All posts by MFP

Weighing the Benefits (and Risks) of Birth Control

A study published last week in the New England Journal of Medicine (NEJM) found a slightly elevated breast cancer risk among women who used low-dose hormonal birth control.

The roughly 20 percent increased risk of breast cancer—similar to the extra breast cancer risk contributed by physical inactivity, excessive weight gain in adulthood, or drinking an average of one or more alcoholic drinks per day—was found to be the same no matter what method of hormonal birth control was used.

When we spoke to Maine Family Planning medical experts, they said women and teens contemplating hormonal birth control (like the Pill, or long-acting reversible contraceptives/LARCs) should not be alarmed by the new research.

For one thing, this was an observational study and therefore it does not prove conclusively that hormonal contraception is definitely the cause of the increased risk—only that it may be a factor, just like female gender or advancing age.

As Aaron Carroll, professor of pediatrics at Indiana University School of Medicine, further explained in Sunday’s New York Times: “This was a prospective cohort study, meaning it was an observational study that followed women over time and saw what happened to them naturally. The data set didn’t allow for adjusting for some factors that could also be associated with breast cancer, like age at first menstruation; whether women breast-fed; whether they consumed alcohol and how much; whether they were physically active; and more. The study found only an association, and not causal proof you might obtain from a randomized controlled trial.”

For another, the increased risk documented by the researchers is still quite small, amounting to one additional case of breast cancer in every 1,500 women. And young women bear even less of the impact.

“The absolute increase in risk [found in the study] is 13 per 100,000 women overall, but only 2 per 100,000 women younger than 35 years of age,” wrote epidemiologist David Hunter, of the University of Oxford, in an editorial accompanying the study in NEJM.

Meanwhile, hormonal contraception continues to carry well documented benefits, including its efficacy in preventing unwanted pregnancy (which carries its own significant health issues), and substantial reductions in ovarian, endometrial, and colorectal cancers later in life. The New York Times spoke with a number of doctors who cautioned against reading too much into the research findings:

While the new study’s findings about breast cancer are important, “these results are not a cause for alarm,” said Dr. JoAnn E. Manson, a professor of women’s health at Harvard Medical School and chief of preventive medicine at Brigham and Women’s Hospital.

“It’s really problematic to look at one outcome in isolation. Hormonal contraception has a complex matrix of benefits and risks, and you need to look at the overall pattern.”

“When it comes to making your own personal health choices, you need to consider the entire set of benefits and risks,” said Kohar Der Simonian, MD, Medical Services Director for Maine Family Planning. “If you have concerns, the best thing to do is to bring them to your doctor or health care provider and find the solution that’s the right fit for you, as an individual.”

Here’s more from Bedsider.

For Maine Women & Families, Susan Collins Must Vote NO on Disastrous Tax Bill

Red alert! Senator Susan Collins is caving and she needs to hear from YOU—today and every day until the Senate votes on the morally vacant tax bill.

There are myriad ways this cruel legislation would hurt low-income and middle-class folks—all in the name of giving tax breaks to corporations and the wealthy—but we are particularly concerned by how the proposal could impact women and families. Not only does the bill cut key deductions that help Mainers make ends meet, but it tries to sneak in major policy changes that have nothing to do with “tax reform,” like gutting Obamacare and inserting anti-abortion language into an obscure provision on college savings. Bottom line: The tax bill is an abomination and it must be defeated.

From eliminating the student loan interest deduction and certain childcare credits to raising taxes on families that have serious and costly medical conditions, the “Tax Cuts and Jobs Act” includes many provisions that will make it harder for lower-income women and families to get by. Multiple analyses have shown that the tax plan’s biggest beneficiaries will be Wall Street titans and the super-rich, while middle- and lower-income households will see few, if any, benefits.

And then there’s the stealth attempt to repeal the Affordable Care Act’s (ACA) individual mandate through the tax bill. Putting aside that the some members of Congress just can’t seem to accept the fact that the American public doesn’t want Obamacare to go away, this is a dangerous proposal that would result in an estimated 13 million people losing their health coverage.

