Most days, I’ve perfected the art of looking like a pleasant and functional member of society. It’s a matter of a little strategic concealer, clothes that don’t wrinkle even when they’ve spent a few too many weeks beneath the couch, and headphones in my ears for the first few hours of the day so that I don’t have to interact with people until I’ve downed four coffees. But I am so fallible: it’s 11p.m. and I just woke up from a three-hour nap. There is very little overlap in my sleeping and waking hours from week to week, and for the two years that I was on the birth control pill, I never ever took it regularly and likely did irremediable damage to my body. Worse still, I took Camila (or the “mini-pill”), a progestin-only oral contraceptive that I chose because I was unduly anxious about the side effects of synthetic estrogen, but that is marginally less effective than the alternative and therefore needs to be taken with even more stringent regularity. It was a decision that I made with a clinician at McCosh early in my first year, before I had settled into my unpredictable and exciting sleep schedule, but which very quickly proved to be the wrong one. And over the time that I took it, I faced so many difficulties getting my three-month supply from the U-Store that I would have to spend hours every few weeks running back and forth from McCosh to the U-Store pharmacy to get my prescription filled. I never took the pill over the summer, and I would sometimes forget to take it for days at a time.
In December of last year, I finally looked into alternatives. Part of that might have been motivated by an uptick in national conversations around accessible birth control, and part of it might have been that more of my friends were having these conversations too. Lydia Weintraub ’18 changed her Instagram bio to “has an IUD.” In my circle, conversations about contraception were becoming destigmatized. I’m lucky that I had never had to politicize my conception of reproductive rights before, but as they came under attack, I protested. I marched for Planned Parenthood with Princeton Students for Reproductive Justice, and I wrote for The Nassau Weekly about my impending IUD, about my last period for the next six years.
It took weeks to schedule my first consultation with McCosh, but on January 12, I spent a half-hour there with a lovely, attentive clinician who made me pee in a cup first, then talked me through the options available through the Student Health Plan. In addition to oral contraceptives, McCosh offers vaginal rings, contraceptive patches, intrauterine devices and subdermal arm implants. I was initially tempted by the seemingly less invasive arm implant, and the nurse showed me a dummy arm that you could press down and feel the matchstick-sized rod in the bicep. The sensation made me feel a little queasy, so I turned to the IUDs. McCosh offers three options: Skyla, Mirena, and ParaGard. Skyla and Mirena are both hormonal IUDs that use my old friend, the hormone progestin, to prevent pregnancy. Skyla lasts up to three years;Mirena, up to six. ParaGard is a non-hormonal copper IUD and lasts up to twelve years. The IUDs can be removed at any time before then. I chose the Mirena, because I don’t plan on having children in the next six years, and because side effects of the ParaGard include heavier periods and worse menstrual cramps. The Mirena typically lightens periods, and sometimes eliminates them entirely. From conversations with friends, there is no evident consensus about which IUD to get; one friend told me she finds it unnatural not to have her period. I replied that I find it unnatural to enjoy going through five days of pain every month, but to each her own.
I scheduled my appointment for January 23, eleven days after my consultation, but had to cancel it that day, and wasn’t able to reschedule until February 11, a month after I first sat down for my consultation. And on February 11, McCosh cancelled on me because they had run out of the Mirena—which I found really problematic at the time, but when they called and emailed me to reschedule, I was a delinquent and never picked up the phone. I fully planned on rescheduling, but because I am only a semi-functional member of society, I slacked off for probably a full six weeks before making my next appointment on April 14.
From conversations with friends, I knew that people’s experiences with IUD insertions range from painless to traumatic. It was all I could talk about that day, and my loving, generous friends regaled me with horror stories: the girl with the tilted uterus who got it inserted in the wrong place, the girl whose IUD broke through her stomach lining, the girl who drunkenly thought the IUD strings were from her tampon and ripped it out… By the time I showed up for my appointment, I was white in the face. A nurse with short purple hair and a huge, inviting smile sat me down in a small, sanitary-looking room. She asked me how I was feeling, and I told her I was nervous. She took my blood pressure and said, “No kidding.” Then she asked me to pee in a cup.
I had definitely forgotten to hydrate so I was surprised when I didn’t struggle to fill it, but quickly realized the cup was mostly filled with blood because my body had graciously decided to gift me with a parting period. I sheepishly turned it in, unsure if they could still insert the IUD, dreading having to reschedule, sad that I had ruined a millionth pair of cute underwear, but also a little proud about not being pregnant.
That’s when I met my nurse practitioner. I awkwardly told her I had just gotten my period, and she said it was no trouble at all. Then she asked me if I had any more questions, made me sign a consent form, and asked if I had taken ibuprofen. I had not.
“Didn’t you have a consultation?”
