Last year, drugmaker Bayer introduced the first new IUD in 13 years. And this week, the American Academy of Pediatrics (AAP) updated its guidelines to say long-acting reversible contraceptives, including IUDs, should be the first line of defense to prevent teen pregnancies.
It’s been a long road for the IUD. It’s been some 40 years since the Dalkon Shield hit the market. The intrauterine contraceptive device was one of many IUDs at the time, but it is still remembered decades later as a spectacular disaster.
Many women developed pelvic inflammatory disease from the device, which had not been vetted by the FDA. The Shield also had a high failure rate, leading to infections, miscarriages and death.
The Dalkon Shield was pulled off the market, and a federally funded study in 1981 said IUDs were dangerous.
Some two decades later, when Jenna Sauers, then in her late teens, went to her doctor asking for an IUD as an alternative form of contraception to taking pills with hormones, her doctor would not prescribe it. She tried a second doctor, and then a third who, she recalled, told her: “That’s only an option for women who have completed their families.”
“The damage done was the perception that all IUDs are dangerous,” says Dr. Jill Schwartz, medical director at CONRAD, an organization that focuses on reproductive health research.
Sauers, who is now 28, finally succeeded after visiting yet another doctor.
“I do think that everybody should have the choice. I think they can be a great option, especially for people who, for whatever reason, don’t like taking hormonal birth control,” Sauers says.
Sauers is confident that her IUD poses little risk, because in the last few decades more research has shown that it was the faulty design of the Shield, not IUDs themselves, that was dangerous. Still, it has taken some time to undo the damage done by the Dalkon Shield. In the 1990s, new research came out that called into question the 1981 study condemning all IUDs. In 2012, the New England Journal of Medicine published a study saying IUDs are 20 times more effective than birth-control pills, the patch or the vaginal ring.
“In the intervening 40 years, there’s been increasing scrutiny and increasing requirements by the FDA and other organizations,” says Dr. Mary Ott, one of the co-authors of the new AAP guidelines for teenage girls. “All the modern devices have at least a decade of safety and effectiveness data in the United States, and 20 years or more internationally.”
Ott says IUDs are now so safe that teenage girls face more health dangers from complications from pregnancy than they do from the IUDs themselves.
“It’s been not only drug companies, it’s academics, it’s the whole community” that’s been behind the effort to make IUDs more available, says Schwartz.
World health groups and nonprofits have also been a part of that effort, with Planned Parenthood launching a nationwide educational campaign last year.
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