How Having an (Insurance-Covered) IUD Is Saving My Life

This article originally appeared on Patheos.

I had no intentions of writing about the Supreme Court’s decision in the Hobby Lobby case. I tweeted my friend Laura Ortberg Turner’s short post on it, because I share her opinions and she wrote with good humor and admirable economy. I expected to leave it at that.

But while reading friends’ Facebook conversations, I noticed two troubling trends in some Christian responses to the Supreme Court ruling. The first trend was simple inaccuracy, as people argued that the case was primarily about Hobby Lobby not wanting to fund contraceptives that cause abortions. First, many would argue that this is not actually what the case was primarily about (for one take on what it was about, read Paul Horwitz’s New York Times op ed). Second, that contraceptives such as “morning after” pills and IUDs prevent implantation of fertilized embryos and thus cause abortion is simply not true. I’m not even going to link to evidence that these and other contraceptives interfere with ovulation or fertilization, not implantation, because it’s so easy to find that it would take me longer to copy and paste links than it would take you to find and read them on your own. (If you want something more fun to read than dry data, check out this post from my colleague the Slacktivist, who points out that fertilization doesn’t occur during or immediately after intercourse. Taking a pill such as Plan B in the day or two after having unprotected intercourse doesn’t abort an implanted fertilized egg; at that point, a fertilized egg most likely doesn’t exist, as sperm are still swimming around refusing to ask for directions. Rather, such medications prevent or delay ovulation or inhibit fertilization.)

The second, and to me more viscerally troubling, trend among some Christians rejoicing in Hobby Lobby’s victory was the characterization of the court’s decision as a dismissal of whiny women who want someone else to pay so they can have lots and lots of sex without worry, because they can have as many abortions-via-contraception as they need.

I can’t believe this point needs to be made, but contraceptives are actually not used solely, or even primarily, by women who want to have lots and lots of sex without getting pregnant. Contraception isn’t a mere “Get Out of Jail Free” card for the promiscuous. It’s a tool that can promote health—physical, psychological, individual, communal, and global. Propagating the idea that medications to halt infections, ameliorate mental illness, and prolong men’s erections are reasonable tools to promote health (and therefore covered by insurance, regardless of your employer’s opinions about the germ theory, the causes of depression, or erections), but contraceptives are a personal choice so that women can give their out-of-control libidos a regular workout without worry is, indeed, an act of aggression toward and dismissal of women.

Contraceptives don’t merely prevent pregnancy for women having lots, or even a little, sex. They support women’s physical, psychological, and emotional health. I’m not just talking about women taking birth control pills for conditions such as polycystic ovary syndrome or painful periods, or women whose circumstances dictate that a pregnancy could kill her or push her family more deeply into dire poverty.

I’m talking about me.

I have had an IUD for just more than eight years. I consider my IUD to be saving my life. I don’t mean that exactly literally, but I do mean it seriously. My IUD protects my sanity and my fragile physical health to such an extent that I consider it necessary to my, and my family’s, health and well-being.

I got my first IUD (I’m now on my second) three months after my third child was born. We didn’t want any more children. Underneath that simple statement are deep, jagged layers of anxiety, pain, and even terror—anxiety, pain, and terror that my IUD, which prevents pregnancy regardless of the timing of intercourse or my memory or the repair history of the condom factory’s equipment, almost entirely ameliorates.

Because of my IUD, I hardly get periods anymore. This is convenient, but it’s far more than that. My periods were horrible, painful, long, irregularly constant (as in, I would sometimes bleed all but three or four days a month), copious, clotty, hideous things. I am deeply grateful for the reproductive goings-on behind even my horrible periods, because they allowed me to conceive and carry three children. I am also deeply grateful to no longer have my vision narrow to a pinpoint in the throes of menstrual cramps or bleed out of my vagina more days of the month than not. (Sorry to be graphic, but I want you to understand from what sort of captivity I’ve been freed.)

