Inner Adjustments was read as part of Miss Spoken’s May 2016 show, Birth Control. You can find Christina at the 40:56 mark.
The decision to get an IUD was almost spur-of-the moment. I wasn’t thinking about it when I went to see my gynecologist for my annual checkup: I was thinking about birth control pills. I’d been taking the pill on and off for about 10 years, which started making me nervous when I hit 30.
I’d become inconsistent about taking them, and paranoid about getting blood clots. There’s a history of heart trouble in my family, plus I’m quick to leap to conclusions about the state of my health whenever I read about the potential side effects of this drug, or stumble across symptoms of some exotic disease online or on TV. Shows like House and Grey’s Anatomy give me anxiety.
I voiced these concerns to my gynecologist, and she responded by telling me to stop being ridiculous. She reminded me my blood pressure was low, I didn’t smoke, and I wasn’t overweight. I probably wouldn’t get a blood clot anytime soon. Then the interrogation began:
“Are you planning to get married?” she asked.
“Well, I don’t think…but, I mean we love each other and have a dog and we’ve been in this relationship for, like, over six years…”
“Six years!” she exclaimed.
“Yeah.”
“Monogamous?”
“Yep,” I said, wondering where she was going with this.
“Both of you? No other partners?”
“Yep.”
“Are you going to have kids?” she asked.
I squirmed and the paper under me crinkled.
“Uh, probably not.”
“Have you thought about an IUD?” she asked.
I shrugged, not wanting to admit I had no idea how an IUD worked.
She gestured to a chart behind her, which listed birth control methods in order of their chances of someone getting pregnant. I’d been on the pill so long, I’d forgotten all the other options: the diaphragm, spermicide, the Depo-Provera shot. Each had their own list of risks and possible side effects.
At the top of the list, with a rate of less than one in 100 pregnancies, was the IUD.
One in 100. That alone was enough to convince me that the IUD was for me. I learned from the pamphlets I took home that the IUD is a T-shaped object with two thin wires coming out the end, like a tail. The top bar of the “T” presses against the uterine lining. The pamphlet stated that it’s not known exactly how this prevents pregnancy, but surmised it’s some combination of thinning the lining of the uterus, thickening cervical mucus, inhibiting sperm movement, and reducing sperm survival.
I wasn’t totally comfortable with the idea of an object being wedged inside my soft nooks and crannies for up to five years, but I decided to go with it. For some reason, I’m less irrationally afraid of a foreign object wedged into my uterus breaking apart or puncturing something than I am of popping pills and getting blood clots.
Or going without anything and risking pregnancy.
It took me a while to admit to myself that I didn’t want kids. When I told my friends in my early 20s, I usually got a “you might change your mind” sort of response. I admitted that was possible. Sometimes, when I saw kids running around the park or a pudgy toddler trying to walk, I thought they were cute and fun—not always frightening, loud, sticky, pooping beasts who demanded all your attention and money. It made me think: What if my friends were right—what if I really did want to have kids some day?
I didn’t. As I got older and my long-term relationship continued, I didn’t start to yearn for a child the same way some of my friends did. I never saw being a mother as part of my identity; my boyfriend never saw being a father as part of his.
After my younger sister had her baby, my uncle asked me when I was going to have kids.
I shook my head and forced a casual tone. “Oh, I’m not going to have kids,” I said.
“Oh really?” He asked. My parents had always been supportive of my decision, and any disagreement or disappointment they felt they kept to themselves. I doubted my religious, conservative uncle would be so respectful.
“Yeah. It’s not something I really see for myself,” I said.
“What? You don’t want a little baby like your sister?” He chuckled as he said it, like he was responding to a joke.
“Nope,” I said. “I don’t.” I didn’t think I should have to convince him of anything, and I didn’t even know how I could. Why couldn’t a simple “it’s not for me” be enough?
After that first gynecologist appointment, my boyfriend and I talked about other forms of birth control. Condoms were cheap and non-invasive, but not as reliable. He offered to get a vasectomy, but I waved away the idea of surgery. A permanent alteration to the body seemed extreme when I had other options. IUDs are fully reversible, and can be plucked out more easily than they can be inserted.
The procedure lasted maybe 10, maybe 15 minutes. There was no incision, no cutting, no stitching, just an uncomfortable and weird and awkward placing of that little plastic intrauterine device.
Imagine a car getting jacked up. Crank, crank, crank, and hold as the mechanic shimmies underneath and starts meddling around with all her cold, metal instruments. She sticks her hand into the bowels of the car and pokes around, making it seem like she’s relying on feel and experience more than sight to make adjustments.
“Cough,” she says. “Cough really hard, on the count of three.”
I coughed really hard and shot the speculum clear out of me. The second time it stayed in, its chilly, steel jaws stretching my insides, and I felt it, an acute scraping, like a sewing needle raked across tissue paper.
I felt vulnerable, cracked open.
This procedure wasn’t optional for me. Birth control and pregnancy worries had been voices in the back of my head for over a decade. Though an IUD gave me statistical comfort, I could never stop worrying that someday I would have to make an impossible decision if birth control ever failed.
There was no way my boyfriend and I could find a balance. Having been together for a while, we were good at splitting things equally: he washed the dishes after dinner while I took the dog out for a walk; we alternated who did laundry. But he couldn’t take my place in five years and get a new Mirena. Should he get that vasectomy instead?
I could think of no other place more precarious than this, having an IUD placed inside of me. I was afraid if I sneezed, I’d rip something. And it was caused by an object only 1.26 inches tall, shorter than an Andes mint, manipulating my body into doing something it didn’t want to do. Still, when all was done, I went to work with a mild, crampy soreness that was gone by the next day. Plus, the medicinal iced latte I treated myself to helped.
Later that night, I told my boyfriend how achy I felt. I knew from his quirked eyebrows he had no idea what I was talking about.
“Because of you know…” I said, gesturing toward my lower abdomen.
“Oh! I knew you had it done, but it didn’t occur to me you’d, like, hurt so much,” he said.
I quirked my eyebrows back at him, wondering how he’d think such a procedure wouldn’t hurt, even just a little. Though maybe I shouldn’t have been too surprised: his nooks and crannies were of a different kind than mine, and they probably wouldn’t ever need to be cracked open with a cold metal instrument. He didn’t have to fret about pregnancy in the same why I did. Women need to be pried open again and again to ensure everything is running properly, and fight through our own neuroses and endure adjustments, however small, however reversible, just to prevent unwanted changes.
Christina’s story was part of Miss Spoken’s March 2016 show – the theme was Birth Control. Listen here.