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Saturday, June 23, 2012

Officially "Garded"

By the ParaGard, that is. Thursday, I finally got to Planned Parenthood while Matt watched Cael. I really didn't know what to expect, but it was really weird going in there. I don't want to be judgy, but some of the women who came in were..uh...trashy. But it's good that there's a place that they can go to get help. I seriously felt like a minority there, being married, and looking for ways to prevent pregnancy, and limit our family size. Of course there were women there who were picking up condoms (you could tell, because they handed them out in paper bags), but there was also a woman there who picked up condoms, but also wanted a pregnancy test. I won't go into details, but the gist of what I got from overhearing her, is that she was 3 weeks post-partum, but she wanted a pregnancy test because a condom broke a week ago. Say what!?! Yikes!

Anyway, I was there for a total of about 3 hours. I ended up getting a pelvic exam, pap smear, breast exam, and the IUD in. Initially, when the nurse was interviewing me, she was explaining what would happen. I would answer questions, have a pap and pelvic done, and then come back when I had my period so that they could put the IUD in. Uh, hold up a second nurse-lady. I informed her that I was still breastfeeding, and haven't yet had a period at 9.5 months old. I re-asked her, and said, "so even if I'm breastfeeding, and haven't had a period yet, and don't know when I'm going to have a period, you're going to make me wait?" She said yes, and I told her I wasn't happy about that, and if I'm going to have to wait potentially several months, I might as well leave, and pretend like I didn't come. She said that she would ask the NP to make sure.

She left before finishing the questions to ask the NP about what they would do. She popped her head in to ask how old my baby was, and then left again. The NP came back in with the nurse this time, and confirmed that I haven't had a period yet. She said that it was odd, and asked the last time we had sex. I explained to her about my granuloma and how sex was painful, and then about how my husband can't use condoms during sex. So therefore, it had been about 3 weeks since we had sex. She said ok, and then said that they would do a pregnancy test, and that they can actually insert the IUD at that visit! I was thrilled. Now, they just had to call the insurance company to see how much they would cover. Great. So I went out into the waiting room, trying not to get my hopes up.

I'll spare the details, but eventually they came out to get me to ask more questions. A lady from the front desk came in, and explained to me that they couldn't get a clear answer from the insurance company, and that they may cover it up to 50%. I chimed in, telling her that I already called the insurance company, and they told me 50% after the deductible was met. So we don't know. So she said that what they would do, would charge me half today (which I needed to pay in full), and then bill the insurance company for the other half. And based off our income, we qualified for a discount, so instead of $800, I would have to pay $575. So I owed $285 at that visit, plus a $20 copay for the exam. She explained that if the insurance covers the other half, then fine - I don't owe anything else. But if they don't, I'll get a bill from PP for $285, in which I can set up a payment plan.

I asked to call Matt so I can talk to him about it. We just had a lot of bills come out of our account, so we had less than $500 in our checking account. Plus, Matt is going to Virginia on Sunday for a week, and we wanted to make sure he had enough money. We got into a little argument over the phone, but in the end, he said to just do it so that it's taken care of. Whether we have to pay for it now, or in a month, we're still going to have to pay it.

I came out and told the nurses that I was going to go ahead with it. I finished the last of the interview questions, and the nurse gave me an Ibuprofen. She then scared me by saying that even if they can't get the ParaGard in, that I would still be charged an insertion fee of $140. That made me really nervous, but as I was passing the NP, she said, "Don't worry, we'll get it in."

Twenty minutes later, I was in the exam room, and having the exam. Much to my surprise, the pap didn't hurt at all. Especially when she inserted the speculum. The last time I had a speculum inserted (at the appointment with the midwife for my granuloma), it hurt so bad it brought tears to my eyes. This time, I didn't feel anything except for the normal pressure of a speculum being inside you. Just proof that the silver nitrate worked!

The nurse told me that I would feel a pinch when the NP tried to get my cervix open. I felt this weird pressure, and feeling inside my uterus. I learned that the NP was measuring the length from the fundus of my uterus to my cervix. Mine measured 6 cm. Normally it's 6-9 cm, and if it's less than 6 cm in length, then they wouldn't be able to insert the IUD because it would likely be expelled. That's something that I didn't even know. I'm very lucky that my uterus was long enough to put the IUD in. I then felt this moderate discomfort, pressure-like twinge. It was uncomfortable, but definitely bearable. I asked if that was the "pinch", and the nurse said yes, and I told her that was nothing. I said that after the pain I had with the granuloma, this was a piece of cake, and definitely manageable. I did experience some cramping when she was putting the IUD in and measuring the length, but it was quickly gone after it was all done.

The whole things was done in less than 5 minutes. The NP couldn't tell me for sure if I was going to experience bleeding, because normally they're inserted when you have your period. She also said that the insertion might trigger my period to start, but again, she wasn't positive. I don't know how it would trigger my period to start, since it's non-hormonal, but I guess I had to wait and see. She gave me a wallet card that had the date of insertion, and said it had to be removed no later than June 2024 (12 years). Normally, they have you call back in 2 weeks, after your first menses with the IUD in, so that you can come back in and be checked that everything is still in place. But since I have a different situation, she said not to worry about it. It kind of left me with clue as to what to do, but I figured that after I had a period - whenever that would be - that I can always call them, tell them when I had it in, and ask if they need to see me. I paid the $305, and was on my way.

Everyone was so nice to me there. I told Matt when I got home, that I was probably a breath of fresh air for them, compared to the people they normally see. Especially 3-week-postpartum-possibly-pregnant-woman. It sounds mean, but it's true.

I must have started bleeding right after I left PP, because by the time I got home, my pantyliner was filled with red blood. As of today, I'm still bleeding, but it's more like spotting. I don't need a pad or tampon, but it's still coming out, more lighter with each day. I researched it, and found that bleeding and spotting is normal after IUD insertion. I'm not going to consider this a period, because I'm not cramping, and when you think about it, my cervix had to be pried open, and there's a foreign object in my uterus. The combination of these things is most likely what's causing me to bleed.

Although it was expensive out of pocket, I don't regret getting it done. Plus, now we're protected for 12 years! It's the best decision for us, and hopefully now we can have normal (condom-free) sex again. It's been a long time, that's for sure. Of course, there's a list of possible side-effects, and problems. They include: ectopic pregnancy, infertility, expulsion, perforation of the IUD through the uterus, pelvic infection (which I'm scare to get. Mostly occurs within the first 20 days of insertion), breakthrough bleeding between periods, increased menstrual cramps, heavy menstrual bleeding, etc. I'm most afraid of it coming out on it's own, because my uterus is so short. Mainly because of the cost of getting it put back in. Hopefully that won't happen.

Overall, I'm thrilled to have an IUD, despite the cost. Hopefully it works well for us, and I don't have any complications.


  1. The cost of an IUD is much cheaper than an unexpected number 2! :) It has to be good news that the pap didn't hurt like the previous time!!
    And ohhh my, 3 weeks PP and having sex and worrying about pregnancy.

  2. I have to agree, Diana! In the long run, since we don't want anymore, it's definitely the cheaper method. I mean, 12 years of protection!? Uh, yes! It's just so expensive out of pocket immediately, but I agree - worth it over time.
    Definitely good news that it didn't hurt. It has to mean that I'm all healed. And not to be TMI, but even Matt said it "feels different" (in a good way) down there. He must have felt it before I had the silver nitrate put on, but didn't want to say anything then. I'm definitely happy about it.
    I can't even fathom having sex at 2 weeks pp. It's crazy!