What will it take to make intrauterine devices sexy?
IUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.
The contraceptives are inserted into the uterus and can prevent pregnancy for years. And they’re reversible. Shortly after they’re taken out, a woman can become pregnant.
IUDs are more than 99 percent effective. The World Health Organization reports they are “the most widely used reversible contraceptive method globally.” But few women in the U.S. use them; the percentage is only in the single digits, in part because IUDs have a checkered past. The Dalkon Shield IUD, marketed nationwide beginning in 1971, was found to raise the risk of pelvic inflammatory disease. Medical complications and deaths sparked lawsuits with thousands of claimants.
“So we had a whole generation in the ‘70s and '80s … where doctors and clinicians weren’t trained and women didn’t have that option,” says Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University in St. Louis.
The two common intrauterine devices in the U.S. are ParaGard, which releases copper to interfere with sperm, and Mirena, which prevents pregnancy with the hormone progesterone. There is still a slight risk of pelvic inflammatory disease. But Bayer Healthcare Pharmaceuticals, the maker of Mirena, says fewer than 1 percent of users of its device get the infection. More common side effects for women using IUDs are irregular bleeding or cramping.
Upfront costs also limit access; the price of the device and getting it inserted can cost hundreds of dollars.
But Mirena works for up to five years, and the copper IUD up to 10. So over time, they can actually be cheaper than monthly payments for, say, the pill. And IUDs, like other contraceptives approved by the Food and Drug Administration, are expected to be covered for most users under the Affordable Care Act.
Maybe you’re thinking about getting birth control for the first time, or maybe you’re ready for a change. Either way, there are some great resources out there!
To get the most out of your birth control, generally speaking, the more methods you use, the more effective it is. NO, that doesn’t mean using multiple condoms at once! It means using condoms along with the pill, or the IUD along with pulling out, or maybe a diaphragm along with Fertility Awareness-Based Methods (not having sex when you’re most likely to get pregnant). There are tons of methods and combinations, so if one doesn’t work the first time, keep at it!
If you’re not sure where to start, Planned Parenthood and Bedsider have tools to help you decide:
To start off Birth Control Appreciation Day, I decided to make an informative masterpost on contraceptives! I hope this helps anyone who may want more information on their birth control or someone trying to decide what kind of birth control is best for themselves! Happy (birth control) hunting! - Paige
The FDA’s May 9, 1960 approval of oral contraception, aka “the pill”, transformed reproductive health. Women’s health advocate Margaret Sanger spearheaded and activist/philanthropist Katherine McCormick funded the R&D needed for this medical research breakthrough to improve women’s lives through “birth control.”
Margaret Sanger, a nurse, coined the term “birth control” and dedicated herself to educating women. Her own mother had 18 pregnancies in 22 years and died from ovarian cancer. In 1914, she started a newsletter, The Woman Rebel, to “advocate the prevention of conception.”
Sanger was indicted repeatedly and even arrested on obscenity charges under the Comstock Laws (1873) which defined birth control as obscene and made it illegal to send contraceptive devices or even info about it through the mail.
Flyer from benefit held on eve of Sanger’s trial for opening Brownsville Clinic. (Courtesy of Sanger Project).
Katherine McCormick heard Sanger speak in 1917 and grew convinced that women could only fully control their lives if they could control ifandwhenthey chose to bear children. She redirected her advocacy to the cause of birth control, even smuggling in diaphragms from Europe to New York at Sanger’s request.
When her husband Stanley died in 1947, Katherine inherited an estate estimated worth almost $40 million (more than $500 million today). Margaret Sanger introduced her to Gregory Pincus who was doing pioneering research on fertilization and hormones.
Katharine funneled to Dr. Pincus more than $2 million ($25 million today), nearly all of the money used to support his lab’s research and development of the contraceptive pill.
Read the National Archives Prologue Magazine storyRich, Famous, and Questionably Sane to learn how McCormick, who was blamed her husband’s inability to consummate his own marriage, became the catalyst for the sexual revolution.
Women Hold Banner at National Women’s Conference, November 1977. NARA ID 7452290.
Word of advice: If you know you don’t want to/aren’t able to go through a pregnancy, and you live in the US, either arrange to get both main and backup contraception NOW for the long term, or talk to your doctor about surgical options.
Too many Gilead-wannabe states are moving to cut off your options starting the moment a sperm gets within six inches of your body.
it will economically devastate women, forcing them to seek out and remain in relationships with (potentially abusive) men in order to avoid poverty. forced birth advocates often see this as protecting marriage and the family— the economic impact of forced birth on women is not just a consequence they don’t care about or haven’t foreseen, it’s THE POINT to keep us in our place.
poverty is used to keep a class of women sexually available to men through either marriage (conservatives) or prostitution (liberals)
The economic impact of forced birth on women is not just a consequence they don’t care about or haven’t foreseen, it’s THE POINT to keep us in our place.
If women can’t prevent pregnancy - and make no mistake about it, they are coming for hormonal contraceptives next - and can’t end a pregnancy, and can’t afford childcare for multiple children, then she can’t afford to stay in school or work full-time. And gosh, well, that just opens up a bunch of positions in higher education and the workforce for men, doesn’t it? If you think this is about anything other than forcing women out of the workforce and into marriage and families, you aren’t paying attention.
