IUDs: Secretly Awesome

This is a useful post.

The excursus on abortion was distracting; one might have mentioned that IUDs are not compatible with life-begins-at-conception extremism and left it at that. Zygote metaphysics deserves a separate post or, better, nothing.

My college health center routinely inserted IUDs for (into?) girls who asked for birth control (mid-late 1970s), and I recall hearing about minor, occasional discomfort (I’m a mid-50s male). I don’t recall hearing about any issues that insertion was a problem if the girl had not previously given birth (no one I knew back then had, to my knowledge). Let’s hope that the smaller ones reduce the discomfort.

The information that I have on Paraguard says that the copper ions and the immunological response to them impair sperm function — from less formal sources, I’ve read that was everything from slowing them down to “making their heads explode” (more accurately heads detaching from tails) — and that with both Mirena and Paraguard the primary mechanism is to prevent fertilization of the egg. Of course, that does indicate there is a secondary mechanism: preventing implantation and no where is there any estimate of whether that is a 99% to 1% or a 51% to 49% split.

“Do these people really think when they go to heaven they will be vastly outnumbered by the souls of fertilized eggs who failed to implant and were washed away during menses?”

Well they’d have to have been baptised, wouldn’t they? Most of them would have to settle for Limbo, at best.

I’d just like to say that all the ladyblogging about ladyparts and ladyissues only of interest to ladies around here lately has been awesome. I’m learning a lot from it.

But do IUDs go back to the veldt?

I used a Mirena for 5 years, between 2005 and 2010. Insertion was bite-on-a-tongue-depressor-painful, and I had cramps for the rest of that day and the next. Otherwise, it was really a wonderfully convenient form of birth control. My doctor told me that some women stop having their periods altogether while the IUD is in, and that was the case with me — it virtually disappeared.
Having it extracted after 5 years was not as simple, however. It seems that my body was beginning to grow around it (I imagine this like a tree growing around and over an iron fence!) and it could not be removed at my Gynecologist’s office. Hospital day visit, full anesthesia. (Done in Europe, perhaps other regions would use local anesthesia.)
Perhaps not for everyone. I do know one woman who uses the hormone patch (this is depo provera in the States?) and is satisfied with it.

The pain, discomfort, etc resulting from a vasectomy is roughly equivalent to one average-to-bad period, based on the admittedly small sample of females I have dwelt with. I spent one afternoon on the couch with an ice pack, walked carefully the next day, and didn’t run or bicycle for ~3 days.

I think you meant to write, IUDs: Secretly Awesome

RE: Marcellina Depo is the shot, Ortho Evra is the brand name of the patch (I don’t know if there are generics available).

I work at a family planning clinic and we’ve seen a huge increase in demand for IUCs and hormonal implants, due no doubt in part to the national Bedsider.org and Ad Council campaigns.

But do IUDs go back to the veldt?

I recall reading somewhere that they go back to camel drivers who would prevent their camels from getting pregnant on long trips by inserting pebbles. This is too good to check, so I haven’t googled.

God knows how the camel drivers got the idea: I suppose you can get really, really bored in the desert.

I always said that we should schedule my vasectomy for the same time as the birth of #2, but my wife’s GP/OB/GYN said that, given my wife’s age, she might just as well get 2 IUDs (in succession, that is) to take her to menopause and be done with it. Since I didn’t really want surgery (I still have my wisdom teeth, even), I wasn’t going to argue.

Will those little dudes be casting down their teeny, tiny golden crowns around the glassy sea?

Favorite sentence I’ve read all week.

Oh well. Back in the day – long time ago in a galaxy far far away – a lot of my girlfriends were using this thing, that was then/there called a spiral (short i, emphasis on a, soft l). Those were the days… Didn’t always work, as I remember.

Hi,

The obvious solution to all of these problems is avaginal sex, if you know what I mean. There are several alternatives, if I’m correctly informed.

Have a nice day!
Antti

Hmmm. I was told for years that I “couldn’t” get an IUD because I might want to have babies in the future and they didn’t want it on their conscience if I could not conceive because of an IUD. I found it much easier to get from women gynecologists and am keeping this one through peri-menopause and beyond.

ADHD and birth control that has to be taken daily is a bad combination.

Having gotten music all over the blog, I am now going to cover it with human blood.

Pretty sure this is the best opening line to a blog post ever on CT ever.

Wife has had one for years now and with her it helps with her periods. She doesn’t have them all that often anymore. Even if I get a vasectomy one day she may want to keep the device in her for that reason.

I think I may fairly say that if your view is an orthodox one, Christianity is way crazier than I was led to believe…at my Episcopalian girls’ school. Because probably 1/3 of implanted pregnancies will fail naturally, and I really don’t think anyone has a very good handle on how much of the time an egg is fertilized and then fails to implant. We really are talking about a world in which god creates a vast share of his human children in the form of multi-celled embryos which are then killed before reaching anything approaching sentience. I’m sorry, but that’s just a very strange way of going about things.

