Actually, this isn’t a truly new option, just one that has gotten no press up to now: using an IUD for emergency birth control:
A copper intrauterine device was 100 percent effective at emergency contraception in a study of almost 2000 Chinese women who had the device implanted up to 5 days after unprotected sex.
The device – called Copper T380A, or Copper T – continued to be effective at preventing pregnancy a year after it was inserted.
“It is by far the best emergency contraceptive option,” Dr. James Trussell, who studies birth control methods at Princeton University but was not involved with the current study, told Reuters Health of the device. “But many people just don’t know about it.”
Copper T, marketed as ParaGard in the United States, is a T-shaped piece of flexible plastic wrapped in a layer of copper that is inserted into the uterus. It works by stopping sperm from reaching the egg and by preventing an embryo from implanting in the wall of the uterus.
Led by Dr. Shangchun Wu at the National Research Institute for Family Planning in Beijing, China, the authors followed almost 2000 Chinese women who were implanted with the Copper T after coming into family planning clinics for emergency contraception. All of the women had engaged in unprotected sex in the previous 5 days.
Now, I have to admit I’m one of those women who remembers the publicity around the Dalkon Shield, including the subsequent lawsuits, and so I’ve never really warmed up to the idea of an IUD. But that’s just an emotional reaction. The safety record of the Copper T is very solid. Its effectiveness in the follow-up year of this study was similar to the overall track record of the IUD, with fewer than 1% of women becoming pregnant. (A few of them didn’t tolerate the IUD; either they expelled the IUD or had it removed due to side effects.)
The Reuters article also lays out the barriers to using an IUD as EC. You need to make an appointment with your gyno, and that may not be do-able within five days. The upfront cost ($500) is daunting if insurance won’t cover it.
One point that the otherwise thorough Reuters report missed: A few doctors still suffer under the misapprehension that inserting an IUD is too difficult in woman who’s never borne a child; it’s not, though it may sometimes be a bit trickier. This is a declining problem, but it’s still been an issue for some women (according to the commentariat at Feministe).
Despite these pitfalls, I can imagine the IUD being an excellent choice for many women who need EC. If you’re someone whose birth control is iffy because you have a hard time remembering to take the Pill, the IUD will solve that problem. If you only use condoms sporadically and therefore need EC, the IUD might be a good solution.
Especially for anyone who’s a repeat customer for EC, the IUD seems like a highly sensible choice. While IUD insertion can cause cramping (which can persist for a few days), Plan B can inflict pretty intense nausea. Having to chase down EC repeatedly is stressful for body and soul. Where 1 in 100 women will still get pregnant on Plan B, it’s fewer than 1 in 1000 with the IUD as EC. And in the long run, a woman who chooses the IUD is highly unlikely to face an unwanted pregnancy.
That’s not a panacea. But it’s a pretty excellent option.
Update 8/9/10, 10:30 p.m.: MomTFH, who (unlike your humble hostess) has actual medical training, added a whole ‘nother dimension to this in comments. Click here to read her whole contribution. A few highlights: “I was actually told by my ob/gyn that I wasn’t a good candidate, even though I had already had a baby, because I was divorced. (!!)
“According to a midwife who taught me about birth control, the reason why IUDs were not recommended for nulliarous women were because so many of them successfully sued over the Dalkon shield. The company had to pay a much higher settlement to women who never got to have children due to their injuries than they did to those who already had children. The indications for the newer IUDs, including the copper T, originally said the ideal candidates were parous women, but that is no longer the case. New recommendations say that pretty much any woman who does not have active pelvic inflammatory disease is a good candidate.”
She notes that the standard of care in the U.S. is to screen for STIs before insertion of an IUD, which would add to the difficulty of using an IUD for EC. I have to wonder if one reason for some practitioners’ coolness toward the IUD is that they worry women won’t take precautions against STIs, yet they also won’t need to come in for an annual exam (as they would if prescribed the Pill, patch, or shot) where an STI could be diagnosed and treated.