Knowing your contraceptive options and being informed about what to look out for, is an incredibly empowering feeling. While every contraceptive method may come with its own version of wahala and side effects, it’s important to know what exactly your options are and what to vaguely expect! 

According to this study, only 17% of women in Nigeria use a form of contraceptive. That number is worryingly low and a host of factors such as the financial costs of contraceptives and sexist social stigmas are negatively impacting women’s contraceptive use. It’s affecting us big time. Paired with our extremely poor healthcare system and illegal abortions, Nigerian women are experiencing skyrocketing maternal death rates and unwanted pregnancies. 

Taking charge of your reproductive health should be a priority amongst us and there’s no time like the present to get a move on. The first thing a lot of us think of when we think of contraceptives are condoms and birth control but there are a variety of different options you can also explore. 

Today, we’re focusing on the lesser-known intrauterine device aka the IUD. FEMME MAG spoke to an obstetrician-gynaecologist to break down all you need to know from pain level to the different types you can get. 

What’s an IUD?

IUD stands for intrauterine device and it is a long-acting, reversible type of contraceptive. Shaped like a “T” and just a little bit bigger than a quarter, the IUD fits into your uterus and prevents pregnancy by stopping sperm from reaching and fertilizing eggs. The IUD can remain in place for 3 years and in some cases up to 12 years, depending on the type. 

“For the most part, intrauterine devices are very safe and record minimal side effects,” says Margaret Ekpo, a practising nurse and midwife with 15 years of experience. “Patients can choose between the hormonal or non-hormonal IUD but in my years of experience, Nigerian women mostly choose the non-hormonal IUDs.”

Ok great, can you explain the difference between the hormonal and non-hormonal IUDs?

Hormonal IUDs work by releasing progestin in the cervix, which thickens the mucus in the cervix and makes it nearly impossible for sperm to reach the egg. Progestin also thins the lining of the uterus and in the unlikely event that sperm can travel to the egg, this thin lining makes it difficult for an egg to implant in the uterus and cause a pregnancy. One of the most popular brands of hormonal IUDs in Nigeria is Mirena. 

Ekpo tells FEMME MAG that like with all other forms of birth control, hormonal IUDs also record side effects. “They are minimal but patients have recorded irregular menstrual cycles and feeling more irritable. In very extreme cases, the uterus can get infected.”

And the non-hormonal?

Non-hormonal IUDs are also known as Copper IUDs because they are wrapped in a copper coil. Copper repels sperm so when copper ions are released into the uterus, it creates an environment that is inhospitable to sperm. The ions also change the lining of the uterus and the makeup of the cervical mucus to further block sperm from reaching the egg. 

“Patients who opt for the copper IUD almost always experience heavier bleeding after,” says Ekpo.

What is an IUD insertion like?

The process of getting an IUD begins with a consultation.

“It is wise to discuss your needs, expectations, budget and medical history with your doctor beforehand,” she says. Of course, IUDs should only be inserted by trained professionals like OB-GYNs, nurses, midwives or other certified professionals.  The consultation is where you can ask in-depth questions like potential side effects, benefits, your health history and family-planning goals. 

After the consultation, where your doctor recommends the best option to suit your needs, an appointment is scheduled for the IUD insertion. To insert an IUD, your doctor will gently insert a speculum into your vagina to widen it. They will then check the size and position of your uterus, clean your cervix and vagina with an antiseptic liquid, look for any problems with your uterus and then line up your cervix with your uterus.

After that, they will use a special insertion tube to pass the IUD through the opening of the cervix and into the uterus. Ekpo tells FEMME MAG typically takes 30 minutes.

What to expect.

Informed consent is very important and it’s your healthcare provider’s responsibility to disclose all information beforehand. While some women have described the process of getting an IUD as painless, other women describe feeling intense and sharp pain. The pain threshold can differ for women who have given birth before or women who experience painful menstrual cramps. 

“Patients are informed to expect pain during IUD insertion. For some, it is mild and for others, it can be agonizing, depending on their pain threshold,” Ekpo says. “Some clinics can offer numbing at the time of insertion and painkillers after the procedure.”

You might bleed lightly after the procedure so it is recommended that you bring along a menstrual pad for that. You might also feel dizzy or faint and have some cramping. Also, irregular bleeding is common for months after the procedure and is nothing to be alarmed about.

Feeling nervous before the appointment is normal, especially if you’ve experienced some trauma. You can discuss this with your healthcare provider or you can seek out options to self-soothe.

How much does the procedure cost in Nigeria?

The price of the different types of IUDs vary from place to place but Dr Ekpo tells FEMME MAG that private practitioners like her charge anywhere from N70,000-N100,000

“For my practice, this price includes the consultation and an aftercare fee,” Dr Ekpo told us.

On the more affordable side of things, Marie Stopes-the leading NGO for contraceptives and family planning in Nigeria charges about N4,500-N6,500. This information was confirmed by a representative from the organization.

The concept of using contraceptives in Nigeria might be confusing and scary but they don’t have to be and there’s always an option for everyone.