When you think about it, that’s a good Catholic argument *for* the IUD. Because if every fertilised egg is a clean little soul who never gets a chance to “…commit unrepentant, grave, intentional sin”, they’ll all get to Heaven. Therefore we’re really giving them the best chance for eternal bliss possible, as opposed to my sinful and unregenerate children who were allowed to be born and then do heaven knows what naughty things (I don’t know, I don’t follow everything they do on Facebook). If they’d been IUD’d before they’d had a chance to implant, they’d be golden.

Ryan,

Why do you believe that every fertilized egg is an ensouled creature? Just curious. It’s not like god actually answered that one with any sky-writing or anything. The record for the Catholic church is all over the place historically, but generally settles around the time of “quickening” which puts ensoulment solidly in the several months-post conception time-frame.

As to IUDs-

I got one after experiencing a failure with a nuvaring. I decided it was time for something that Really Worked so I wouldn’t have to go through a (very early, medication-based) abortion ever again. I’m on my second and while I’d much rather go hormone-free, I can’t for irregularity/pain reasons. The dosage tapers from 20 mcg/day down to less than half of that by the end of 5 years, and I could tell the difference (e.g., sadness for no reason) at the beginning of each. The first one was actually a trial for a lower-dose (3year) version of mirena that I liked very well.

Final note: if you get a Mirena, the chances of pregnancy are very low. But some large (50%?) fraction of those rare pregnancies are ectopic, and thus emergency situations. Still worth it. (Especially the no periods part. So F-ing Awesome.)

As a strictly non-hormonal-contraceptive user, can I just say that the various menstrual calendar apps available for the iPhone are extremely useful, and I wish something similar had been around when I was younger and more likely to be worried more often. In fact, Period Tracker is one of the most useful apps on my phone.

And I’d like to warn younger women that menopause can happen a lot later than you expect, so don’t let your partner get out of that vasectomy with ‘Well, it’s only a couple of years till we won’t have to worry’. Ten and counting, in my case.

Belle,

I agree that many “pro-life” activists don’t share this position, but it is the basis for the Catholic Church’s opposition to direct abortion in all cases (including extremely controversial ones e.g. ectopic pregnancies).

In terms of theodicy, I won’t make light of that as a general problem for theists, but I’m not sure how this adds much to the problem in a world where basically everybody dies of dehydration, starvation, injury, or disease at some point, whether a day post-conception or 100 years post-conception.

As for the future basking, resurrected bodies are odd things–we definitely don’t know much about how they work, except that they seem to have both natural and supernatural capacities, and have had injuries brought up to glory (e.g. Christ’s wounds). How that works for those who never developed full bodily capacities, whether due to abortion of pregnancy or those born with severe developmental disabilities, is very hard to say.

Malilo,

The Thomistic view is that the soul is not some kind of extra-physical infusion but rather the form of the body itself. Before modern biology, I guess it was pretty unclear when the developing organism had gained its form, so “quickening” was a good guess. The modern moral view is actually a response to modern biology–we know that the zygote has its complete genome, and therefore its body has form, at conception. Ergo, it’s a baby human person.

Catholics aren’t consequentialists

…which, together with the assertion that a human life forms at conception but not earlier, makes their condemnation of all forms of physical contraception all the more astonishing. (Admittedly, I don’t really understand how anyone can square in their minds defending to the ends of the earth the rights of a conceived cell once it implants, but not care about the countless cases where even in the absence of an IUD a fertilized egg is expelled from the body. Don’t those fertilized eggs have every bit as much a right to life, if they too are babies? Why are we supposed to shrug off implantation failure?)

I don’t think we should let the Catholic apologetic’s standard “we’re just looking out for the baby’s interest once the baby has formed” assertion stand unquestioned until they’ve offered a pretty thorough explanation of why this implies we all should neither ever go on the pill nor ever insist on using a condom. (That might be worded badly. Modify as needed.) Why should we make any attempt to accommodate the demands of a group to have authority over our sexuality, or more generally, over how we use our own bodies? Why should we trust them when they claim they’re restricting their attention strictly only to protecting what they see as a baby, when that conflicts with other parts of their own professed doctrine?

Anyone who wants us to take their claim to be a baby-defender seriously needs to first demonstrate they’re not in any sense anti-sexuality, and since the official formal doctrinaire Catholic position is not pro-baby nearly so much as it is anti-sex (or specifically anti-nonprocreative-sex), the Catholic apologetic will have no small amount of work to do to convince us that we can trust them to respect, defend, and uphold our right to sexuality while also defending the rights of entities they perceive as human.

Admittedly, I wouldn’t bother to bring it up if this issue hadn’t suddenly just become so, uh, salient, here in the U.S.

