If you can stomach the thought of having a stranger shove a one-inch long object through your vagina, past your cervix, to reside in your uterus for three to 12 years, you’re in luck. Not only do Intrauterine Devices (IUDs) have no negative impact on your fertility after removal, they may actually improve your chances of conception relative to former birth control pill users. Instead of shelling out every month for pills or shots or rings or whatever doohickey is on the market next, you are covered for years of your life. Cha-ching $/¥! No setting daily alarms reminding you to pop a pill or panicking when you forgot to bring them with you on vacation. IUDs are readily available in Shanghai too, but as with pretty much everything here, there is a layer of complexity you may have to contend with. I dealt with it first hand.

*Public service announcement: IUD's won’t protect your bits from STDs. Be safe. Get tested.

Getting an IUD

I got my first IUD 5 years ago in Canada. It had a five-year lifespan.

Knowing I was moving to China while living in London last year, I begged my doctor to replace it one year early. She refused.

Thanks to a seriously vague insurance policy document, I incorrectly assumed my IUD replacement at an international hospital would be paid for by my insurance. I checked out my options out of curiosity, receiving quotes of about 10,000rmb. I work at a non-profit and make less than that in a month. Not happening.



So I decided to go local. But I shouldn’t have worried. For obvious reasons, China is a hub of IUD usage. Over 40% of women in China use IUDs to prevent pregnancy, and there is a wide selection available. Unlike Canada, where your doctor might insert a few IUDs per week, in China, a gyno could be inserting dozens in one day.

Adventures in Local Hospital Hopping

A friend of a friend suggested the 455 PLA Hospital. I went armed with a working knowledge of Chinese, a list of gynecological vocab words provided by my Chinese teacher, and Google Translate on my smartphone.

Anyone who has been to a local hospital knows the usual process: Register, then talk to a doctor, pay, get tests/meds, rinse and repeat as needed. Add taking numbers and sitting in uncomfortable seating surrounded by thousands of sick people and it makes for an unpleasant field trip. In spite of these annoyances we were treated like royalty at 455 PLA. I was ushered to the front of the line for the many tests I was put through and the "gyno" whom I was dealing with patiently typed out everything she wanted to say on Google Translate.

All downhill from there...

It was explained to me that I basically had cancer and that it needed to be operated on immediately. After translate-explaining that she could replace my IUD after removing the unsightly, dangerous lumps on my cervix, my husband and I decided to call his coworker to have her describe to me as clearly as possible what was going to happen, because, obviously, I was supposed to go under the knife right then and there.

After speaking with this doctor, the colleague got on the phone with me. "Get out of there now. Run. Call me when you’re out." I felt like I was in some kind of sexual health action movie, if such a genre even existed. I awkwardly asked for my test results (including an unflattering side by side shot of my lumpy-looking cervix and a “normal” cervix—which I am convinced was just a picture of a peeled grape—and reassured the doctor that we would call her.

Over the phone, my husband’s colleague lectured me about some hospitals having less-than-lofty motives. She lambasted me for listening to my non-Shanghainese friend for clinic recommendations. On the Metro ride home, I searched "cervical cysts" and the hospital on my smartphone.



I learned a valuable lesson: Do a little research on your hospital ahead of time to make sure it isn't seriously fucked up. I quickly learned that not long ago a guy died at this hospital after receiving medically unsound "stem cell treatments".

Also, cervical cysts are usually not something you need to worry about. Dr. Lady Parts Butcher was going to do a cosmetic procedure on my cervix. Let's take a few moments to ponder the ridiculousness of that previous sentence:

Cosmetic surgery. On an internal organ.

Fuck me...

We later met up with my husband's colleague, who brought me to a different local hospital in Pudong. Her friend was working in the gynecology department and got me in to show a sane doctor my tests. The doc looked at the images, laughed, and said I was totally fine but couldn’t get an IUD until I had just finished my period. This was reassuring, because that was also what I was told in Canada.

Fast-forward a couple of months until I could finally get some time off to go to a hospital. The same colleague had another friend working as a lab tech in Xinhua Hospital’s gynecology department. This time around I wasn’t taking chances, so I hired my Chinese teacher to translate for me for the day.

What Happened to My Body

A lot of women are afraid to get IUDs. Unfortunately, one of the first on the market was responsible for side effects including death in the 1970’s. IUDs nowadays are much safer and side effects such as expulsion, perforation of the uterus, and ectopic pregnancy are quite rare. In fact, IUDs are the most popular form of reversible contraception in the world.

All IUDs are not created equal, however. I chose Mirena because it’s widely recognized as the most effective at preventing pregnancy. Skyla, another popular hormonal IUD, and copper IUDs have similar effectiveness (99.1-99.4% effective vs. Mirena at 99.8%). Of course, these matters are best discussed with your doctor. He or she will know which option suits you best.

A few blood tests and a physical are really all you need before you’re in business.

The insertion process and removal experience differ a lot from woman to woman. In my case, it hurt a lot. For some reason, cervical penetration and a foreign object entering or exiting my uterus is a hell like no other. But still worth doing twice for 10 years of baby-free sexing!

At Xinhua Hospital, IUD insertions are done on Monday, Wednesday, and Friday at 1pm (at the time of writing). At 1, about 20 women were ushered into a reception room where we changed in front of each other into gowns and rubber sandals. We then were brought to an adjoining room with 4 hospital beds. My heart started to beat quickly as I realized that I would need to lie, legs spread, in front of all of these women while a doctor made the IUD swap.



Of course, they didn’t actually do the procedure in the group room. Even the Chinese have their privacy standards. I was called into an operating theater that was concealed by a curtain. I hopped up onto the operating table, stuck my legs in the stirrups, and within three minutes, the doctor had yanked out Mirena the First, violently inserted Mirena the Second, and then dangled her predecessor in front of my face. FYI, it’s no longer white after five years.

I yelped when he pulled it out. I felt so guilty when I left that operating room and walked past the women waiting their turns. I smiled and pretended I wasn’t sore, but they heard…

Conclusion

I would absolutely return to Xinhua Hospital for an IUD again. It was marginally cheaper than in Canada, 1800rmb versus the equivalent of 2300rmb. The painkillers sucked and I didn’t get any cervix dilating pills like I did back home. But the doctor was clearly familiar with the procedure, and experience is really what you want when someone is tampering with the goods, no?

Pain seems to be the leading reason why most women I know don’t want to get an IUD and rely on less effective methods of birth control like pills or condoms. Seriously, if pushing a fishing hook-like device into your junk hurts that badly, getting something the size of a watermelon out of there probably isn’t worth propagating the species. Both times I had an IUD inserted, my mantra was: "This must hurt less than pushing out a baby."

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[Editor's Note]: We at SmartShanghai are not medical professionals. Like any medical procedure, getting an IUD and all of its ramifications is a matter best discussed with your personal physician.

Below are some links to reputable hospitals offering gynecological care. Nevertheless, we strongly advise you to do your own research to find which healthcare provider is right for you:

OB/GYN Hospital of Fudan University
American-Sino OB/GYN Service
Shanghai First Maternity and Infant Hospital
International Peace Maternity and Child Health Hospital