According to the Maine Center for Economic Policy, without the individual mandate, Mainers could see their premiums go up by as much as $3,000 in Maine’s more economically-depressed regions and the state’s uninsured rate would go up from 6.8 percent to 11.8 percent within 10 years.

When folks lose their health insurance, it puts more pressure on organizations like ours—Title X-funded health care providers who serve low-income, uninsured patients every day. When you consider that the Trump administration is simultaneously waging war against birth control affordability and family planning providers (not to mention the “anti-abortion Easter egg” tucked into the tax bill), you have a perfect storm with women’s health and autonomy in its eye.

Call Senator Collins TODAY and urge her to vote NO on the obscene tax bill. Urge her instead to support proposals that improve the health and well-being of Maine women and families. Together, we can make our voices heard.

Call (202) 224-2523 now.

Or call one of her state offices (you can call any office, not just one near you):
Augusta – (207) 622-8414
Bangor – (207) 945-0417
Biddeford – (207) 283-1101
Caribou – (207) 493-7873
Lewiston – (207) 784-6969
Portland – (207) 780-3575

After Cyber Monday Comes #GivingTuesday

Reproductive Justice Champions support a wide range of Maine Family Planning services and programs.

Tomorrow, November 28, is Giving Tuesday, a global day of giving that offers folks the opportunity to support their favorite charities amidst holiday shopping and deal-scoring bonanzas.

We hope you’ll participate in this altruistic activity by donating to Maine Family Planning. In particular, we urge you to consider our Reproductive Justice Champion monthly giving program. By committing to a monthly donation, you help us provide comprehensive reproductive health care to women, men, and teens across Maine. You help us empower teens to make healthy decisions through our Best Practices sexuality education curriculum. You help us advocate for your rights in Augusta, in Washington, D.C., and in courtrooms. You help transgender Mainers, rural Mainers, low-income Mainers… You get the picture.

And we need your support now more than ever. With a hostile administration in Washington, D.C., family planning providers like us have a target on our backs. From affordable birth control to abortion access, the Trump administration is waging a multi-pronged attack on women’s health care. Loyal friends like like you help us fight back.

Donate here.

‘We Can’t Be Complacent’: Thoughts on Transgender Day of Remembrance

Trans Day of Remembrance vigilToday is international Transgender Day of Remembrance, a day where we honor those whose lives were lost in acts of anti-transgender violence. According to the Human Rights Campaign, 2017 has already seen at least 25 transgender people fatally shot or killed by other violent means—and the vast majority were transgender people of color. “While the details of these cases differ, it is clear that fatal violence disproportionately affects transgender women of color, and that the intersections of racism, sexism, homophobia and transphobia conspire to deprive them of employment, housing, healthcare and other necessities, barriers that make them vulnerable,” HRC declares.

GLAAD has more about the history of TDOR here; a number of vigils are taking place around Maine. A memorial was also held in Portland on Sunday evening.

Maine Family Planning offers Open Door trans health services to folks at our clinics in Waterville and Lewiston, and statewide through our groundbreaking telemedicine technology. We are thrilled to also be on the cusp of expanding in-clinic services to additional locations in 2018. Soon, clinicians in Belfast, Bangor, and Fort Kent will also be able to offer trans health care on-site. This is an important deepening of our organizational commitment to reproductive justice. As Cazembe Murphy Jackson wrote today at Rewire: “It is so important for trans people to be included in the conversations about reproductive justice. ”

Jackson said:

We must reflect on our struggles and ensure that all of us have the ability to decide if, when, and how to become a parent, on our own terms. I believe this is at the core of reproductive justice: In order for any of us to have a taste of reproductive justice, it must be available to all of us. We must honor trans people as we are, while we are here, in every expression of our gender identity and reproduction. Honoring our resilience is resistance and remembrance.

To mark TDOR, Maine Family Planning nurse practitioners (NPs) Meredith Hunt and Sara Hayes—who manage the Open Door Program in Waterville and Lewiston, respectively—offered these reflections on the transgender health services they offer and their impact in Maine communities.

