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
Parents of infant who died in wrong-way crash on Ontario's Hwy. 401 were in same vehicle
Ontario’s Special Investigations Unit has released new details about a wrong-way collision in Whitby on Monday night that claimed the lives of four people.
Three Quebec men from same family father hundreds of children
Three men in Quebec from the same family have fathered more than 600 children.
B.C. mayor stripped of budget, barred from committees over Indigenous residential schools book
A British Columbia mayor has been censured by city council – stripping him of his travel and lobbying budgets and removing him from city committees – for allegedly distributing a book that questions the history of Indigenous residential schools in Canada.
OPP's mandatory alcohol screening during traffic stops 'not acceptable': CCLA
A spike in impaired driving-related collisions has caused Ontario’s provincial police to begin enforcing mandatory alcohol screening (MAS) at all traffic stops in the Greater Toronto Area -- a move one civil rights group says is ‘not acceptable.’
Maple Leafs down Bruins 2-1 to force Game 7
William Nylander scored twice and Joseph Woll made 22 saves as the Toronto Maple Leafs downed the Boston Bruins 2-1 on Thursday to force Game 7 in their first-round series.
Jurors in Trump hush money trial hear recording of pivotal call on plan to buy affair story
Jurors in the hush money trial of Donald Trump heard a recording Thursday of him discussing with his then-lawyer and personal fixer a plan to purchase the silence of a Playboy model who has said she had an affair with the former president.
Southern Alberta store broken into by burly black bear
Staff at a small southern Alberta office supply store were shocked to find someone had broken into the business last week, but they were even more confused when they discovered the culprit was a bear.
Captain sentenced to 4 years for criminal negligence in fiery deaths of 34 aboard scuba boat
A federal judge on Thursday sentenced a scuba dive boat captain to four years in custody and three years supervised release for criminal negligence after 34 people died in a fire aboard the vessel.
New scam targets Canada Carbon Rebate recipients
Fake text message and email campaigns trying to get money and information out of unsuspecting Canadian taxpayers have started circulating, just months after the federal government rebranded the carbon tax rebate the Canada Carbon Rebate.