When news broke last month that Justice Anthony Kennedy was retiring from the U.S. Supreme Court, the immediate concern for many people was what this could mean for abortion rights. President Trump has promised to appoint Supreme Court justices that would vote to overturn Roe V. Wade, the landmark decision that gave women the right to choose a safe and legal abortion, and he seems to be delivering on that promise with the nomination of Brett Kavanaugh, a well-known conservative approved by the anti-abortion rights conservative legal group, the Federalist Society.
Panicking over the possibility of losing your right to choose? Join the club. As Democrats and every major reproductive health advocacy group launch a major offensive to block Kavanaugh's nomination, onlookers are also urging women to stock up on birth control while they still can, just in case. Now is the time to get an intrauterine device (IUD) implanted ASAP, says the Internet.
But as with all health concerns, there are important things to consider beforehand. Here's what you need to know before getting an IUD.
For starters, what even is an IUD? It's a T-shaped device made of plastic or copper that's inserted in your uterus by a healthcare provider. Once up there, IUDs prevent pregnancy in one of two ways: hormonal IUDs emit hormones that thicken cervical mucus and make it harder for sperm to reach the uterus, while copper IUDs essentially act as spermicide. IUDs are "long-acting reversible contraception," and are often referred to as a "set-it-and-forget-it" method, because once they're inserted they can last between three and 10 years. Compared to other types of birth control, IUDs are incredibly effective, with a less than 1% failure rate.
This is why IUDs are among the most popular form of birth control in use today, and why, given the turbulent political situation around not just abortion but also birth control access, people are pinpointing the IUD option as your best bet. "I think it’s certainly something to think about, not only related to Justice Kennedy’s retirement and whomever replaces him on the court, but also in terms of other things happening," says Mara Gandal-Powers, senior counsel for reproductive rights and health at the National Women’s Law Center.
Currently, there are a few important decisions that directly impact access to birth control and could ultimately end up before the Supreme Court. For example, Trump's newly proposed "domestic gag rule," which would, if implemented, reduce the number of Title X-funded family planning clinics for low income women to turn to. But these changes aren't going to happen overnight, says Ginny Ehrlich, CEO of Power to Decide. "Women should be watchful of that when [they] think about what type of upfront investment they want to make," she says.
For example, Trump has been trying to block funding for any family planning clinics that provide abortion services. If you go to a federally-funded family planning clinic (like Planned Parenthood) or if you see a doctor through a clinic that uses a sliding scale, then it could be difficult to find a qualified clinician in the future. Or if your employer has religious objections to covering birth control in their company health insurance, then might have difficulty getting the birth control you need. "I think that it's terrifying that there could be effects beyond those we've seen," Gandal-Powers says.
While getting an IUD might seem like a very logical step you can take to ensure that you have birth control, remember that all of this remains up in the air. A lot can change in three years, and even more can change in a decade. There's no telling what the political landscape will really look like by the time you're ready to have your IUD removed. Most notably, you might be able to get your IUD inserted now, but you could end up needing to pay out of pocket for the cost of an IUD removal and replacement in a few years — and that can be pricey.
An appointment to have your IUD removed typically costs around $150-$250 without health insurance. If your health insurance stops paying for birth control, then that could be a prohibitively expensive bill to suddenly have to pay. Even if your own health insurance coverage doesn't change, or you can afford that out of pocket cost, there are millions of people who rely on federally-funded health care who wouldn't be able to afford this on their own. According to Planned Parenthood, 78 percent of patients who use federally-funded clinics to get birth control and other reproductive services have incomes below 150 percent of the federal poverty level. "Our concern with that is that we are going to have fewer clinics providing no and low-cost contraception to those women who are on the lowest income," Ehrlich says.
Not to mention, the IUD is not the perfect birth control option for everyone (studies suggest people with certain types of breast cancer shouldn't use IUDs, for example), nor is it the only long-acting reversible contraceptive out there. Some people might find that an arm implant is the better long-acting reversible contraception option for their needs. But the arm implant has to be removed after three years, which can cost up to $300 out of pocket, according to Planned Parenthood. So, despite the many people who may be urging you to get an IUD, know that it might not be right for you.
At the end of the day, if you're not planning on getting pregnant any time soon, investigating all of your birth control options with your doctor is a great idea, regardless. But if the political situation has you rushing to your gyno, that's understandable. In addition to taking care of yourself during these trying times, you can also use your voice, Gandal-Powers says. "Call your senator, no matter where you live, even if you think your senator is completely opposed to what you think on this," she says. "It is important that they hear from people and know that they’ll be held accountable."
If you need free help getting no-cost birth control, contact the National Women's Law Center at CoverHer.org or call 1-866-745-5487.