The Dying Need for an IUD

With the increasing rise of death related to childbirth, women in the United States need effective forms of birth control now more than ever.

Source: Case Western Reserve

According to an article written by USA Today, the maternal death rates have more than doubled in the United States over the past 25 years. In 2014, the United States had the highest maternal mortality rate of 18 deaths per 100,000 live births. Not only is this statistic alarming, but it also makes me wonder how many of these births were planned for and how many of these women could possibly have reduced their chance at death with proper access and knowledge about birth control.

There are many issues within our healthcare system regarding the topic of birth control such as: improper education surrounding the use of birth control, the lack of knowledge of the options that are out there for birth control, or lack of access these women have to birth control. As these are all major issues, I think one of the simple issues that could help reduce the overall risk of maternal mortality is increasing the knowledge of the different forms of birth control, especially long term, reversible, birth control.

On the right is the IUD on the left is the arm implant
Source: babygizmo.com

In a piece written by Governing, Mark Funkhouser, the former mayor of Kansas City, MO talks about long-acting reversible contraceptives (LARC) such as intrauterine devices (IUDs) or the arm implant. He states some of the statistics of the amount of women in the United States that use these contraceptives compared to those statistics around the world. According to the census in 2012, only 5.3 percent of women who use contraceptives use LARCs compared to the 23.3 percent of women who use them in Norway. I do not think that women in the United States have proper knowledge about LARCs. Compared to the United States, Norway has a much lower maternal mortality rate of 2.2 deaths per 1,000 births. With these statistics alone, I think that there is a major correlation in LARCs and maternal mortality rate. We should be acting more like Norway and take the incentive to try and lower our maternal mortality rates.

Source: Case Western Reserve 

Whether this be the older population of women hearing horror stories from the early stages of the IUD or younger girls hearing different stories about how their friends’ experience has been with an IUD, women are scared of the IUD. When thinking about the early stages of the IUD, Chikako Takeshita does a great job describing what happened in the early stages of development in her book The Global Biopolitics of the IUD. When discussing the early stages of the IUD in the United States, she describes the horrible stories of one of the first IUDs, the Dalkon Shield. The Dalkon shield caused horrible infections, miscarriages, sterilizations, and even death. The connotation of the IUD has not changed much today with the young women in the United States, they hear how horrible the implantation process is, how it is possible to cramp out the IUD, and how it can get lost inside of the body. As these are all risks, you do not hear many positive remarks made towards the IUD.

The story surrounding the IUD needs to change, as it could possibly save a woman’s life.

Women should be talking to their healthcare professionals about what the best option for them is. An article posted by CNN does a great job laying out both the positives and the negatives of the IUD. Articles such as these are so important for women to see how great of an impact they can have, so they can start to see the positive impacts of the IUD. In this article, the author discusses how the IUD is very low maintenance, so basically the woman does not have to think about her birth control at all. The article also discusses how the device can help reduce menstrual pain and heavy flows and how the device is 99% effective for protecting against pregnancy.This brings up another issue of how a lot of women do not have access to healthcare or cannot afford a specialist, such as a gynecologist.

This is where my struggle with IUDs comes in. With the United States maternal mortality rate being so high, it is especially high within African American women at 40 deaths per 100,000 live births, as stated by the same Governing article. It is no secret that the African American community within the United States is lower to middle class families. So, when these women get pregnant, I would have to imagine that it may not be planned, or if it was, they may not be getting the best prenatal care or birthing care within hospital systems. However, if the answer to the lower mortality rates could be LARCs or more specifically the IUD, how do you expect these women to pay for it? The CNN article regarding the IUD states that an IUD can cost up to $1,300. If this woman is even a part of a middle class family, they cannot pay that much money for contraception. So then these families are going to test their luck with different forms of birth control such as condoms, withdrawal, or possibly the pill, which all take serious discipline to administer correctly. This then leads to unwanted pregnancy and comes full circle with the high risk of maternal mortality.

The IUD and other long-acting reversible contraceptives are a great idea on a way to start lowering the maternal mortality in the United States. However, I think there needs to be lots of change before the IUD can become a majority of contraceptive use in the United States. To make this happen, the conversation needs to include informed consent in a way that benefits women. Takeshita mentions, “The feminists’ aim to enable women to make informed decisions about birth control…” (Takeshita, 97).  Making these informed decisions about what type of birth control would be the best for the woman’s body and the most manageable for her lifestyle is so important in helping reduce accidental pregnancy which then lowers maternal mortality. As Takeshita believes, the original intent of informed consent is to allow women the full knowledge they need to make proper decision for their own personal healthcare (Takeshita, 97). Overall, we need more knowledge and positive information going to the women who do not yet have a family or cannot afford the best healthcare. These women are the ones at risk for a tricky pregnancy and therefore a tricky birth. We need to change the way that we view contraceptives, especially LARCs, and the way we promote the products. We need to find a way to fund the IUD to get it to the women who need it the most.

Relevant Course Readings:

Takeshita, Chikako. The Global Biopolitics of the IUD: How Science Constructs Contraceptive Users and Women's Bodies. The MIT Press, 2012.