, the health care provider first inserts a speculum into the patient’s vagina, which widens the walls of the vagina, and then a tenaculum – a scissor-like type of forceps – youSED to stabilize the cervix. Then, they use a special inserter to insert the IUD through the opening of the cervix and into the uterus.

For some, IUD insertion is not a problem. For others, like Anthony, it is extremely painful.

A AccessBC researchers’ paper Sana Sundarji, Anahita Seraji and Victoria Green found that there are three main sources of pain during IUD insertion: tenaculum placement, which pinches the cervix; Cervical manipulation, because the cervix has to be dilated to allow the IUD to pass; and uterine contractions due to prostaglandins released during insertion.

But there are other things that cause pain, as the paper points out, including speculum insertion and if the patient is anxious.

That’s why AccessBC has launched a new campaign called Not Just a Pinch, calling for better pain management for people getting IUDs.

“AccessBC’s goal is to ensure universal access to contraception as well as reproductive and sexual justice,” Sundarji told CBC. initial version,

Look Sundarji explains why better pain management is needed:

“One of the things we have to work on is pain, because it poses a barrier to accessing contraception for many individuals.”

The group says some specialty clinics offer advanced pain management for IUD insertion, but most British Columbians receiving an IUD are simply told to take pain medication such as Advil or naproxen.

Sundarji said the lack of pain management for IUD patients stems from long-standing misogyny in the medical world.

“Women are expected to tolerate pain, especially when it is associated with gynecological procedures,” she said. “The reality is that this is a procedure that takes place in sensitive tissues. And like any other procedure, pain relief must be provided. That’s the ultimate thing.”

The campaign is calling on the province to create guidelines for pain management for IUD insertion, MSP billing mechanisms for pain control, mandatory training requirements for physicians and equitable access to pain management in all areas.

In an email statement to CBC News, the Ministry of Health responded to the campaign, saying access to reproductive care is a priority for the province.

It said it has introduced changes to the Medicare Services Commission payment program in 2023 that increase compensation for IUD insertion, including a new $25 fee for a cervical block — a local anesthetic — for pain management.