I got my IUD replaced at my university — here’s how it compared to my clinic near home
by Priya Hay-Chatterjee, MD NARAL policy research intern
When I got my Skyla intrauterine device (IUD) in 2016, I was 17 years old and looking to start some form of birth control. I had a contraceptive consultation during my first sexual and reproductive healthcare screening at a local sexual and reproductive health provider, and a hormonal IUD seemed like the best option for me. I consider myself pretty responsible and diligent, but I was slightly concerned about my ability to remember to take a pill at the same time every day. I assumed going into the appointment that I’d get a prescription for a birth control pill, but after hearing about all my options, it seemed that a low, long-term dosage of local hormones through an IUD in my uterus would be a lot better for my mental health than readjusting to new hormones all over my body. In the long run, the temporary pain of an IUD insertion seemed far less tedious and daunting than committing myself to taking pills daily and potentially adjusting types of pills until one felt like it was working for me. My gynecologist recommended Skyla, which is a sort of “starter” IUD intended for younger people. The insertion process was painful, as expected, but the side effects after the procedure were even more difficult. Immediately following the insertion, I had a lot of pain and cramping but was given no time to recover from the procedure. Instead, I waited alone and in pain in the lobby for my mom to pick me up.
The doctors told me to call if I had any concerns, but when I called with concerns about how long my symptoms were lasting, they told me I was worrying too much. I experienced a lot of discomfort because the strings on the IUD were too long, but when I called to ask if they could cut the strings shorter, my doctor told me to stop worrying about my symptoms and said I was overreacting. I insisted the doctors see me to confirm that the strings were the right length, and when they gave in, they cut off an inch and a half of excess string that had been causing me physical discomfort for weeks. (For reference, the vaginal canal is three and a half to six inches long. IUD strings are only supposed to be about two inches long, and the doctor initially cut mine to three and a half inches.) It was frustrating that I had to be my own advocate at this clinic and that the doctors valued their time over addressing my discomfort. I would spend up to 45 minutes at a time in the backlogged waiting room to see arrogant and judgmental doctors — one doctor even made a negative comment about my ear piercings. Though the IUD worked well for me, I haven’t been back to that provider in years.
Since then, I’ve been getting my sexual and reproductive healthcare from the University Health Center (UHC) at the University of Maryland, College Park (UMD). I had a contraceptive consultation in the Fall semester for my IUD replacement, and once again I evaluated all my birth control options and decided the IUD was still right for me. I was happy with how Skyla had reduced my cramps during my periods, so I wanted another device that would do the same. This time I decided to get the Liletta IUD, which has a higher hormone dosage than Skyla and lasts twice as long: six years, rather than Skyla’s three years. A doctor placed my IUD while a member of the Health Center staff stood by me and offered to hold my hand if I needed it. I was given 15 minutes after the insertion to rest on the table before the doctor came back to check up on me and answer my questions, then encouraged me to call if I had any concerns. I was in pain after the procedure, but the next day I received a message from a member of the UHC staff checking in with me and asking how I was feeling. Receiving this message brightened my day after a stressful week. The only disappointment was that even though I was in increasing pain, I couldn’t get a doctor’s note to miss class after the procedure because an IUD insertion is an “elective” procedure. Instead, I had to use the one self-signed note I’m allowed each semester to excuse myself from my two remaining classes that day. Since IUD insertions are done on weekdays during business hours, I feel this should qualify for an excused absence from class.
Aside from the trouble with excused absences, it was refreshing and comforting to know that there are health providers within students’ reach that care about their patients and want them to feel as comfortable as possible before, during, and after such procedures. The UHC is an invaluable resource for students, offering a range of services, including compassionate, non-judgmental sexual and reproductive healthcare for college students so they can have agency over their sexual and reproductive health. While some other colleges and universities in Maryland provide contraceptive prescriptions, UMD’s UHC has one of the broadest ranges of contraceptives available to students, including insertion of long-acting reversible contraceptives such as hormonal and non-hormonal IUDs and the Nexplanon implant, as well as a pharmacy that can fill birth control prescriptions.
To ensure students’ access to contraceptives and healthcare, other universities must follow UMD’s example of providing a range of services useful to students. The fact of the matter is that no university (not even religious ones) can control whether their students have sex. What universities can control, however, is whether they are providing the holistic healthcare their students need.