Meredith Hunt:

I really enjoy providing transhealth services.  It feels good to have such a direct impact on improving people’s lives. I love when I can see the happiness in someone’s face when I say “Yeah, I can help you with that.”  I also love that my patients in the Open Door Program really like coming in.  Many of them have told me that it is the only medical appointment to which they look forward.  I think what we are doing is so important and I see the impact in the community first hand. It is not just young people coming to see us. I have several patients who are over 50 and are so happy to finally have a place to go where they are accepted as who they truly are.

I will be attending the Transgender Day of Remembrance (TDOR) services in Waterville this year.  I have attended the ceremonies in Portland in the past.  When they read all the names of the transgender people who have lost their lives in the past year, I can’t help but get emotional.  It is just so wrong and heartbreaking.  I hope that by providing the services we offer, that we in some way are making the lives of transgender people in Maine better.

Sara Hayes:

I am very proud of our trans program at MFP.  We currently have roughly 100 trans patients who Meredith and I are helping through this process and I absolutely love my trans practice.

Working with trans folk to get their inner and outer selves in balance is incredibly rewarding.  Going through puberty as a teenager is especially rough for trans people and together we go through it again, but this time getting the hormones right. I love hearing about and seeing the physical changes my trans patients go through and their excitement is catching, for sure.

I’m also pretty excited that we are expanding the number of MFP NPs doing trans care. We have patients coming to us all over the state.  Meredith and I can do visits via telehealth at any of our sites but I think it is important that we expand our on-site trans care options as well. Julie in Belfast has been getting up to speed and thanks to a MeHAF grant, we are getting Priscilla from Bangor and Christina from Fort Kent trained as well.  My dream is that before too long, trans care is going to be available at all sites with any of our NPs.

Trans folk, especially trans women, have been the targets of violence and derision for forever.  I have been doing trans care for almost 5 years and I hear from my patients that they are getting more support from their families and friends than trans folk have in the past. But for many, safety and support are not a given. The Transgender Day of Remembrance is not only a tribute to those who have tragically lost their lives because of other people’s hate and intolerance, but it is a reminder to all of us that we can’t be complacent about safety because unfortunately trans people are still and will continue to be targeted. Especially since the current administration in Washington is just adding fuel to sparks of intolerance and ignorance that will ignite into violence, not only against LGBT people. but also against minorities, women, and low-income people.

Reflections on Listening to Feminist Leaders

Here is a dispatch from intern Casey Rogers. Casey is a senior at the University of Maine, studying social work, and is spending this academic year as a field practicum student with Maine Family Planning.

Earlier this fall, I had the fortune of attending the Maine Women’s Summit on Economic Security. When I first read about the summit, I was excited for the opportunity to hear two amazing women speak on their experiences in leading major social justice movements in the U.S. The first of these powerful women is Alicia Garza, a co-founder of the Black Lives Matter Movement. During her talk, Garza reflected on her experiences that led to Black Lives Matter, and I was moved by her strength, eloquence, and wisdom. It’s important to note that Black Lives Matter is a movement that was started by three Women of Color, and one that fights for all Black people, including women, queer and transgender people, poor people and immigrants. The second speaker is the amazing Loretta Ross, a professor at Hampshire College and co-founder of the SisterSong Women of Color Reproductive Justice Collective. Reproductive Justice is a movement also founded by Women of Color, and one that merges reproductive rights and social justice within a human rights framework.

Loretta Ross

Loretta Ross, a co-founder and former national coordinator for SisterSong Women of Color Reproductive Justice Collective, in Augusta last month.

