From the late-night Senate vote to repeal the Affordable Care Act to attorney general nominee Jeff Sessionsâs demonstrated inability to disavow anti-abortion domestic terrorist groups, the incoming administration is looking like some fresh fucking hell if you possess a uterus. In the months following the election, I heard from women stockpiling Plan B, scheduling emergency IUD insertions, getting real about long-discussed vasectomies for their partners, and devising strategies to maintain their sanity and bodily autonomy in a country soon to be led by creepy old men who want them to have neither. You might feel alone right now if youâre going through this too, so remember: Youâre a foot soldier in an army, fighting back against tyranny with birth control preparedness. And Iâm here to help.
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One of the greatest things about the Affordable Care Act was the birth control coverage mandate, which required insurance plans to cover birth control as the preventive care it is. This is why youâve probably heard a lot recently about IUDs (intrauterine devices, for those of us who didnât go to a womenâs college). Not only are IUDs one of the most effective, longest-lasting forms of birth control currently on the market, theyâre also incredibly expensive without insuranceâ$500 to $900. For women who live in strongly pro-choice states, larger concerns about access to abortion under the travesty that is the Trump administration may not be as immediately applicable. But the encroaching high cost of birth control? That is. The birth control benefit may already be on its way out by the time you read this, so if youâre thinking about getting an IUD, nowâs the time.
If youâre going the IUD route, your birth control preparedness starts with a decision: Hormones or nah? Hormonal IUDs (Mirena, Skyla, Liletta, Kyleena) contain a synthetic hormone that stops ovulation and thickens your cervical mucus. Copper IUDs (ParaGard) harness the power of copper to make your uterus an environment thatâs toxic to sperm (a friend once aptly compared her ParaGard to a sentry warding off intruders; I have never forgotten this beautiful comparison). I know a slew of happy Mirena users who are especially enthused about the deviceâs serious side-benefit of making their periods lighter over time. Meanwhile, the ParaGard, while not adorably marketed like its vaguely floral-sounding sistren, has been around since the â80s and lasts up to 12 years, so itâs tried and true: the sensible used Volvo of IUDs. It can also double as emergency contraception if itâs inserted within five days of unprotected sex. There are other hormone-free IUDs in use abroadâlike the frameless, futuristic Gynefixâbut theyâre not yet available here, because (in case this wasnât yet clear) America is way behind many other countries when it comes to birth control.
If youâre planning on getting an IUD, Iâm guessing your next question is about insertion. And for good reason: Getting the ParaGard rates among the most painful experiences of my life, possibly ahead of running a half-marathon? (YMMV.) While many women Iâve spoken to are here with me in the âTHE FUCK?! THAT FELT TERRIBLEâ camp, a handful report only minor cramping followed by a pleasant bike ride home (LOL I CANâT EVEN IMAGINE THIS). And if youâve already given birth? I suspect we childless young women bent over our heating pads look like a bunch of crybabies.
Oh yeah, and your birth control preparedness plan? It doesnât HAVE to include an IUD. I want to be clear about this: When it comes to birth control, youâre putting foreign objects and substances in your body to ward off babies, and only you have to deal with the side effects, which run a delightfully strange gamut from clear skin to unwittingly living under an emotional stormcloud for five years. As with all deeply personal medical decisions, you should never, ever feel pressured to undergo a medical procedure that doesnât feel right for you, or welcome side-effects into your life that donât seem worth it. So if youâre not feeling the IUD, donât get one. Iâm not a doctor!
Itâs also important to remember that despite the quasi-religious fervor surrounding IUDs, there are plenty of options out there that have their own devoted followings: the pill, the patch, the ring, and the frequently ignored diaphragm (a new model just came out that doesnât require fitting and comes in a delightful purpleâso if you think the diaphragm is a thing of the â80s or Carrie Bradshaw, you are incorrect). Whether you like your pill packs or cling to the trusty, unattractive ParaGard, your birth control has a simple job: It should prevent pregnancy or treat any of the conditions that birth control is prescribed for off-label (despite the GOPâs obsession with sex, there are lot). AND IT SHOULD BE RIGHT FOR YOU.
But whatever your preference may be, get it in order now. Do it because it will make Mike Pence cry. Do it because it will make you feel more secure in an insecure world. Do it because your capacity to get pregnant shouldnât control your life. But most of all, do it for yourself. Because when it comes right down to it, thatâs who youâre doing this for. Thatâs kind of the thing about reproductive rights: Itâs not up to anyone but you. 
