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
Signs of Alzheimer’s were everywhere. Then his brain improved
Blood biomarkers of telltale signs of early Alzheimer’s disease in the brain of his patient, 55-year-old entrepreneur Simon Nicholls, had all but disappeared in a mere 14 months.
Box tree moths have infested Ontario and experts say more are coming. Here's what to do to protect your garden
An invasive moth species is on the rise in Canada and, if you've planted a certain shrub, it could stand to ruin your garden.
Lyon-bound Air Canada Boeing 787-8 Dreamliner from Montreal turns back midflight due to pressurization alert
Passengers heading from Montreal to Lyon, France on Friday were forced to return home and depart the next day after a pressurization indication was detected in flight.
The eight most expensive homes for sale in Ottawa this spring
Ottawa's ultra luxury housing market is blooming like the tulips this spring, with a significant increase in the number of homes sold worth more than $2 million.
$500K-worth of elvers seized at Toronto airport
Fishery and border service officers seized more than 100 kilograms of unauthorized elvers at the Toronto Pearson International Airport on Wednesday.
B.C. pipeline company argues its 'haulers' are not trucks, for tax purposes
A contractor working on the Coastal GasLink pipeline has been denied more than $333,000 worth of tax rebates because pieces of machinery it purchased – and claimed were not trucks – were deemed sufficiently truck-like in B.C. Supreme Court.
Usyk beats Fury by split decision, becomes undisputed heavyweight champion
Oleksandr Usyk defeated Tyson Fury by split decision to become the first undisputed heavyweight boxing champion in 24 years.
To plant or not to plant? Gardening tips for May long weekend
May long weekend is finally here, and with the extra time off you may be getting the itch to head out to your garden and plant. However, the old debate whether you should plant now, or wait, is still ever-present.
Jesus is their saviour, Trump is their candidate. Ex-president's backers say he shares faith, values
As Donald Trump increasingly infuses his campaign with Christian trappings while coasting to a third Republican presidential nomination, his support is as strong as ever among evangelicals and other conservative Christians.