(Safe) Sex and the Single Woman

Or why my abstinent ass got an IUD.

At 8:30 a.m. on a Friday morning early this month, I braced the cold to jump on the 47 bus to Beth Israel Deaconess Medical Center. Late, I huffed through the corridors and landed at the OB/GYN on the 8th floor. Minutes later I was weighed, measured, and naked with my feet in the stirrups and an uncomfortably air conditioned breeze wafting up my canal.

An unreasonably handsome gynecologist entered the room and shook my hand before letting me know that I could probably put my legs together and down. We went over my medical history. Allergies? No. Hypertension? No. Irregular bleeding? No. Diabetes? High cholesterol? Breast Cancer? Uterine Cancer? Seizures? Migraines? No. No. No. No. No. and No. STIs? Hopefully not.*
“Is there any chance you could be pregnant?”
I laughed. The gynecologist scrunched his (unreasonably handsome) brow.
“No. Literally no chance.”
He brightened and said, standing up, “Did you want the Mirena or the Paraguard?”

I hadn’t thought about it. One sounded like a Greek sea nymph and the other like flavored denture sealant. “Um. The Mirena?”
He handed me a teal pamphlet and went to fetch the small plastic T that he would be shoving through my cervix and into my womb. I propped my feet back up in the stirrups and rested the pamphlet on the lap of my hospital gown, opened it to the middle panel, and read: “It is not known exactly how Mirena works.”

I closed the pamphlet. Opening it again, my eyes scanned “pelvic inflammatory disease”, “life-threatening infection”, “embedment in the uterine wall”, “perforation of the uterine wall”, ”ectopic pregnancy”, “cysts on the ovary”, and dizziness. Thanks to my hypochondriac tendencies, the dizziness was already setting in, as was the panic.

The really quite attractive gynecologist returned with an equally teal box and a set of forceps. As he was making small talk while prying apart my labia and sliding the cold metal tongs up my internal slip n’ slide, I tried to remember why I decided getting an IUD would be a good idea in the first place. After all, I hadn’t had sex in a year. Hence my laughter at possible pregnancy. Not only is birth control primarily for women who have sex, but the Mirena IUD in particular is marketed to women who have already borne children. Hence the gynecologist’s quizzical (and shapely) brow. My self-doubt grew as he slid a small plastic tube through my cervix and I felt the first sharp pain of a serious uterine cramp. I began to rationalize.

To begin, my year of abstinence was neither intentional nor imposed. After breaking up with a long-term boyfriend, I simply hadn’t had sex. Then summer happened, and then school got busy, and then it was winter and I had absolutely no desire to leave my warm room or shave my hairy legs. As the months wore on, no romantic prospects emerged, and to be perfectly honest, sex with strangers or near strangers doesn’t appeal to me. Whether it’s due to deep-seated insecurity or a Law & Order SVU-induced fear of instant kidnapping and murder, I don’t do one-night stands.

And yet, every day at 1:03 p.m. since my junior year of high school, I dove into my school bag at the sound of my cell phone alarm to dry-swallow a small, round, pink pill that most months just regulated my period. Five years of daily pills is a lot, especially when sex is sporadic or nonexistent. The tedium of the pill, combined with my inevitable slip-ups and subsequent pregnancy paranoia meant that I was ready for a birth control change. When my prescription expired in December I didn’t renew it. I flew contraceptive-free for a glorious three months and then remembered that I am graduating in May. With graduation come a new city and a new dating pool. With graduation goes my Harvard health insurance.

For those of you unaware, under the Student Health Insurance Plan IUDs are entirely free. With hormonal intrauterine device such as Mirena lasting up to five years and copper IUDs like Paraguard lasting up to ten, after the initial insertion and a quick follow-up appointment, IUDs are for many women the single most hassle-free way to prevent pregnancy. Although they were initially marketed to women who have had at least one child due to fears that they caused infertility, modern IUDs are in fact safe for almost anyone who has a uterus and is healthy. With a failure rate of less than 0.2% compared to oral contraception’s failure rate of 9% and the male condom’s failure rate of 18%, IUDs also provide peace of mind unparalleled by any form of contraception other than hormonal implants or tubal litigation. Although the teal pamphlet reminded me that in rare cases the side effects of IUD implantation can be serious, after initial cramping and spotting as the body adjusts to the device, many women experience significantly lighter periods or no period at all. Having battled a particularly vengeful crimson tide for the better part of the last decade, I was thrilled to think that a free plastic T might abolish my period altogether. With only a few months left in senior year and no idea where I’d be after graduation, I made the decision to get an IUD while I knew that my insurance would still cover it. Financially, medically, and mentally, the IUD made sense.

As the (seriously, why was this man a) gynecologist fiddled around with the insertion tube and waves of phenomenally painful cramping spread through my lower abdomen and into my stomach, I tensed, expecting whatever finale he had planned to entirely break my poker face. But he was done. Peeling off his blue gloves dotted with my blood, he handed me two Advil and a pad and told me to see him in a month. Sore but relieved, I waddled back on the bus and spent the rest of the day in my bed curled up in the fetal position with what felt like the worst period I’ve ever had. After a few days of spotting and mild soreness, the IUD didn’t fall out and the worst of it was over.

Over the past month, despite my pregnancy immunity, I still have not had sex. Moreover, as I write this I’m on day ten of light but nonetheless obnoxious period, a common side effect in the first three months of IUD insertion. I have to go back later this week to have my favorite gyno stick his hand back up the vag to ensure that it is still in place. After all of that and more than enough complaining, I’ve had friends ask if getting an IUD was worth it. Considering that the entire procedure was free, their question might be moot. However, even with cramping and bleeding and no sex to show for it, I still know that if I wanted to and found someone willing I could have sex at any moment (with a condom—an IUD does not a clean sexual partner make) and not worry about anything more serious than ball sweat. I know that for the next five years, I don’t have to stock up on birth control pills before a trip, or remember to refill prescriptions, or think about what I would do if I accidentally got pregnant. Even if I don’t use it, just knowing that I have the freedom to have sex without worry allows me to live a little more spontaneously. Knowing that I have the agency and insurance support to make these decisions about my body and sexuality is liberating.

So, Harvard students with uteri, while you’re here I implore you to take full advantage of the University’s contraceptive resources, whether that be on the level of fully covered IUD insertion or in the form of free condoms from Peer Contraceptive Counselors. Your gynecologist will thank you.

Anonymous looks to the day when there is an IUD in every uterus and a condom ‘round every cock.

* Jokes. I’ve been tested. UHS will do that shit for free.