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Home / Lifestyle

New training to combat issues with painful IUD fittings

By Emily Moorhouse
NZ Herald·
9 Jun, 2021 11:29 PM4 mins to read

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The measuring and insertion of an IUD can be difficult for GPs. Photo / Getty Images

The measuring and insertion of an IUD can be difficult for GPs. Photo / Getty Images

It took three "painful" attempts to fit Sherida Wilson's intra uterine device (IUD).

The Christchurch 20-year-old barista had tried contraceptive pills in the past but, after a blood clot scare, was advised by her doctor to switch to an IUD.

The GP who performed the insertion struggled to fit the IUD, and the procedure was "way worse" than Wilson could have imagined.

"She was really shaky and kept mucking up," Wilson said. "When she finished, I went to the sink and threw up. I was obviously so sick from the pain."

Wilson's experience is not uncommon. The measuring and insertion of an IUD can be difficult for GPs, particularly if the patient isn't relaxed.

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The IUD is a form of long-acting reversible contraception (LARC) that sits inside the uterus, preventing sperm from reaching the egg or stops the egg from attaching to the wall of the uterus if sperm does reach the egg.

Sherida Wilson was advised by her doctor to switch to an IUD. Photo / Supplied
Sherida Wilson was advised by her doctor to switch to an IUD. Photo / Supplied

The IUD is more than 99 per cent effective and can last up to 10 years depending on the type. It's a "fix and forget" option as opposed to the contraceptive pill which needs to be taken daily.

Family Planning is now running a training programme with the Ministry of Health to address health professionals' "gaps in knowledge" around inserting IUDs.

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Family Planning medical adviser Dr Beth Messenger said the training programme, which began in January, was prompted by the lack of any formally recognised training standard, which left health practitioners guessing at their competency to insert IUDs.

It also aims to address some practitioners' inexperience at managing complications during and after the procedure.

The Merina IUD (left) is the most common option, the copper IUD doesn't have hormones. Photo / Getty Images
The Merina IUD (left) is the most common option, the copper IUD doesn't have hormones. Photo / Getty Images

Messenger said the training programme was not mandatory, as that could be a barrier to practitioners who had not completed the training but who were still capable of performing the procedure.

"If it was mandatory then it could potentially stop these practitioners from providing the service."

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Christchurch student Alyssa Tomaszewski, 21, is another who had an IUD inserted incorrectly in January and believes training should be mandatory so women can feel safer.

She said the nurse who had fitted her IUD was not confident, which made Tomaszewski "really nervous".

"You expect nurses doing a procedure like that to know what they're doing. I had to ask her to repeat herself lots because she was mumbling."

After experiencing painful stomach cramps and visiting another health centre, Tomaszewski was told the pain was caused by her IUD being inserted incorrectly and she would have to get it reinserted.

Auckland GP Orna McGinn said it's "almost impossible" for women to navigate trained providers and hoped the new training rollout would provide women with a greater choice of trained practitioners.

McGinn said it's important for women to have all the information they need and feel confident in making the right choice when deciding to get an IUD.

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Sherida Wilson's experience is not uncommon. Photo / Supplied
Sherida Wilson's experience is not uncommon. Photo / Supplied

"Almost everyone is suitable for an IUD. There's lots of myths out there which is why women have been reluctant to get one but the procedure is very straightforward."

A Ministry of Health spokesperson said the new training programme aimed to increase the competency and confidence of health professionals and widen access to IUDs.

"New Zealand needs more GPs, doctors and nurses to be trained in inserting IUDs. Ibuprofen is recommended to reduce the pain and discomfort of insertion. Some providers offer a local anaesthetic injection, although this requires further training to administer."

They said if someone has concerns about the adequacy of care of inserting IUDs, they can lodge a complaint with the practice or the Health and Disability Commissioner.

Canterbury District Health Board executive director Ralph La Salle said insertion of IUDs could be "unpleasant" but the device remained an "excellent contraceptive option".

"We encourage all providers to undertake the NZ Family Planning online modules on contraception."

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