Wait, How The Heck Did This Woman Get Pregnant With An IUD?

From Women's Health

Sure, there are many reasons a woman ultimately decides to get an intrauterine device (IUD). But the main reason to have your doc lodge this long-acting contraceptive in your uterus is to steer clear of getting pregnant. After all, an IUD is more than 99 percent effective at preventing pregnancy, according to Planned Parenthood.

But there’s still that tiiiiiiny chance you can get pregnant with an IUD, and that's not super comforting when you're counting on that little thing to do its job. Take it from Alabama woman Lucy Hellein, who rocked the people of the Internet’s world when she posted a photo of a baby holding an IUD with the caption, “Mirena fail!” back in 2017. While Hellein told Florida’s First Coast News at the time that the photo was staged, she explained that it was very much real: A nurse actually placed the IUD in her son’s hand after it was found during her C-section.

Still, the idea that a woman got pregnant with an IUD is more than alarming for anyone who relies on this form of birth control. But is it really worth all that worrying? Here’s all you need to know about whether or not you really can pregnant with an IUD.

First, a quick primer on how an IUD works.

An IUD, or intrauterine device, is a small, T-shaped piece of flexible plastic that’s inserted into a woman’s uterus through a quick procedure. The insertion process feels different for everyone. For some women, especially those who’ve already given birth, insertion is a minor annoyance.

For others, however, it can be rather painful, especially if the doctor needs to call in tools like dilators to further open up your cervix in order to get the IUD placed in the proper spot. The good news, though, is that the worst discomfort should be over in a matter of minutes. But you might experience cramping or spotting for three to six months after insertion, according to Planned Parenthood.

There are two types of IUDs-non-hormonal copper and hormonal-both of which have the same basic T-shaped look and small strings at the end that protrude through your cervix into your vagina.

A hormonal IUD, like the Mirena, works to prevent pregnancy by releasing the hormone progestin, which thickens the mucus in the cervix to stop sperm from fertilizing an egg. It also keeps the lining of the uterus thin so it’s not a hospitable environment for fertilization, explains Sherry A. Ross, MD, ob-gyn and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period.

A non-hormonal copper IUD prevents sperm from reaching the egg (meaning it also can't fertilize the egg) by acting as a spermicide, according to the U.S. Department of Health and Human Services (HHS). There are four hormonal IUD options on the market and they last three to five years. But there is only one type of non-hormonal IUD currently available: ParaGuard, which can offer protection for up to 10 years.

So then how did that woman get pregnant with an IUD, you're wondering?

Let's reiterate the fact that the chances of getting pregnant with an IUD are very, very, very slim. According to HHS, fewer than one out of every 100 women with an IUD will get pregnant while they have one.

“If they’re inserted correctly, they are 99.9 percent effective-more effective than a vasectomy,” Dr. Ross explains. And the Center for Disease Control and Prevention (CDC) backs Dr. Ross up, noting that IUDs are one of the most effective forms of birth control, with a failure rate of less than 1 percent for both non-hormonal and hormonal IUDs (0.8 percent and 0.1-0.4 percent, respectively).

But can it happen? Yes. "[Lucy Hellein’s] IUD may not have been inserted correctly or may have displaced itself after being inserted," Dr. Ross says. That’s why Dr. Ross uses an ultrasound to help ensure an IUD is placed in the right location. It’s also why docs recommend coming back in a month after insertion to make sure the IUD is in the right place in your uterus.

You can also check that it’s still in place every month after your period by feeling for the strings and watching out for any irregular bleeding or pelvic pain, which can be a sign it’s been displaced, Dr. Ross says. “Feeling for your strings” can sound like work, but it’s actually not too hard and thus allows IUDs to continue to boast being relatively low maintenance.

How to feel for 'em: Sit or squat and insert a finger into your vagina to feel for the strings. “You need to go up a little high and usually can just feel it with the tip of your finger,” Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies, previously told Women’s Health. Rather than feeling like your tampon strings, IUD strings will “feel like very taut dental floss,” Dr. Greves says.

So, you’ve gone searching for your strings and found them to be very much there? Great! Just please do not pull on them. If the IUD comes out even ever-so-slightly, you may lose protection and your doc might have to remove the IUD all together, according to Planned Parenthood.

Okay, so what happens if you do get pregnant with an IUD?

If you learn you’re pregnant via a home pregnancy test and believe you still have your IUD in place, call your doc stat-for many reasons. First, your provider might be able to remove the IUD to lower the risk of miscarriage or other problems, according to the U.S. National Library of Medicine (NLM).

Getting pregnant with an IUD also puts you at a higher risk of an ectopic pregnancy, which is when a fertilized egg grows outside the uterus (about 90 percent of the time in a fallopian tube), per ACOG. In addition to the usual signs of pregnancy (missed period, tender breasts, upset GI system), at first an ectopic pregnancy might also cause you to have lower back pain, abdominal pain, or pelvic pain and cramping.

As the fetus grows, however, these symptoms can escalate into sudden and severe abdominal or pelvic pain, shoulder pain, weakness, dizziness, or fainting, per ACOG-all of which warrant an immediate doc or ER visit, given that an ectopic pregnancy can be life-threatening.

The bottom line: You really shouldn't let a fear of getting pregnant on an IUD scare you away from using this birth control method. “They’re a very safe, effective, and efficient form of birth control for women, especially those who are sensitive to hormones,” Dr. Ross says.

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