Both leaders centered feminism and intersectionality, and what these concepts mean to them, in their discussions. Garza commented on our need to redefine feminism to better address intersectionality, as feminism is not about just one issue. Looking through an intersectional lens means recognizing that we all have many aspects to our identity:  our race, sexuality, gender, and socioeconomic class. It also means analyzing how these aspects intertwine, and how we may experience power and privilege in some ways, while experiencing powerlessness in others. A lot of what Garza said about intersectional feminism strongly resonated with me. I believe, both as a future social worker and as an individual, that you cannot look at one aspect of a person’s identity and expect to understand the bigger picture. When Garza described intersectional feminism as “transformative” and the “feminism that could free us all,” I was very much on board. Loretta Ross brought another perspective to the table. Ross prefers the term “justice feminism,” adding that “intersectionality is a process, human rights are the goal.” Ross calling herself a justice feminist reflects her feminist goals, while practicing intersectional feminist analysis better describes the process.

Garza and Ross are two powerful women in the fight for racial and reproductive justice. However, while they share some common goals, the process or paths they take may differ due to many factors, including being from two different generations, growing up in different areas, and, of course, being two different people with unique experiences. I felt that Ross touched on this well when she said, “If I only worked with people whose minds worked just like mine, I’d have a movement of one.” As a social work student, I’ve had discussions with my classmates on our tendencies to assume the people around us think exactly as we do. In reality, while we may have common goals surrounding justice and social growth, we may also see different paths to these ideas. A strong point to take away from Ross’s discussion is not to debate what “type” of feminism or advocacy is the best, as the energy spent doing so only takes away from the goal, whether your goal is getting certain policy passed, or changing the dialogue around a social issue. As Ross put it, “calling each other out on not being ‘woke’ enough is not helpful.” She discussed our need to change the dynamic from “calling out” to “calling in.”

It’s easy to write someone off because they are not on the same page, or they said something wrong, or because they come from very different experiences. However, when we’re put in a situation where we can “call in,” we may be surprised by the change we are able to make. This fall, as part of my internship, I participated in outreach work with the Mainers for Healthcare Campaign. When I started, my supervisor and MFP’s Community Organizer, Cait Vaughan, went through a canvassing training with me. Cait explained that while many interactions will be positive, that might not always be the case. She then gave me a piece of advice that really stuck with me, which is that people may say things that feel like they’re coming from a place of anger, when they may actually be coming from a place of fear, or having misinformation. It’s easy to react to anger with anger, but if we are able to stop and ask questions instead, we are also then able to meet the person where they are in how they are honestly feeling. Weeks and several canvassing shifts later, I have had a few of these interactions with folks where someone made a cringe-worthy comment, and while it was difficult not to feel upset, I did my best to engage with them and ask questions.

With all of this said, I feel it is also important to note that we are not always able, nor are we ever obligated, to “call in.” While I agree with the notion of leaning in and asking questions when we are able, call-in culture should not come at the expense of sacrificing one’s values. We should always leave room to allow ourselves to draw a line and exit a conversation if someone really is coming from a place of anger, hate, or aggression.

Being able to attend the Maine Women’s Summit on Economic Security and experience Alicia Garza and Loretta Ross’ talks was an amazing and inspiring opportunity. Seeing so many strong women from Maine, the country, and the world was a wonderful experience to take away from my field placement with Maine Family Planning. It gives me hope for my community and excitement to go out and work with some of these amazing people in my career.

Waiting for the Title X Shoe to Drop

NFPRHA graphic on Guttmacher

Graphic via National Family Planning & Reproductive Health Association on Twitter.

Any day now, we expect the Trump administration to issue its Title X Funding Opportunity Announcement (FOA)—and to be honest, we’re a little nervous.

After all, the Department of Health and Human Services (HHS) political appointee overseeing the Title X program, Deputy Assistant Secretary for Population Affairs Teresa Manning, has publicly opposed the use of federal funds for family planning and stated that contraception is ineffective. The former anti-abortion lobbyist also opposes emergency contraception. What’s more, a memo leaked last month suggested that advisers to the Trump administration are seeking to slash Title X funding by half—and/or to promote the “fertility awareness” method of birth control in place of other, more effective forms of contraception.

The National Family Planning & Reproductive Health Association, of which we are a member, sees the likelihood of an attack on Title X as “High;” the Guttmacher Institute said in October: “Never in its history has the nation’s family planning safety net been in such jeopardy as it is today.”