“Yeah, but it was a while ago.”
“So you didn’t take any painkillers?”
She probably saw more color drain from my face, and she rushed out to get me a massive pill that I swallowed like a pro. Then she instructed me to undress, wrap myself in a large sheet of paper, and lie on the exam table.
A few moments later, she came back and put my feet up in stirrups and had me scoot all the way down so I could only look at the ceiling directly above me, where there was a reflective plastic smoke detector. Narcissist that I am, I spent most of the time staring into a distorted version of my face.
My nurse practitioner was dope. She prefaced everything by saying, “You’re not going to want me up here,” but she also talked me through every step and made sure I was as comfortable as I could be, given the circumstances. At first, she measured my uterus, checked my cervix, and inserted a speculum to separate the walls of my vagina so she could get up in there. I’m morbidly curious, so I asked to know my measurements and felt wholly validated to learn that my uterus is perfectly average and that its size will make literally no difference in my life, not even during childbirth. So far, nothing really hurt, though the speculum was cold and kind of unpleasant. She warned me that she would have to straighten my uterus to insert the IUD, and that would cramp pretty badly. I put my once-a-month yoga to use and inhaled really deeply as I gripped the sides of the table, but holy mother of god that hurt so bad. She explained that the peaks of pain are essentially the cervix cramping, which can also happen occasionally during deep penetration or after orgasm, but the sensation is most familiar to women during contractions—only contractions are much closer together and last much longer. It’s hard to describe the pain with any accuracy now that I’m removed from it, but it felt like I was being punched from the inside. She joked that because the ibuprofen hadn’t yet kicked in, it was like I was giving natural birth, which was a kind but bold-faced lie.
After the procedure, she said, “You have five years of great sex ahead.” She told me I have a high pain tolerance, which exactly no one had ever done before, and which I know to be completely false. She left the room and asked me if I wanted anything, some water maybe, and warned me not to get up. I said no and lay there with my face scrunched up, trying not to cry. The cramps were really terrible—like food poisoning, but in your uterus. She came back carrying an armful of peanut butter and cheese crackers, an assortment pack of mini cereal boxes, pretzels, and juice boxes. She opened the side flaps of an apple juice box so I wouldn’t spill on myself and insisted I take some pretzels. Then she got me a heating pack and laid it on my stomach to dissipate the cramps faster. The royal treatment.
I stayed for maybe fifteen or twenty more minutes. She explained that most people usually leave with cramps that are a one, maybe two, on the ten-point pain scale. I asked her if it would be inappropriate to take Nyquil and knock myself out for the rest of the day. She didn’t really answer that one, but she let me stay for as long as I needed. The nurse with the purple hair came back in and distracted me by showing me pictures of her toddler, an adorable chubby-cheeked goober. There was no time pressure, and I probably could have asked for more food if I had wanted any. But I am impatient, and my phone had died when I tried to snapchat my friends “hot dogs or legs: the IUD edition,” and I figured that if I was going to be moaning in pain, I might as well be curled up in my own bed. So I put on a brave face and fought through the cramps, and they let me go.
I made a follow-up appointment on the way out and was talked through how to get reimbursed for the IUD step-by-step. That was necessary, but I could barely hold it together. Then I walked home.
If you saw me trekking from McCosh to Laughlin on April 14, and I was holding both hands to my uterus like it was going to fall out, and I didn’t say hi, it’s because I thought I was going to pass out. It took me twenty minutes to make it back to my dorm. I had to pause for a little bit outside of Dillon. Someone came to my room and gave me more painkillers, but I can’t remember who because that afternoon is awash in a drugged-out haze (but thanks, friend!). I spent the day with my face in my pillow, drifting in and out of sleep, watching Parks and Rec. I felt like I was going through five years of period cramps in just one night.
And when I woke up the next morning, having slept maybe fourteen hours (but who’s counting), the cramps were gone.
I’ve been prompted to recount this story a dozen times since my IUD insertion. Women are curious, questioning—some, a little on edge. My nurse practitioner told me that she had seen a spike in women seeking reproductive counseling from McCosh following the presidential election. She had inserted four IUDs before mine on Friday. She thought it might have something to do with a generational comfort level—that seeking birth control, and especially IUDs, was increasingly normalized among college-aged women. I agree with her: many of my friends are exploring their contraceptive options, and many are doing so independently of their sexual activity or preferences. But the fear and secrecy around the process, the difficulty of obtaining information, and the ignorance of many—men and women alike—speak of historical stigmatization. The freedom to choose when and whether to have children is an essential element of a woman’s mobility in this world. It’s something that should be celebrated. Women have the power to subvert patriarchal institutions by reclaiming access to what should always have been theirs in the first place—that begins by taking control of our bodies.