Help Me Have Faith in Birth Control Again

February 10, 2018 11:14 PM

I've gotten pregnant with a copper IUD in, which was supposed to have been one of the most effective forms of birth control. Should I get another one because lightning hopefully won't strike twice?

I found out after missing a period that I am very unexpectedly pregnant. I'm lucky that I have a very supportive partner, super supportive friends, an appointment at the local Planned Parenthood, and the means so this won't be a problem.

But the main part is, I'm pretty confused on what to do next in terms of birth control. I'm hesitant to go on the pill because I don't want to mess with my hormones and because it's not supposed to be as effective as IUDs.

I considered having a hormonal IUD, but I'm pretty sure the lack of period every month will freak me out more, especially after this episode. It also doesn't help that my doctor mentioned how she has seen 3 other IUDs (all hormonal) fail in the last 6 weeks (though mine was the only copper one that failed).

Or do I go with another copper IUD? I had a good four year run with the current one until it failed, but didn't have much trouble with it otherwise. Help!

posted by anonymous to Health & Fitness (12 answers total)

If you’re willing to give hormones a shot, the implant has a 0% failure rate as long as it’s inserted correctly. It can do wacky things to your period, from stopping it completely to frequent lengthy periods (the latter is my situation), and you won’t know until you try it how your body reacts. Other than that annoyance, it is zero-maintenance for its three-year lifespan and I adore mine.
posted by epj at 11:32 PM on February 10, 2018

You might find this tool useful: my contraception tool

No contraceptive method apart from abstinence has a 0% failure rate, but the implant has a very, very low failure rate of 0.05%. Here is a table of typical use and perfect use failure rates for 15 different types of contraception: comparing contraceptive efficacy

The copper IUD is the only long-term reliable contraceptive method that doesn't use hormones aside from sterilisation. So you need to balance up whether you are more worried about the potential lack of periods (or other shenanigans) or the fear that the copper IUD will fail again. Or alternatively if you don't want to have children at all, either you or your partner could consider sterilisation.
posted by plonkee at 12:24 AM on February 11, 2018 [1 favorite]

Should I get another one because lightning hopefully won't strike twice?

The Empire State Building will get hit multiple times by the same storm, while most other buildings in NYC don't.

The copper IUD may be effectively similar to a medication, and if a medication that works for 99% of people fails to work for you in particular a first time, that particular medication probably has a stronger chance of a undesired outcome for you a second time, while still being 99% reliable for the rest of the population. (I've utterly no medical training, but I think I've read strongly worded advice that people shouldn't ignore their own previous negative experiences with particular medications.)

Unless your doctor and folk say that in fact there's lots of information and statistics about people who continued with a copper IUD despite a first unwanted pregnancy and had the copper IUD be completely reliable afterwards. But it seems like most people with that first experience would be very firm about using a different method.

So, something else might be better.
posted by sebastienbailard at 2:51 AM on February 11, 2018 [3 favorites]

"Only a history of previous IUD expulsion was found to be a risk factor for failure", according to that large research study (emphasis mine). That is, the only reason they found to believe a copper IUD may be less effective in a given women is if she had already expelled one. This would seem to contradict the suggestion made by sebastienbailard above, in that this study did not detect any effect of previous pregnancy with IUD.

This is indeed "talk to your doctor" territory though, but until then, you can read up on comparative strengths and weaknesses of all methods commonly used in the USA using this paper that gives a good readable overview, discusses differences in terminology and use, and provides authoritative failure rates for perfect and typical use.
posted by SaltySalticid at 5:40 AM on February 11, 2018 [2 favorites]

I have a question: were you checking the strings? I also had a pregnancy on the copper iud but when it dislodged I didn't know because I hadn't been educated about checking strings. I'm curious because I have the same question myself.
posted by catspajammies at 5:42 AM on February 11, 2018

Hello! I got pregnant with an ostensibly properly functioning IUD, and since I am superstitious in my own way but try to be overly cautious with birth control, I opted for an Implanon contraceptive implant in my arm. I'm on my second Implanon now and pretty happy with it: no periods, no other noticeable side affects. It's a little brutal when they dig the old one out, but that's fine with me.
posted by redsparkler at 8:35 AM on February 11, 2018 [1 favorite]

How about condoms? You could use them in combination with the copper IUD as a backup. I feel similarly about the hormones and I've used only condoms for years. I did get pregnant during that time but intentionally. Failure rates with condoms that are used correctly are extremely low; condoms plus an IUD should get you down to a pretty much zero chance of getting pregnant.
posted by peacheater at 10:41 AM on February 11, 2018 [1 favorite]

Anecdata re: condoms, as a cis woman dating primarily men--I used to think that using condoms "correctly" was just a matter of rolling down the correct side, leaving space at the tip, etc. But despite repeating reading about how to use them "correctly" online, I've still experienced multiple failures (no pregnancies, but condom slipping off and/or breaking). Part of the "correct use" paradigm is having the right size for the man's apparatus, and I can say from experience that both on-the-smaller-side and on-the-larger-side can cause problems. Switching brands helped a bit, not entirely.

I'd still say that condoms + IUD is pretty safe, but I would never use condoms as primary BC unless I was having sex with exactly one partner who already has a history of successful condom use.
posted by serelliya at 2:32 PM on February 11, 2018

Condoms + copper IUD. I hear using two forms of birth control is more common in Europe.
posted by aniola at 2:40 PM on February 11, 2018

Condoms + copper IUD. I hear using two forms of birth control is more common in Europe.

Anecdata, but my younger friends of baby-making age who own uteruses and like penises are largely using this combination. It's a nice way to share the responsibility.

Also, I just wanted to add that if you feel the need to buy a fatpack of Dollar Store pregnancy tests or cheapie pregnancy tests from Amazon and pee on a stick every single month for as long as the back of your brain is worried, that is perfectly fine and not unusual after an unplanned pregnancy resulting from bc failure. I'm sorry you are in this shitty club.
posted by DarlingBri at 5:17 PM on February 11, 2018

Minimum of two methods if you absolutely do not want a pregnancy. Copper IUD plus condoms, copper IUD plus withdrawal method, copper IUD plus spermicide, copper IUD plus fertility awareness method...you have options.
posted by pecanpies at 5:35 PM on February 11, 2018

I've also been mostly happy with my implant, but its not ideal. It'll be one year for me in April. First month my arm was very tender, but then it was fine and i never thought about my arm again. My first few periods were very irregular, then it was many months of being like clockwork. My last period lasted 3 weeks. I'm overall happy, since I hate pills (got pregnant) and IUDs creep me out, but it is definitely not perfect.
posted by gatorae at 6:17 PM on February 11, 2018