You can see why we’re not exactly optimistic.

There are a few ways HHS could go after family planning providers through Title X:

  • By cutting or eliminating Title X funding altogether;
  • By altering the parameters of the grant to include so-called “crisis pregnancy centers” (which use tactics of misinformation and deception to prevent women from accessing abortion care) as eligible entities or “tiering” providers (giving preference to public health departments or primary care providers in order to shut out non-profit organizations like MFP);
  • By putting onerous conditions on Title X recipients—and their patients—such as requiring parental notification and consent for teens seeking contraceptive care, a policy repeatedly rejected by the Maine Legislature;
  • By instituting what’s known as the Domestic Gag Rule, which would bar Title X-funded health care providers from talking about abortion as one of three choices available to pregnant patients who come to us for comprehensive options counseling.

Under any of the above scenarios, the Maine Family Planning network of providers (18 MFP clinics, plus four Planned Parenthood sites, 20 Federally-Qualified Health Centers, and five school-based health centers) would be hamstrung in its ability to provide a full range of contraceptive and reproductive health care services to low-income, uninsured, and underinsured women, men, and teens around the state.

We are staying vigilant as the right wing’s latest attack on women’s health care looms. Stay tuned.

We’re Still Fighting

#ImStillFighting

I’m Still Fighting image via Physicians for Reproductive Health

Today, we celebrate Maine’s historic vote to expand Medicaid (MaineCare). The margin of victory (59 to 41 percent, as of this writing) and geographic distribution of votes (supportive communities stretched from towns bordering Canada all the way to southern Maine) clearly demonstrate that Mainers believe access to health care shouldn’t depend on where you live or how much money you earn. Tuesday’s vote means more low-income folks will benefit from a full range of critical health care services, including family planning and reproductive care, and thus brings us closer to realizing our overlapping goals of reproductive and economic justice.

But we’re still fighting. 

First, we must ensure that our elected officials act on the will of the people. Already, Gov. Paul LePage (R) is snubbing Maine voters, declaring Wednesday that his administration will block the expansion until the program “has been fully funded by the Legislature at the levels [the Department of Health and Human Services] has calculated.”

That’s not right—or legal.

According to Talking Points Memo:

Mainers for Health Care, the organization behind the campaign to expand Medicaid, said despite LePage’s bluster, he can’t stop the expansion train without violating state law.

“Under the state constitution, 45 days after the legislature reconvenes, Medicaid expansion will become the law of the state,” the group’s spokesman David Farmer told TPM. “According to the statute, the Department of Health and Human Services has 90 days after that to submit an implementation plan to the federal government, and the implementation itself will take place in mid-August of 2018.”

As Maine Family Planning community organizer Cait Vaughan reminded supporters in an email today, “we’ll need all of you to show up and make sure state legislators follow through on Medicaid expansion.”

Meanwhile, we must remember that until women can use their Medicaid coverage for all the medical services they need—including abortion—this victory remains incomplete. And so we’ll continue our battle to overturn the state’s ban on Medicaid coverage for abortions.

We’re fighting because the right to an abortion is meaningless if low-income or rural women can’t access one.

It’s appropriate that we participated today in the #ImStillFighting “tweetstorm” organized by Physicians for Reproductive Heath, marking one year since Election Day 2016—a year that has seen a wholesale assault on reproductive rights, the family planning safety net, and women’s health care.

See why other, like-minded organizations are Still Fighting, below:


Yes on Question 2 is a Vote for Women’s Health

Maine Family Planning is part of a statewide coalition working to pass Medicaid expansion on November 7th. Here, our community organizer Cait Vaughan shares a little more about why Yes on 2 is a vote for Maine women.

As the community organizer for Maine Family Planning, I’ve spent the last couple of months talking about little else but Medicaid expansion and the opportunity to vote YES on statewide ballot Question 2 on November 7th. Along with our incredible UMaine Orono intern and MFP volunteers, I have been making phone calls, speaking at events, engaging patients in the clinic waiting room, and (most importantly) knocking on doors to encourage Mainers to vote in favor of expanding this critical program. Back in May, I wrote about Medicaid as a feminist issue and how this joint federal and state-funded program is a crucial aspect of the family planning safety net. With Election Day rapidly approaching, I wanted to focus in a bit more on why we at MFP view expanding Medicaid—known as MaineCare in our state—as a vote in favor of women’s health and autonomy.

