Kara Tucker (left) and Jenny Matthews

With this month’s news via a leaked draft opinion that the Supreme Court intends to overrule Roe v. Wade, birth control is taking on even greater significance in the U.S. If and when the court rolls back abortion rights, Tennessee’s so-called trigger law would effectively outlaw the procedure altogether, likely forcing pregnant people to travel out of state to obtain an abortion. 

IUDs — an acronym for intrauterine device — are more than 99 percent effective in preventing pregnancy, and they last five to seven years. The CDC’s most recent National Survey of Family Growth shows that 14 percent of women ages 15 to 44 use an IUD as contraception, a number that has grown steadily from 1 percent in 1995. 

Even before the Supreme Court draft decision leaked, nurse practitioner Kara Tucker noticed an uptick in IUD placement in recent years at her place of work, Woods Gynecology in Belle Meade.

“I do think IUDs in general are definitely having a comeback,” Tucker tells the Scene. “I think women talk to each other a lot. If somebody likes the IUD, then they’ll tell their friends about it.” 

IUDs are covered by TennCare. But without insurance or another assistance program, an IUD can cost $1,500. A Step Ahead Middle Tennessee is a nonprofit that covers the cost of long-acting birth control, which also includes Nexplanon, an arm implant. The group has paid for IUDs or birth control implants for 1,700 people in the Midstate since it was founded six years ago. 

According to A Step Ahead executive director Jenny Matthews, in the days following the Supreme Court decision leak, the organization has seen a slight uptick in calls and online inquiries for their services. She anticipates that over time, that number will grow. 

“I think that with what we’re doing, it’s such a high percentage of effectiveness that people will turn to this as a really great pregnancy prevention option, should they not have other options,” she says. 

A Step Ahead was hitting its stride in 2019, Matthews says. And now, as the pandemic has steadily slowed down, the nonprofit is serving a new clientele — those who left their job-provided insurance. 

“We are finally seeing an increase in our numbers to where we’re serving more clients than we ever have before,” Matthews says. “People are going back to providers for things that aren’t related to COVID, plus as the Great Resignation made more people self-employed or laid off, they might not have insurance that covers IUD insertion.”

Tucker recommends IUDs because of their high rate of effectiveness, and says the hormonal IUD can make periods less severe or stop entirely. There’s also an option that doesn’t contain hormones. 

However, Tucker says, another barrier to getting an IUD placed is the discomfort of the process. It’s important to prepare patients by telling them about the pain associated, she says, but her office goes another step by offering the anesthesia nitrous oxide for an additional fee. It relaxes the pelvic floor muscles and wears off quickly enough that the person can drive themselves home. 

“Obviously, a lot of people are really anxious about it,” Tucker says. “You talk to your friends, and you hear horror stories, and you can get really worked up. That plays in a lot with pain as well, and also with our ability to insert it.”

In terms of discomfort associated with insertion, which varies from patient to patient, Tucker says she’s noticed no pattern when it comes to age of patients or whether they’ve given birth. Some offices will offer anxiety-relief prescriptions to help the patient relax as well, she says. 

“I definitely think it’s really important to give people a fair heads-up to what they’re about to have done,” she says. “I think that really helps with patient expectation, and it helps with the overall pain level. I don’t think I’ve ever been like, ‘It’s a breeze, just take ibuprofen, you’re gonna be good.’ It’s important to tell people that it’s uncomfortable. It’s not going to be something you want to come back and do every single day or even every year.”

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