Note To The Reader: Let it be known that this is a post about birth control and speculums, so if you are squeamish, not interested in hearing about female anatomy, or just don’t care about birth control, stop reading here.
When my son was born, I was 21 years old. I was a single mother and a senior in college. Needless to say, I wanted to have effective birth control going forward. So, I opted for the Mirena IUD. I was six weeks post-partum, so the insertion of an IUD was nothing compared to giving birth. Also, it was nearly six years ago and my memory sucks.
My five years was up this past fall, so I had it removed. I lacked the foresight to get another one inserted, so I have been IUD-free for three months up until yesterday.
Hear ye, hear ye, let me tell you a tale of a Mirena insertion.
Two weeks ago I scheduled an appointment to get the Mirena re-inserted. I checked with my insurance (BCBS) and found out I only had a $15 copay for the whole thing. This is super awesome because the device is upwards of $1,000 and I am not sure how much a doctor’s office bills for the provider’s time but overall, it was a bargain.
I have a lot of experience in doctor’s offices and hospitals, not only as a patient but I have also done a significant amount of volunteer work on top of being raised in a family of medical providers. So it should be slightly shocking when I say that I get absurdly anxious when I sit in a waiting room at my PCP.
I waited 25 minutes past my schedule time, and during the course of that 25 minutes I measured my resting HR three times. It was around 100 every time. I was so anxious. For what!? I kept thinking, but then I remembered that I was having a piece of plastic pushed into my uterus.
So my name gets called and I go into the exam room. The nurse is very sweet, I’ve seen her a dozen times and she’s always very kind and funny. My stomach is in a knot and my blood pressure was 133/81 when she took it. It was through the roof; typically I’m about 110/60.
“I always get so anxious!” I say.
“You’re only here for a consultation, don’t be nervous!”
What. A consultation? I’ve been gearing myself up for two weeks for this, and it’s a consultation?
I started to cry.
“Why are you crying?” the nurse asks, alarmed.
“I just thought I was getting it inserted today and I had geared myself all up and…” She looked at me very concerned.
“I think I will go get Jodie,” she said and left the room.
Jodie is the NP that I see. She is a goddess. She is petite, with shoulder-length salt-and-pepper hair. She is probably mid-forties, and speaks with the kindest, gentlest, quietest voice. She always remembers more than she ought to about my family, and asks me wonderfully insightful questions about my life. She really seems to care.
So Jodie walks in and I am trying to wipe up my stupid, anxiety-filled tears.
After some discussion about my history with partners, the fact that I have had a Mirena before, and the fact that I’ve had a baby, we decide that I can just have it placed that day. Thank the gods.
So, I get all prepped (clothes off from the waist down, you know that whole deal) and sit up. Jodie apologizes for having to use the stirrups, as she says she’s a firm believer in not using them wherever possible.
Here’s the more graphic part so readers may want to skip down to the last paragraph if you’re not into OB/GYN descriptions.
The first step is procedural and always done: a swab to test for chlamydia and gonorrhea. The reason this is done is to ensure that no infections travel up into the uterus via the strings of the Mirena. It is performed on every person who gets a Mirena regardless of sexual activity and history.
That part was easy, just a swab. Jodie then proceeded to clean off my cervix, which again didn’t feel like much, just swabs and some pressure.
At this point, Jodie insists I use a mirror to look at my “beautiful cervix which made way for your son!” She says it so breathlessly, like she so admires my cervix that I am momentarily convinced that my cervix is beautiful and unique and wonderful and talented. So, I checked it out with a mirror. It is shaped like a donut and yes, it might be talented but it wasn’t super beautiful. I did feel proud of its ability to make way for my son but again, I am not a cervix-worshiper so I didn’t quite get it. At least now I can say I’ve seen it.
So I checked out my cervix and then Jodie says, “I like to tell patients that there are three different cramps.” She goes on to explain that the first is to essentially clamp my cervix in place, the second is to measure my uterus (if you’re wondering, mine is 8cm in diameter) and the third is to actually do the insertion.
The first cramp was not too bad. Ok, little bit of period-type cramps. Fine.
The second cramp was a period-cramp on steroids with a slight bit of scraping feeling.
The third cramp was period-crampy, not so bad. So, I’m done right?
Nope. Then, a flash of pain. I was a little surprised because Jodie hadn’t mentioned this part, so I wondered if it was normal. It turns out, that flash of pain was from the arms of the Mirena being outstretched. Yum.
So after a couple of seconds (the whole thing lasted probably five minutes from introduction of speculum to removal of speculum, including cleaning & tests) she had manipulated the Mirena into place, and I was all done.
Jodie asked me if I felt lightheaded or anything, which I didn’t. I felt slightly crampy, like period cramps the day before your period starts.
I drove home and went on with my evening.
About an hour and a half later I started feeling really seriously cramps. Like, the worst of the worst menstrual cramps. I put a hotpack on my belly for a half hour, took some ibuprofen, sat on the couch with my son and husband, and just hung out.
By the time I went to sleep it had been five hours since having it inserted, and the cramps were essentially gone. I only have had a little bit of bleeding, hardly even enough to warrant a very thin panty liner.
This morning, still spotting a little with some cramping but minimal.
Overall, I would rate the experience this way:
On a scale of 1-10, with 10 being “awful,” I would rate:
My anxiety immediately beforehand: 10
Pain of insertion procedure: 4-5
Pain after insertion: 2
If you are thinking of using a Mirena, here is why I got a second one put in:
– It completely eliminated my period for five years. This is apparently not uncommon.
– It’s kind of like a bulletproof vest for your uterus in terms of birth control.
– I don’t have to remember to take a pill every day or get a shot every month or anything like that.
– It’s 5 years if I want it to be, or whenever I choose to have it removed.
And that is my Mirena story. Cheers!