Written by Anne Marie Ward
“Beautiful uterus!” The ultrasound tech trilled, eyebrows raised high. The monitor showed that it is triangular, with no scarring, no sign of the occasional variance of rabbit ears or heart shape.
A heart-shaped uterus sounds lovely, poetic, like a biological valentine with hormone-laced trim tucked inside a corporeal mailbox. Rabbit ears sound cute, bunny-esque, a sweet little animal curled up and tucked in a soft pink den pulsing with gentle sleep–but these anomalies are not compatible with IUD insertion, the ultrasound tech explained. My inverted triangle-shaped womb works for IUDs.
That was one of the concerns: Maybe my uterus wasn’t a good fit for Paraguard. After I came back for my 6-week post-insertion checkup, they found it halfway out of my cervix. I had to schedule reinsertion with an ultrasound guide; they had to make sure I was anatomically compatible with the device. That’s why the ultrasound tech was commenting.
“Oh dear,” the OBGYN, Dr. X, peered past the speculum, “Yep… I see it coming through the cervix.” Forceps suddenly in hand, she pulled the IUD the rest of the way out. “You’ll have to come back for an ultrasound insertion… and we’ll have to do a pregnancy test. Right now. Um, we need to make sure you’re not pregnant. Right now.” Her voice had the stilted flatness of stifled alarm. “Wait here, the nurse will be back for a urine sample.”
“You really didn’t feel anything?” The very pregnant nurse asked incredulously with a thick Eastern-European accent.
I shook my head as she handed me the urine cup and escorted me to the bathroom. My limbs were sparkling with anxiety, little insect bites all over the surface of my skin, and my heart was beating in my hands and ears, tears welling in my eyes.
“Oh, bad luck! Normally when an IUD expels you feel bad cramping. Don’t worry, it probably just happened! It will be okay. It will be okay…”
Urine collected, I sat rattling my leg in the chair. I called my boyfriend, a tear running down my cheek, “Hey, what’s up, gorgeous?” We might have a big problem. Phone pressed to one cheek, I collapsed my head into my other hand, falling inward. “It will be okay; we’ll work through it. I’m here for you.” He was doing his best to be supportive and reassuring, but I still felt alone. Alone with my body which suddenly reminded me it was ultimately out of my control. I was bitter that he would never feel this particular alienation from himself, even though I know that these realities are not what we choose. He didn’t have procedures and medicine and follow-ups to keep his life on track, in this way. I was so frustrated and resentful. I bit my lip and squeezed my eyes shut as hard as possible, thinking of the last six weeks and all the years to come.
The first IUD insertion was unexpected. I went for my annual checkup and pap smear, but also to get my hormonal implant removed from my arm. It expired this year. It was a dystopian little device, a tiny rod the width of a lollipop stick, that they inserted under the skin of my arm close to my armpit. It would continuously release hormones to prevent pregnancy. It was convenient: set-it-and-forget-it for three years. However, it had seriously messed with my periods–making them super long, close together, but also sometimes short and sporadic—very irregular. My hormonal acne on my jawline also got worse. Huge, swollen, painful cysts popped up on my chin, pulsing like they had their own cardiovascular system. It wasn’t the best for me, but I liked the convenience and efficacy of it. I also knew a handful of other women who got it inserted and had no side effects.
“Since you’re getting the Nexplanon implant removed today, did you have in mind what you wanted to do for birth control now?” Dr. X tried to distract me while she cut the device out of my arm. I explained that I wanted to do the copper IUD. I wanted something that was long-term and didn’t require maintenance, and since the hormonal implant had given me annoying and inconvenient side effects, I thought I would do the non-hormonal IUD, as it also lasted the longest. I assumed that I would have to come back for insertion. However, they were ready to do it immediately.
They prepped me for insertion following my checkup and pap smear. “Don’t tell your boyfriend about the IUD strings,” the nurse advised, “while you should periodically check in the shower to make sure they are still there and haven’t seemed to move, if you tell your boyfriend about them, he might get paranoid and think that he can feel them. It’s better to avoid the trouble.”
Dr. X said aloud everything she was doing as she was doing it: “I’m using the speculum to open up your cervix. I’m using this swab to clean and sanitize the area. You’re going to feel some cramping as the device goes in; that’s normal. Please relax your muscles and wiggle your toes. Breathe.”
The pain radiated through my pelvis and down my thighs, sizzling like something electric. Sweat gathered on my forehead, my butt, the backs of my said sizzling thighs. All my muscles clenched, despite me trying to relax them. I found that I was holding my breath; I needed to breathe. The pressure in my abdomen made me afraid I was going to lose control of my bowels on the exam table, as the cramping in my lower stomach made me think of a large laxative dose hitting me suddenly and urgently and excruciatingly.
“Are you okay?” Dr. X studied my face, my color, my eyes, worried I was on the verge of passing out. I nodded, happy that my mother would be driving me home, though. Yes.
She nodded. “You’ll need to come back in six weeks for a follow-up. In the meantime, You might feel some bad cramping for the next few days. Take a Tylenol and maybe use a heating pad. Okay? Schedule the follow-up with reception, and I will see you in six weeks! You did really great today!”
All the turmoil for nothing, the scariest ten minutes of my personal past five years, but I wasn’t pregnant. The Eastern-European nurse burst into the room suddenly, as I rocked nervously in my chair, to tell me the news. “Not pregnant!” I let out a huge breath of relief. Oh, thank goodness. I walked to the front desk receptionist feeling buoyant but fragile, a bubble landing on an extended fingertip. Voice shaky, I told the receptionist, Dr. X wants me to have an ultrasound-guided IUD insertion ASAP, with whatever doctor is available next available. I got an appointment with Dr. Y for the beginning of the following week. My bladder did not have to be full for this ultrasound, the receptionist informed me, sounding far away, fading.
Can I get one of those snapshots of my beautiful triangular uterus? Like people get of their fetuses? As if fetuses don’t look like found-footage of cryptids roaming the isolated southern Appalachians, or intelligent but hostile extraterrestrial life leaked to online forums. I didn’t think this with animosity, just a little humor, because human bodies are just so, so weird.
The tech laughed at my silly request, but I was only half kidding. I would love a grainy pic of my womb to hang on my fridge next to coupons for my beloved herbal teas and last year’s Christmas cards. It’s not a self portrait I would normally get to see; there is something surreal about seeing my own internal cogs, my wiring exposed.
She squirted more jelly on my belly and took a look at my ovaries. The right one is much smaller than the left, making it hard to find–”Just natural variation,” assured the tech as I got dressed later after the whole procedure was over.
But now she said, “I’ll get Dr. Y and the nurse and let her know we are ready for the insertion. It should be much better this time around!”