Getting an IUD can hurt. B.C. doctors say it doesn't have to
Dr. Ana Armas Enriquez remembers the agony of getting an intrauterine device (IUD) as a teen.
“It was a horrible pain,” she said. “It’s excruciating.”
Decades later, the Nanaimo-based women’s health physician strives to alleviate that pain for her patients.
There are several pain-management tools to choose from, including oral painkillers, numbing gel, a cervical anaesthetic, and in extreme cases, sedation. Those options aren’t always offered to patients, Armas Enriquez said.
“It’s like going to a dentist and getting a root canal or a tooth extraction and not being offered freezing,” said Armas Enriquez, owner of Women’s Vita Medical Clinic.
Kaitlynn Hoffman has had several IUDs, which are inserted into the uterus through the cervix.
“It was quite painful and I was not offered any… pain management aside from being told Tylenol would work,” she said.
“It just feels like somebody is stabbing you with… some sort of sharp object in your uterus.”
She underwent the procedure for the third time in October. That time, Hoffman said she was offered cervical numbing and an Ativan.
“That was the best experience that I’ve had,” Hoffman said.
'WOMEN'S PAIN DOESN'T MATTER'
Last year, the Society of Obstetricians and Gynaecologists of Canada released a statement outlining pain management options. Still, a family planning physician said there aren’t any firm rules that explain how to make a patient more comfortable.
“Pain management is individual and it involves combining multiple methods. That’s very hard to study and so that’s why we don’t have clear guidelines and a lot of people assume that means to use nothing,” said Dr. Renée Hall, co-medical director at Willow Clinic.
Hall trains other physicians on IUD insertion. She said medical schools need to provide more robust training for the procedure.
“We have a lot of people who would never even consider one of the most effective options for birth control that has one of the lowest doses of hormones… because of all that they’ve heard from their friends about how painful and traumatic it was,” she said.
Asking women to grit their teeth through the procedure sends the message, "That women’s pain doesn’t matter or that we can tolerate more,” Hall said.
MEDICATION COMES AT A COST
Hall and Armas Enriquez said doctors need to be paid more for IUD insertions.
Their practices focus largely on women’s health, which means they aren’t compensated under B.C.’s family physician payment schedule. The province introduced the payment model in 2022 to address the doctor shortage through increased pay.
“I cannot participate in such a program because then I have to redefine my practice,” Armas Enriquez said.
As a result, she and Hall are compensated under the old fee-for-service model. That means they make $46.79 per IUD insertion.
That fee does not cover the cost of a cervical anaesthetic, an injection that numbs the cervix.
“How many people… with a debt of three quarters of a million dollars from going to med school in family practice can afford to do all of this?” Armas Enriquez said.
The health ministry said work is underway to improve compensation for IUD insertions.
Going forward, Hoffman is optimistic more patients will have a positive experience like she had in October.
“Hopefully we can learn from the doctors that are doing the work and taking the time just to make the experience a little bit better,” she said.
CTVNews.ca Top Stories
Hackers release corporate data stolen from London Drugs
Retailer London Drugs says cybercriminals who stole files from its corporate head office last month have released some of the data after it refused to pay a ransom.
Toronto man falls off his chair after seeing $70M Lotto Max win in his bank account
A Toronto man who won $70 million in a recent Lotto Max draw literally fell off his chair when he saw the funds in his bank account.
Montreal-area high school students protest 'sexist' dress code
Approximately 50 Montreal-area students — the vast majority of them female — were suspended Wednesday after their school deemed the shorts they were wearing were too short. On Thursday, several students staged a walk-out to protest what they believe is a "sexist" dress code that unfairly targets girls.
McDavid scores in 2OT to lift Oilers over Stars in West Final opener
Connor McDavid tipped Evan Bouchard's shot from the boards past Dallas Stars goalie Jake Oettinger 32 seconds into the second overtime to give the Edmonton Oilers a 3-2 win in Game 1 of the Western Conference Final..
'Looking over our shoulders': A killing looms large in a little B.C. town
Something shifted in the pretty little village of Lumby, B.C., after Tatjana Stefanski vanished. It used to be the sort of place where parents let their kids roam free or play in the local creek, but everything has changed.
What is 'slapped cheek disease' and should parents be concerned?
Despite its rough name, experts say most cases of 'slapped cheek disease' are mild and not a cause for concern.
American Airlines retreats after blaming a 9-year-old for not seeing a hidden camera in a lavatory
American Airlines has distanced itself from a court filing in which the carrier said a nine-year-old girl should have noticed there was a camera taped to the seat of an airplane lavatory.
Unknown Newfoundland soldier from the First World War heads back home from France after 100 years
Canadian soldiers and government officials arrived in northeastern France this week for a historic mission: returning an unknown Newfoundland soldier back home.
Calgary Philharmonic takes action following investigation into 'deeply troubling' comments by 2 musicians
The Calgary Philharmonic has confirmed its taking action after controversial online comments made by two members of the orchestra.