MFP serves roughly 21,000 patients each year across our 18 clinics that span 12 of the state’s 16 counties.  Roughly a quarter of our patients receive Medicaid right now, which makes sense, considering that women receiving Medicaid are more likely than those on private insurance to receive gynecological care at a family planning clinic or Federally Qualified Health Center (FQHC) instead of a private physician’s office. Women receiving Medicaid are also significantly more likely than those with private insurance or uninsured women to speak with their providers about important issues like contraceptives, sexual history, HIV, and domestic violence. Another 38% of patients who visit our clinics utilize the sliding scale payment option, largely due to a lack of access to health insurance.  This means that many women rely on us as their sole health care provider, and they are some of the folks who will be most positively impacted by expansion. While our clinicians provide excellent and compassionate care, patients need access to the full range of health care services in order to lead lives of dignity, opportunity, and self-determination. Those qualities truly encapsulate our greater mission as a health care provider and advocate in the feminist tradition of improving women’s lives.

One of our greatest contributions as a provider might be the advances we’ve made—via telehealth services—to improve access to sexual and reproductive health care in Maine’s rural and low-income communities. Voting Yes on 2 would allow us to go even farther. Half of the state’s current MaineCare recipients live in rural areas, and MaineCare provides coverage for many telehealth services (not currently inclusive of abortion care). Expanding Medicaid could complement the steps we’ve already taken to ensure that crucial health care services are available to our patients in rural towns like Fort Kent, Machias, and Rumford. MaineCare expansion can assist patients in overcoming economic barriers to health care that are compounded by geography and a sorely lacking public transportation infrastructure.

As a Title X provider, it’s also important to note that Medicaid has become the most significant public funding source for family planning services in the past decade. Medicaid’s funding for family planning outpaces even federal Title X, which is consistently targeted for cuts and has not been able to keep up with the rising costs of delivering care. We experience firsthand the many ways that access to a quality public health insurance program like Medicaid supports improvements in women’s health, the benefits of which have a ripple effect on our entire statewide community. We hope you’ll join us in voting Yes on 2 on Tuesday, November 7th and take an important step in making women’s health in Maine the way it should be.

If you’d like to volunteer a few hours of your time to support Yes on 2, you can join a special canvass of Friends of Repro Rights jointly led by Maine Family Planning & Planned Parenthood this coming Monday, October 30th in Augusta. Find full details & register here.

Sources/For More Information:

New Abortion Data: A Clarion Call to Family Planning Advocates

On Thursday, the Guttmacher Institute released a new analysis published in the American Journal of Public Health, giving insight into US abortion trends.

The data is fascinating and Maine Family Planning views it as a clarion call to continue and expand the work we’re doing in our clinics, in court, and in our communities.

The report from Guttmacher shows an overall decline in the US abortion rate between 2008-2014. Despite the 25 percent decline, abortion is still a common procedure in this country; one in four American women will have an abortion by age 45. Deep disparities remain among different demographic groups, with abortion increasingly concentrated among poor women and a long history of racism and discrimination contributing to differences in the abortion rate according to race and ethnicity.

These findings underscore the important work Maine Family Planning is doing to increase contraceptive use and abortion access around the state, as well as how much is at stake amid political attacks on reproductive health care nationwide. We see a declining abortion rate as a victory only if it is rooted in advances in comprehensive, affordable reproductive health care and the political and social conditions to support reproductive self-determination for everyone. Unfortunately, at least some of the recent decline can be attributed to politically-motivated & medically unnecessary state-level abortion restrictions that prevent women in many states from accessing care when they need it. Additionally, it’s clear that quality health care services remain financially out of reach for some Americans, rendering them unable to effectively plan pregnancies. As the hostile Trump administration continues its assault on health care, we fear these factors will only become more pronounced.

