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  • Medical trauma from IUD fitting: it’s not just five minutes of pain for five years of gain

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    Summary

    In this personal account, hub member Sophie talks about the trauma she experienced after a painful contraceptive device (IUD) fitting, and the impact this has had on her subsequent experience of medical procedures. She argues that damaging narratives around female pain cause harm to patients in multiple ways and have consequences that reach far beyond the initial experience of pain.

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    A public conversation has finally started about pain relief for IUD fittings. Several women in the public eye, such as Naga Munchetty and Caitlin Moran, have come forward with appalling stories about their experiences in the stirrups. Like with recent public reckonings about violence against women in public spaces and in various industries, it’s a shame these conversations were only started when women aired their bloodstained laundry out in public, in the hopes that someone, somewhere, might give a damn. Anyone who does care now has plenty of accounts to sift through, as more and more people share horror stories of excruciating agony, screams echoing down the surgery corridor, uncaring doctors and going into shock - all from a procedure which the NHS website describes as potentially ‘uncomfortable’.

    However, something desperately important is missing from this conversation: the long-term impact these traumatic experiences can have on physical and mental health.

    I was 22 years old when I decided to get the coil. I was fed up with side-effects from the pill, and wanted something lower maintenance and non-hormonal. The coil seemed perfect for me. Walking into the clinic, I wasn’t too worried about it being painful. 'If it was that bad, they’d never let anyone do it without anaesthetic', I thought. 'I’m not especially squeamish, and everything I’ve read says paracetamol is enough'. Thirty minutes later, I was lying on the table feeling like I’d just been skewered on a doner kebab rotisserie. I was allowed to leave despite barely being able to walk. I remember hobbling to the toilets, and seeing in the mirror that my face had turned grey. I remember sitting on the toilet, ears ringing, and then everything going black. I was found some time later sitting in the waiting room with my head in my hands, struggling to process what had just happened. 

    Personally, I think there’s a general tendency to believe that female genitalia is built for pain. It’s a belief that those of us who grow up female are drip-fed in a hundred small ways. Being told that sex is meant to hurt the first time, that it’s normal to bleed. Drip. Being told that women have naturally higher pain thresholds, that our bodies are just machines for making babies. Drip.

    It’s ubiquitous in accounts of difficult coil fittings; one person’s GP told her that if she thought the coil hurt, she’d have ‘no chance’ during childbirth. Drip. Being told by the nurse after my own fitting that I’d been ‘very brave’. Brave for what? For feeling pain which I hadn’t been told I might experience, without screaming my head off? Drip, drip, drip. If thousands of personal accounts aren’t enough – and so far they clearly haven’t been - then please, dig into the wide range of scientific studies analysing gendered pain bias.[1] 

    This deep-rooted belief that pain counts less when it happens to female genitalia changed my life for the worse when a medical professional thought it was a good idea to artificially dilate my cervix without analgesics. This is one reason why the burden of asking for pain relief during coil fittings should never be put exclusively onto the person getting the coil – because we’ve been pressed from day one to believe that excruciating pain in our reproductive organs is natural. Inevitable. Good practice for childbirth.

    Like all people my age with a cervix, I’ve now started getting letters inviting me to cervical cancer screening. On a rational level, I’m grateful to live in a time and place where I can access such fantastic lifesaving healthcare, free at the point of delivery – but as we all know, trauma is not rational.

    Before I got the coil, I had no problems with doctors poking at my cervix. I’d done it several times and found it uncomfortable, but very manageable. I could get on with my day afterwards. After the shocking pain of my coil fitting, that peace of mind is gone.

    During the smear test, my rational mind said, ‘relax, this isn’t going to hurt,’ – but another voice whispered, ‘but you didn’t think it was going to hurt last time either! If it happened then, why not now?’ I was extremely tense the entire time, which made the procedure more difficult for the nurse, and more painful for me. 

    To make things worse, my results came back ‘abnormal’. I needed a colposcopy and biopsy to check if the minor cellular changes to my cervix were benign. Although this would be stressful for anyone, lingering trauma from my coil fitting massively compounded that stress. I barely slept the night before the procedure. On the table, when I felt the biopsy tool scraping against my cervix, that whispering voice picked up a megaphone. I was convinced that lancing, kebab-skewer pain was coming for me, any second now. I started sweating and crying uncontrollably, head spinning, and again, was completely unable to relax, making the whole ordeal more painful for me and more difficult for the gynaecologist. Fortunately, the results came back fine. The cellular changes aren’t malignant, and even if they have worsened by my next check up, treatment is very effective when it’s caught so early. 

    But what if I hadn’t gone for the test? I’m positive there are many people out there living with medical trauma from painful coil fittings, who put off getting cervical smears and other vital tests.

    If I’d done the same – and there was part of me which really wanted to - and if my cellular changes had developed unchecked into cervical cancer, my life would have been at risk. That’s a heavy price to pay for contraception. The utter shock of how painful my fitting was has damaged my relationship with my own gynaecological health, with my own body. This damage is probably permanent, and if that isn’t medical malpractice, then I’m not sure what is.  

    Have you experienced pain during an IUD fitting? You can share your story in our community conversation about painful IUD fitting.

    Related reading

    The ripples of trauma caused by severe pain during IUD procedures (BMJ Opinion, July 2021)
    The pain of my IUD fitting was horrific…and I’m not alone
    The normalisation of women’s pain

    References

    1 Jennifer Billock. 'Pain bias: The health inequality rarely discussed'. BBC News, 22 May 2018

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    Sorry to have to welcome you to the club.

    Sadly IUD fittings are not the only painful procedures that we have to endure despite being led to believe that they just might be uncomfortable or 'like period pains'.

    My hysteroscopy and biopsy experience now mean that I no longer go for cervical screening and found even Covid-19 vaccinations traumatic. Why? because I can not trust the NHS staff to tell the truth.

    I have recently binned the bowel cancer screening kit. Why? because it might mean that I have to go for a colonoscopy. Again NHS information tells us that it might be uncomfortable, but friends' experiences do not match that information. Therefore trust goes out of the window.

    A friend working for the NHS is frustrated by her female patients not coming forward for screenings. And why is that? because her patients have had traumatic and painful experiences.

    I am no longer prepared to be told to 'be a good girl' or 'be brave'.

    But do I have to die for it???

    NHS needs to get its act together - yes, offering pain relief might be expensive, but how much more expensive are the treatments when someone's cancer or other disease has progressed further; diseases that could potentially be treated more easily and cheaply the sooner that they are identified. 

    We need a joined up campaign to raise awareness around all potentially painful gynaecological procedures to ensure that everyone with a womb has access to effective and supportive health care for that part of our bodies that are at the core of how we see ourselves.  

     

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