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
India's foreign minister reacts to murder charges, claims Canada welcomes criminals
India's Foreign Affairs Minister accused Canada of welcoming criminals from his country in response to the RCMP's recent arrests in a homicide that has roiled tensions between the two countries.
15-year-old boy stabbed in Ottawa on Thursday dies
A 15-year old boy who was critically injured after a stabbing in Nepean on Thursday has died of his injuries, Ottawa's English public school board said Sunday.
Dash cam catches moment suspected drunk driver hits parked car, sends it careening into North Shore flower shop
Police say it’s fortunate no one was injured or killed in a collision at North Vancouver’s Park and Tilford shopping centre Saturday evening that sent one vehicle careening into a flower shop and another into a set of concrete barriers outside a Winners store.
'A tiny city:' Pro-Palestinian campus protesters organize for another week
Pro-Palestinian activists have set up tents at universities in Toronto, Ottawa, Vancouver and Montreal, following a wave of similar protests at campuses in the United States linked to the Israel-Hamas war.
Lawsuit against Meta asks if Facebook users have right to control their feeds using external tools
Do social media users have the right to control what they see — or don't see — on their feeds?
A Holocaust survivor will mark that history differently after the horrors of Oct. 7
This year's Holocaust Remembrance Day, which begins on Sunday evening in Israel, carries a heavier weight than usual for many Jews around the world.
Princess Anne lays wreath at Battle of Atlantic ceremony; honours late Queen
Princess Anne saluted Canadian veterans and current forces members and honoured her late mother during separate ceremonies Sunday in Victoria as she wrapped up a three-day British Columbia West Coast royal visit.
El Nino weakening doesn't mean cooler temperatures this summer, forecasters say
As Canadians brace themselves for summer temperatures, forecasters say a weakening El Nino cycle doesn’t mean relief from the heat.
As storms moves across Texas, 1 child dies after being swept away in floodwaters
A child in Texas died Sunday after being swept away in floodwaters as storms swept across the state.