According to Gallup’s 2021 Moral Issues Survey, Americans’ views on sexual morality continue to become more liberal overall. In fact, for some of the issues on this survey, Gallup recorded the most liberal views on record.
Among the more notable changes are that Americans are increasingly comfortable with same-sex relationships, sex between unmarried adults, divorce, and having children outside of marriage. However, while significant shifts have occurred in those attitudes over the past two decades, Americans’ attitudes toward other sex-related issues—such as abortion and infidelity—have not changed quite as much.
Check out the table below for a closer look at the numbers and how they have changed over the last two decades. Note that Gallup started asking about most of these topics in 2001-2003; however, they added more issues to the list around 2013 (including pornography, birth control, and sex between teenagers), which is why I put that year in the table as a reference point. Also, new this year (in 2021) is a question about the morality of changing one’s gender.
Percentage of Americans Who Think Each Behavior Is Morally Acceptable (Gallup, 2021)
As you can see, the most dramatic change to occur is that a large majority of Americans now believe that gay and lesbian sexual relations are morally acceptable. Public opinion on this issue has shifted in a major way since 2001. Back then, most Americans believed that same-sex behavior was immoral; however, that has notably changed alongside the important social and political gains made by the LGBTQ+ community in recent years, including the fact that same-sex marriage is now legal throughout the nation (the result of a Supreme Court decision in 2015).
Sex between unmarried men and women and divorce were rated as the most morally acceptable behaviors in 2001, and they continue to lead today. By contrast, both consensual non-monogamy (specifically, polygamy) and non-consensual non-monogamy (cheating) are the least accepted.
However, it is interesting to note that the number of Americans who think polygamy is morally acceptable has almost tripled over the last 20 years. It would be interesting to know whether moral acceptance of other forms of consensual non-monogamy—by which I mean polyamory, open relationships, and swinging—has changed over this same time period. However, Gallup has not inquired about the acceptability of these relationship configurations in their surveys, which means we can’t really say what, if any, changes have occurred. I would certainly hypothesize that their perceived acceptability has likely increased as well (especially in light of how interest in open relationships has surged over time), but we need more data to know for sure.
It’s also worth noting that while attitudes toward abortion have remained fairly stable since 2001 (increasing by just 5%), attitudes toward stem-cell research have become quite a bit more favorable during that same time period (increasing by 12%).
As for the additional issues asked about in 2013, we can see that there have been some significant shifts in the moral acceptability of porn use and sex between teenagers; however, most Americans appear to find these issues morally unacceptable, which is interesting considering how common these behaviors are—most people have sex as teenagersandmost people use porn at some point. By contrast, use of birth control is almost universally perceived as morally acceptable, with 9 in 10 Americans saying so.
Americans today also seem split on the moral acceptability of changing one’s gender: 46% say it is acceptable, while 51% say it is not. When you consider that 69% say gay and lesbian relations are morally acceptable (vs. 30% who say it is not), this points to an important disparity in the moral lens Americans apply to different segments of the LGBTQ+ community. Unfortunately, we don’t have historical data from Gallup on how attitudes toward changing gender have shifted (it’s likely that they have), but the overall extent and pace of change is unknown.
With all of that said, it’s important to highlight that while Americans’ sexual attitudes overall are increasingly liberal, the numbers in the table above indicate that many Americans hold conservative sexual values. This cultural divide is regional, with attitudes being more liberal in the northeast and west, and more conservative in the south. The partisan divide is greatest on LGBTQ+ and abortion issues, with more than 40 percentage points separating liberals and conservatives in their attitudes. All of this helps to explain why sexual morality issues are much more controversial in some states than others—and aren’t going away any time soon.
Want to learn more about Sex and Psychology? Click herefor more from the blog or here to listen to the podcast. Follow Sex and PsychologyonFacebook, Twitter (@JustinLehmiller), or Reddit to receive updates. You can also follow Dr. Lehmiller on YouTubeandInstagram.
Growing up you could say that I was incredibly lucky; my family as always fostered an open environment of communication, any question we had about anything, we were free to discuss. It ensured that we never went to obscure places to find answers we were searching for, and from my mother’s point of view (with her midwife’s head on) we always had the right answer too. And she would explain it the best she could, whether that was by whipping out a medical textbook. Or giving up with them and drawing a better picture herself.
But as I’ve got older the roles of the teacher and the student has morphed and changed, it’s me sometimes explaining what things mean to her. This has found her exploring new phrases (few of them publishable!) and also how I found myself explaining what a dental dam was on a spring Sunday evening. As someone who works in the sexual health area, she was fascinated at the prospect of protection for oral sex.
A dental dam is a relatively new contraceptive method and works as a piece of latex stretched over the vulva. It can also be used during oral sex performed on the anus. This therefore protects the giver from the potential STIs held by the receiver. They can also be made by cutting off the tip and the base of a condom, to make a square. It is recommended that a thin condom be used to retain sensitivity. I have to say it made for an educating if not interesting evening, exploring new contraceptive methods.
Yet, I think it’s important to continue this discussion and questioning, even if the person explaining has changed over the years. When protection or even words are changing with such speed and ferocity, it is important to always keep learning to ensure that we fully understand. Even if you do end up discussing contraception with your middle aged mother.
