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
More than 115 cases of eye damage reported in Ontario after solar eclipse
More than 115 people who viewed the solar eclipse in Ontario earlier this month experienced eye damage after the event, according to eye doctors in the province.
Toxic testing standoff: Family leaves house over air quality
A Sherwood Park family says their new house is uninhabitable. The McNaughton's say they were forced to leave the house after living there for only a week because contaminants inside made it difficult to breathe.
Decoy bear used to catch man who illegally killed a grizzly, B.C. conservation officers say
A man has been handed a lengthy hunting ban and fined thousands of dollars for illegally killing a grizzly bear, B.C. conservation officers say.
B.C. seeks ban on public drug use, dialing back decriminalization
The B.C. NDP has asked the federal government to recriminalize public drug use, marking a major shift in the province's approach to addressing the deadly overdose crisis.
OPP responds to apparent video of officer supporting anti-Trudeau government protestors
The Ontario Provincial Police (OPP) says it's investigating an interaction between a uniformed officer and anti-Trudeau government protestors after a video circulated on social media.
An emergency slide falls off a Delta Air Lines plane, forcing pilots to return to JFK in New York
An emergency slide fell off a Delta Air Lines jetliner shortly after takeoff Friday from New York, and pilots who felt a vibration in the plane circled back to land safely at JFK Airport.
Sophie Gregoire Trudeau on navigating post-political life, co-parenting and freedom
Sophie Gregoire Trudeau says there is 'still so much love' between her and Prime Minister Justin Trudeau, as they navigate their post-separation relationship co-parenting their three children.
Last letters of pioneering climber who died on Everest reveal dark side of mountaineering
George Mallory is renowned for being one of the first British mountaineers to attempt to scale the dizzying heights of Mount Everest during the 1920s. Nearly a century later, newly digitized letters shed light on Mallory’s hopes and fears about ascending Everest.
Loud boom in Hamilton caused by propane tank, police say
A loud explosion was heard across Hamilton on Friday after a propane tank was accidentally destroyed and detonated at a local scrap metal yard, police say.