You may have seen a meme floating around the internet after November 8th, urging women to get birth control that will “outlast a Trump presidency.” While it’s true that a copper IUD can be safely used for 10-12 years, is it really so urgent to get one right now? And are they right for everyone?
Copper IUDs (intrauterine devices) are nearly 100% effective at preventing pregnancies, and I have written about them in the past as a good public health initiative to decrease abortion rates. They’re controversial amongst the religious right because some consider IUDs to be less contraception, more abortifacient. This is because of a debate about when conception truly begins- most doctors agree that conception begins when a fertilized egg attaches to the uterine wall, while members of some religious groups believe that conception begins when an egg is fertilized. (This belief was at the crux of the infamous Hobby Lobby case). In cases in which IUDs do not stop sperm from fertilizing an egg, they are still effective at making the uterus inhospitable to a fertilized egg.
Most of the time, however, copper IUDs are not at all abortifacient. Copper kills sperm, and so there is rarely an opportunity for an egg to become fertilized. Because of this, there is never an opportunity for one to know how, exactly, the IUD prevented pregnancy- just that it did prevent an unwanted pregnancy, and did so effectively.
Despite their impressive record, however, copper IUDs are not very widely used by young women. The median age of the copper IUD user is 30. Many of the women who use it get it implanted directly after having a child, because of the fear of insertion pain which can be extremely different in every case. Copper IUDs like Paraguard also have the potential for side effects like spotting, cramps, inflammation, or even expelling the IUD. Some of these symptoms are more likely to occur in young women, or women who have not yet had children. This may serve as a deterrent.
Delaware and Colorado currently offer programs discounting long acting contraception for young women. I’ve written about the success of Colorado’s program in the past. Despite this, there are certainly things to think about before embarking on a ten-year journey with an IUD. Make sure that your doctor knows all of your concerns before making a rash decision based on the results of the election.