IUD problems cost women time and money
Pharmaceutical funding does not cover the cost of inserting or removing the IUD if complications occur, which has been a problem for many Kiwi women. Photo / Getty Images
At the end of 2019, Pharmac announced its funding of the Merina and Jaydess IUD to make contraception more accessible to women.
But that didn’t cover the cost of inserting or removing the device if there were complications, which was a problem for many Kiwi women.
Abby Symon, 26, from Wanaka, had her first Mrina IUD inserted by her GP in November 2019 and said it was “the most painful thing” she has ever experienced.
She was bedridden for two days after insertion and had monthly bleeding for a year, which her IUD was designed to prevent.
“I paid $ 55 about 4 to 5 times to go see my doctor and find out why I always had such horrible problems.”
In November 2020, Symon paid $ 250 to have an ultrasound in a private practice because she “urgently” needed it and discovered that her IUD had moved, tearing one of her ovaries.
She had it removed and replaced the same day by a doctor, costing her an additional $ 110.
“I hated having to pay to be told to give him more time, then after a year I was told he was in the wrong place probably from the start. I probably paid close to $ 900 at the total.”
A spokesperson for the health ministry said some health services, including the insertion and removal of long-acting reversible contraceptives (LARCs), are not funded by the government and that these charges will be set by the health care provider.
“The ministry provides a limited amount of funding to district health boards to improve access to contraceptives, including insertion and removal of LARC.
They said the eligibility criteria for accessing this funding include people with a community service card, those living in severely disadvantaged areas and others who are at high risk for ill health.
“DHBs can adjust the criteria in order to manage the available budget.
Anna *, 26, had a copper IUD inserted in October 2019 and said the insertion was “uncomfortable”, but the procedure went well.
Six months later, Anna got pregnant and signed up for an ultrasound which revealed that the IUD had been poorly fitted because Anna had a complete septate uterus.
This is a rare condition where the uterus has a septum or “wall” that divides the inner part of the uterus.
“An IUD should never have been inserted for a person with a uterus like mine. Then I had to remove the IUD, and then I miscarried.”
Anna also had to undergo a saline infusion ultrasound to “assess the severity of [her] illness ”which cost $ 500, of which $ 250 was covered by his health insurance.
“My condition has turned out to be incredibly expensive and I have little financial support.”
She said it should be “mandatory” that ultrasounds be done before IUD insertion so that health care practitioners can “be sure of the anatomy” to avoid complications.
“It was heartbreaking going through what I went through, and if a CT scan could have saved me from birth control failure and subsequent miscarriage, I would have wanted it.”
Dr Emma Jackson, a specialist in obstetrics and gynecology from Christchurch, said implementing mandatory ultrasounds before insertion could be a barrier for women due to additional costs.
She said if a healthcare professional is having difficulty inserting an IUD, they should stop and examine the uterus with an ultrasound to check for possible problems.
Jackson said the cost of IUDs can be “pretty cheap” thanks to the low-cost consultation fees, but she “doesn’t know” how well women are accessing them.
“In an ideal world, I think contraception should be free for everyone. We were very happy as a group of consultants when the funding improved. [for IUDs]. “
Jane *, 30, was on her third IUD and had good experiences, until she wanted to remove it to have another baby six years ago.
She went to family planning to have it removed, but was told that her Mirina IUD was “built into it.” [her] uterine wall “, she should therefore remove it surgically.
This is called uterine perforation, a rare complication that can occur during the insertion procedure, occurring when an IUD migrates through the body.
Jane went to a doctor and was told it would cost him $ 5,000 to have it surgically removed, otherwise he could give her a relaxing pill and take it out himself.
“There was no way I could afford it. The hospital said it wouldn’t be covered,” Jane said, so she had the doctor removed it.
“Two people cornered me and he must have torn it from my uterine wall. Come to think of it, it could have done so much damage. It was brutal.”
The experience was enough to deter Jane from using an IUD for good despite her previous positive experiences.
“I never went looking for another one. I never will.”
Jackson said an IUD can sometimes move and migrate around the body with a risk of perforation.
“I have seen IUDs that have changed in women. The highest rate of this occurs during the first year of insertion.”
She said if a woman has a migrated IUD that needs to be removed, there will be no charge if she is referred through the public system.
Jackson said complications such as an IUD that embedded in the uterine wall were rare, and that the IUD was still a “fantastic” option and could be a “lifesaver” for women with difficult periods.
“I would definitely recommend that women consider an IUD if they want a good form of contraception.”
Auckland Phee Nicks, 30, had 3 Mirina IUDs inserted by a gynecologist and said the process was “very beneficial”.
“It would be a complete lie to say it doesn’t hurt, but the few minutes of pain seems minor compared to the years of pain from PCOS [polycystic ovary syndrome]. I would never get a Mirina from someone who isn’t specialized. “
PCOS is a hormonal condition causing enlarged ovaries with small cysts on the outer edges. Mirina IUDs may be recommended to protect the lining of the womb from abnormal thickening, which can occur in a woman with PCOS.
Where to go when things go wrong
If women have concerns about their IUD procedure, they can file a complaint with the Commissioner for Health and Disability (0800 11 22 33).
If they have concerns about an injury caused by the insertion or removal of the IUD by a licensed healthcare professional, they can file a complaint with the ACC (0800 101 996).