Our focus remains on empowering women to avoid unintended pregnancies via highly effective contraceptive methods, to be able to access abortion when they need to, and to make decisions based on their own visions of the families they want. Maine Family Planning is battling on many fronts to achieve full access to reproductive freedom: From offering comprehensive prevention programming in schools and long-acting reversible contraception (LARC) in our clinics; to providing innovative abortion care via telemedicine; to fighting in court to expand Medicaid coverage for abortions and overturn Maine’s burdensome law prohibiting nurse practitioners from providing abortion; to working with like-minded groups on the upcoming Yes on 2 vote to make Maine the first state to expand Medicaid by referendum. Guttmacher’s latest statistics prove that our work remains vital and necessary.

What Contraceptive Method is Best for Me? Part 3 – LARCs

So far in this blog series, we have focused on the two most common forms of birth control options used by teens; condoms and the birth control pill. For this post, we will be discussing LARCs. Of course, there are plenty of other birth control options, such as the Depo-Provera™ shot, the hormonal patch and NuvaRing®. These are also great options, but are much less popular than the condom, pill, and LARCs.

LARC is an acronym for long-acting reversible contraceptives. This means you get these types of birth control inserted into your body and basically don’t have to think about it again for anywhere between 3 and 12 years. Two great examples of long-acting reversible contraceptive options are the implant and the intrauterine device (IUD).

As with any birth control method, there are horror stories that scare teens away from taking the plunge and getting a LARC.  LARCs do seem like kind of a big deal, because you actually have to go to your doctor and have them inserted, but they are very safe and very effective. I, personally, have had both the implant and the IUD, and I can assure you, the insertion for each is not scary in the slightest bit.

For starters, let’s focus on the implant. The implant (Nexplanon®) is a little plastic bar that is inserted under the skin of your arm (around your bicep area) by your doctor. It contains the hormone progestin that works in two ways to prevent pregnancy; this hormone thickens your cervical mucus to keep sperm from reaching an egg, and it also works to prevent your ovaries from releasing an egg in the first place.

The implant can be a great option for teens because once it’s inserted, you never have to worry about it again for up to 4 years! Of course, using a condom as well is important because the implant does not prevent the contraction of STIs. Once the implant is inserted, it is nearly undetectable. You may have a tiny dot scar at the place of insertion, but besides that, nobody would ever know there was an implant in your arm. This is great for teens who don’t want people to know they are on a form of birth control!

The insertion process for the implant is simple! It is almost just like getting a shot. The implant is placed on the inside of your upper arm, and it is inserted through a needle. Before getting mine, my doctor went over the process and showed me the device used to insert the implant. It was nearly pain-free. The worse part of the process was getting a shot in my arm that numbed the area before the insertion! A lot of teens worry about birth control methods like the implant because it requires a doctor’s visit and a “procedure.” However, it is very simple, safe, and pain-free.

The implant can be expensive, but it is covered by most insurance plans! If you are not insured or do not want the implant to go through your parent’s insurance, check with your local Family Planning to see what options they might have for free or low-cost implants! The arm implant is over 99% effective, and it’s a great option for teens because there really isn’t any responsibility to maintaining that effectiveness like there is with the daily oral contraceptive.

The implant can cause some irregular bleeding or spotting for 3-6 months after insertion, but otherwise is very safe and free of any serious side effects. If you want more information about the implant, be sure to contact your local family planning clinic http://www.mainefamilyplanning.org/ or check out Bedsider for all the pros and cons of Nexplanon® here: https://www.bedsider.org/methods/implant#side_effects

The IUD is a bit different than the implant because it is a T-Shaped piece of plastic that is placed in your uterus. All IUDs work similarly by making your uterus too hostile an environment for pregnancy. There are hormonal IUDs that also use hormones to stop conception, and non-hormonal IUDs that prevent pregnancy without the use of hormones. The non-hormonal option is great for people who cannot have hormonal birth control!