I once went so far as to read the first pages of a recent Catholic argument, IIRC intended as part of a legal brief, that “life” ought to be considered to start at conception, rather than at “quickening” which has been considered the start of life for most religions for several centuries. A significant part of the argument depended on language in the first chapters of elementary biology textbooks, which tended to use words like “miracle,” “this is where the glorious story of life begins,” and so forth. This rhetoric was used as evidence that biologists believe the (current) Catholic view themselves, and that such a view is therefore supported by science.

I find myself unable to say that such arguments struck me as being in especially good faith.

Also, obviously we should keep this clean, but I assume we all know perfectly well the religious basis for the prohibition on barrier methods of contraception. Why this doesn’t apply to calendar-based methods, IIRC, is because a good marriage is important. Why this doesn’t make women 12-times a year murderesses, however, is another question. I suppose we could say it all goes back to Eve and rest satisfied with that.

Salient,

I don’t know that we do shrug off implantation failure (see: opposition to hormonal birth control as an abortifacient), but in the natural case what are we to do about it?

The condemnation of contraception is part of the Catholic understanding of the marital relationship. I don’t understand the logic that Catholic stance on contraception leads to an increase in abortions–why would you keep a derivative rule if you’re going to ignore one of the first order? Again, not being consequentialists, the question is what actions are permitted, not what lesser evils we should tolerate. Evil *may never* be done in the service of a greater good.

In short, why can’t one say that abortion is murder, and that contraception makes otherwise licit sex illicit?

Bianca @55,

I genuinely don’t understand. Contraceptive sex is wrong, but it isn’t murder. Choosing not to have sex at a particular time is a human right, not murder. An unfertilized egg is not a person, and therefore its expulsion is not a moral problem of any kind…

In short, why can’t one say that abortion is murder, and that contraception makes otherwise licit sex illicit?

You most certainly can, but others are free to deem you a moral monster for your position on what you call `illicit’ sex, and can use that as perfectly legitimate ad hominem justification to not give your opinion about abortion any particular credence or attention, and to justify not making an effort to include you in any conversation about public policy for either topic. In which case you’d be entirely free to complain about that, on some variant of “just because I happen to be [perceived as] a moral monster about contraception doesn’t mean I’m wrong about the issue of personhood” grounds. In other words, you’re free to argue that ad hominem is a logical fallacy. In which case I’d counter-argue that the declaration “we ought to consider a fertilized egg a baby person” is a declaration of axiomatic moral principle (you can’t prove a fertilized egg is a “baby person” when the whole point is to choose a definition for “baby person”), and if we’re trying to decide whether or not to take your declaration seriously, literally the only thing we have to go on is an ad hominem evaluation of your overall moral code. So your moral judgments in other contexts really are an appropriate thing to request and assess, especially your moral judgments regarding the topics of sexuality and reproduction, which are, no pun intended, intimately related to the question of when independent personhood begins.

If we were going to give weight to your opinion on the “baby person” definition without resorting to ad hominem, we need to be able to be comfortable that you’re withholding as much as possible, and expressly not advocating for, any of your other moral principles. That’s really not the case here.

On the other hand, this is all basically a technical/formal argument. Consider, I’m still around and listening/reading, so just because I can’t in good conscience take your assertions of anti-abortion arguments on good faith doesn’t mean I’m encouraging you to shut up or even ignoring you. I’m not even providing any real argument for, or description of, my own competing moral code. And I would be surprised and a little bewildered if you didn’t think my moral code is monstrous (or whatever word you’d prefer), so it’s safe to assume there’s some reciprocity in how we feel.

Longer reply having been moderation-trapped and probably for good reason, I’ll satisfy myself with the pithier response, “Declaring that ‘contraception is evil’ is evil, and that evil calls into question any other allegation of evilness that person might make.”

Personally, I don’t mind a heaven largely populated by fertilised but undeveloped ova. To me, their main problem is the free will paradox; the idea that the supernatural omniscient, omnipotent being somehow shares the universe with free agents that it itself created. Extremely arrogant view, I must say. But nevertheless predetermined. They should drop their ‘free will’ heresy once and for all, and then there is no problem whatsoever: anything and everything people do is fine.

Back on-topic, one year I traveled overseas twice, and the second time the pill just stopped working, apparently, even though I think I did everything right, didn’t miss a dose, and didn’t get sick. The only thing I could think of was that the place where we were traveling maybe fed hormones to livestock.

I liked the mixed progesterone-estrogen pills, in terms of mood and weight related side effects, but more breakthrough bleeding. We found a brand and dose that seemed good, then my new insurance wouldn’t pay for them and recommended instead what seemed to be a higher dose, and it took a while to find a better one that insurance would cover. I think I may have been paying out of pocket before the insurance change, but ignoring the insurance company never seemed to occur to me or anyone else as a possibility.