Biological:

©2012 ADAM, Inc

The IUD is one of the most effective forms of birth control in the world, second only to sterilization. Currently, over 160 million women use the IUD to prevent or delay unplanned pregnancies. The two types of IUD are hormonal or copper, both of which work to prevent sperm from fertilizing an egg. The hormonal IUD releases the hormone progestin which thickens the cervical mucus. Because of the thickened cervix, sperm is unable to reach the egg. The non hormone IUD is releases copper which acts as a powerful spermicide. Although IUD has a 99.9% rate of effectiveness, there is still that margin of error in which pregnancy can occur. If an egg is successfully fertilized, the IUD can cause inflammation in the uterus which makes it more difficult for the egg to implant. The difficulty of trying to implant in the uterus can cause an egg to implant elsewhere, leading to an ectopic pregnancy. Ectopic pregnancy is when a fertilized egg implants outside the uterus, often in the fallopian tubes. (American Pregnancy Association, 2012) Since the fallopian tubes are not capable of carrying a growing embryo, an ectopic pregnancy must be treated or else the egg will fail to develop properly.

Social:

One thing that has continuously popped up in my research is that American women do not use the IUD nearly as much as women in other countries. While there are cultural and educational factors at play for this, another reason could be that the IUD serves certain women better than others. The IUD is most effective for women in monogamous relationships, as the IUD does not protect from STDs. In fact, getting an STD while having an IUD can lead to pelvic inflammatory disease. So, women who have/intend to have multiple partners should not use this form of birth control without taking extra precautions to prevent genital infections.

Overall, the IUD is a female gynecologist’s contraception of choice, mostly due to their safeness and effectiveness. (Zar, 2015)

Cultural:

Comparatively, women in the United States have a much lower rate of IUD usage than other regions such as Scandinavia and Australia. Only approximately 1.5% of women in North America use IUDs whereas women in Scandinavian countries have a usage rate of 18.2% and Australian women at 5.2%. (Wilson, 2008)

Economic:

©2012, Jezebel

Birth control availability is an issue that affects women AND men, but it is almost always women who suffer the worse effects of unplanned pregnancy. One thing that sets IUD’s apart from typical birth control is their cost effectiveness, as mentioned in the “sales” section. For an maximum of $1,000, an IUD user could effectively prevent a pregnancy for nearly 12 years. In that time, the user would save thousands of dollars on other methods of birth control or the cost of raising a child.

Political:

Politically, the IUD has created controversy because of the way the copper IUD works. As mentioned earlier, non hormone IUD releases copper which kills sperm on contact. Various pro life groups have considered this a “continuous abortion”. It is a very extreme and misinformed argument against methods of birth control, mostly the IUD. This belief has been heavily supported and discussed by Colorado Republican politician Bob Beauprez, who has said that he believes IUDs should be banned because they are “abortifacient”. 

The argument against the IUD maintains that a fertilized egg is prevented from implanting, so therefore a life is created and destroyed in one fell swoop. However, the purpose of the IUD is to prevent fertilization, not implantation. Additionally, there are many times in a natural, unobstructed cycle that a fertilized egg does not implant. (Schumaker, 2015) What it boils down to is misled definitions of “conception” and “pregnancy”, and leads to unfounded fear against perfectly safe methods of birth control.

Video where Rachel Maddow debunks this argument. 

Educational Factors:

It is speculated that one reason why IUDs are so unpopular in the United States is because of misinformation and lack of education. Women have heard the horror stories of IUDs perforating the uterus or causing infertility. While these risks are always present, they are extremely unlikely.

The mistrust stems primarily from the problems that came from use of the Dalkon Shield over 40 years ago. But, since then medical science has made strides in making the IUD a much safer device.