There are four types of hormonal IUDs—Mirena®, Skyla®, Liletta®, and Kyleena™.  These hormonal IUDs are effective from anywhere between 3 and 6 years depending on which type is best for you. They vary in size as well, assuring that there is an IUD to fit every woman, regardless if they’ve had children or not.

There is only one type of non-hormonal IUD and it is Paragard®. Paragard® is made of plastic and copper and works for up to 12 years!

An IUD is a great birth control option for teens, because, like the implant, once it is inserted it will protect from an unwanted pregnancy until it is removed. Just like with the implant, it is important to continue to use condoms even after you have an IUD inserted. IUDs are excellent at preventing pregnancy, but they do not prevent STIs.

This can be a scary option for teens, because having an IUD inserted requires a doctor’s visit. You can get an IUD inserted at any point in your cycle, but it is best to do while you are on your period because that is the point during your menstrual cycle that your cervix is the most soft and open. Call your doctor or your local family planning clinic to find out if the IUD is a good option for you!

Like I stated above, I have had both an implant and an IUD. I, too, was terrified to take the plunge and get an IUD because I was worried that it might hurt! So, I want to tell you in detail how the whole insertion process works so you can know what to expect if you think an IUD is a good option for you.

Before getting an IUD, my doctor suggested taking Tylenol about an hour before my appointment. This is good because often there is some cramping after insertion, so the Tylenol makes that cramping a bit more bearable. Personally, I’ve always had pretty painful periods, so that’s the type of painful cramping I was expecting, and that’s just what it turned out to feel like. At the office, you’re asked to take your pants off and sit on the table with a sheet over yourself just like you would for a pap smear. Easy enough!

At my appointment, my doctor came in and explained in detail every little thing about the Mirena® IUD, and told me exactly how the insertion would be done. First, they would go in (using tools just like with a pap smear) and look at my cervix. The worse part of the whole process is a little pinch when they grab onto your cervix to steady it so they can get to your uterus. Honestly, the pinch was uncomfortable, but it wasn’t necessarily painful.

Once they’ve grabbed a hold of your cervix, the hard part is over! They first use a tool to measure your uterus (to make sure it’s the correct size for whatever IUD you have chosen,) and then they insert the IUD. Once it is inserted, they trim the little string attached to the device and you’re done! That little string will curl around your cervix in time. The string is there as a way to check that the IUD is still in the cervix where it belongs, and it comes in handy in 3-6 years when you’ll need to have your IUD removed.

If, after having an IUD inserted, your partner can feel it during sex, call your doctor. The string can be cut shorter if need be so that it can’t be felt during sex. Often if the string is cut too short in the first place, it can’t curl around the cervix and can poke your partner during sex.

You’ll usually have a follow up appointment in a month or so just to check that everything is all set. Often, this is a good time for the doctor to trim the string if your partner is feeling it during sex. After this checkup, your doctor will just check on that little string at your yearly exam.

After insertion of my IUD, I was a bit crampy for the rest of that day, but after that everything felt completely normal and suddenly I didn’t have to worry about taking a birth control pill at the same time every day anymore!

The costs for IUDs vary, but they are covered by most insurances. If you do not have insurance, contact your local family planning clinic to see if you can get an IUD for free or at a reduced cost.

IUDs are over 99% effective, and are the longest lasting form of birth control. This is also a great option because there are both hormonal and non-hormonal options. The Mirena® IUD is a good option for women who have heavy and painful periods, and it often stops women from having their period! As with any type of birth control, IUDs can cause some irregular bleeding in the first few months while your body adjusts, but this is normal. Lots of women stop having a period after the first few months of having an IUD.

If you have any questions, contact your local family planning clinic http://www.mainefamilyplanning.org/directories/24/clinic-locations or check out Bedsider for more detailed information about the pros and cons of IUDs here: https://www.bedsider.org/methods/iud#side_effects

Chynna is attending the University of Maine pursuing graduate work in the field of human development with a focus in human sexuality. She is originally from Maine and enjoys spending her free time taking her dog for walks on campus.