More important, because of my IUD, I carry no anxiety about an unwanted pregnancy. My desire not to have another baby is not just because we have three beautiful kids and that feels like enough, just right. I don’t want another baby because I’m convinced that carrying and giving birth to another baby would damage me, and secondarily our entire family, in deep, perhaps irreparable ways.

There’s this:

During my third baby’s c-section birth, the doctors had a lot of trouble getting my epidural in properly. I had epidurals with my first two children; the first was straightforward, the second less so. But the third was a nightmare. They were poking needles into my spine for 15 or 20 minutes, each time producing a painful burst of shock-like sensations up and down my spine. I endured silently, expecting that soon I’d be numb from the ribs down and ready to meet our son.

Except when they began cutting my abdomen, I could feel it, enough to produce both pain and panic. At that point, there was nothing to do about the epidural. The anesthesiologist, in my husbands words, began “throwing” meds into my IV and the mask over my nose, including nitrous oxide and various other cocktails. The point, the anesthesiologist explained, wasn’t to erase the pain. Nothing could really do that. The point was to make me loopy enough that I wasn’t fully engaged with the fact of my abdomen being sliced open without adequate anesthesia.

While I made it through the ordeal (obviously), I became shaky and agitated any time I thought about it. The thought of having another baby—another epidural, another c-section—didn’t just make me weary. It made me (makes me) panic.

And there’s this:

I tore cartilage in my knee toward the end of that third pregnancy. Who knows if that sped along my inevitable march toward arthritis or not? I do know that the injury, which occurred because of the extra weight I was carrying on my already precarious joints, was the beginning of something life changing. I no longer have much cartilage left in either knee, and take powerful opioids so I can function as a mother, wife, homeowner, and writer despite pain and impairment. I know, literally in my bones, that I could not carry another pregnancy without at least exacerbating the pain, and at most, permanently worsening the condition of my joints. I would also have to go without my medication for the duration, which would involve unpleasant withdrawal and worsened pain. And when it was all over, I suspect my ability to care for a new baby, three other children and our household, to cook and clean and walk the dog and take the kids sledding, would be either diminished or destroyed.

I might someday, even without another pregnancy and another baby, need a wheelchair for mobility, hired help for cleaning and cooking, or other aids. While I don’t relish those possibilities, I will make those decisions when the time comes. But I have reason to believe, and a tenacious hope, that such decisions are still years down the road.

Really, what it comes down to is this:

If I were to become pregnant again, there is enormous potential for another harrowing birth and permanent damage to my body and ability to do the things that I love, want, and need to do. That potential means that I would seriously consider having an abortion.

I don’t know if I would or not. But I know the question would be an open one. I know I don’t want to face that decision. I know that a tiny boomerang of hormone-infused plastic ensures that I haven’t had to, and won’t have to, make such a decision.

This is why I feel like my IUD is saving my sanity, my family, my life.

Our health insurance paid for both of my IUDs (they are replaced every five years), at a cost of $500 – $1,000 a pop for the device itself, insertion, and follow-up. If our insurance didn’t cover it, most likely we would have chosen a less expensive birth control method—one requiring more regular involvement, one feeling less sure.

That wouldn’t be a tragedy. I know that. But it would deal a real blow to my health.

That blow would largely take the form of much more anxiety around having another baby. As a Christian, a believer in God’s word made flesh, I understand health as incorporating body and mind and spirit. The state of our bodies dictates the state of mind and spirit, and vice versa. This is why I feel like my IUD, by protecting me and my family from the potentially ruinous consequences of another pregnancy as well as the deep worry about that happening in the first place, is saving my life.

Some Christians’ rejoicing in the Hobby Lobby decision is based on bad science about how contraception works. And some of it arises from graceless, inaccurate assumptions about why low-cost contraception isn’t merely a choice or a convenience for many women—including monogamous, responsible, married women like me—but a necessity. Contraception can be a life- and sanity-saver for women who want to be good stewards of the bodies and minds and spirits—our own and our families’—that God has entrusted to us. That’s something a so-called “Christian” employer might consider good.

Ellen is the author of ‘No Easy Choice: A Story of Disability, Faith, and Parenthood in an Age of Advanced Reproduction’.

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