IUD Migration and Perforation

​As an advocate of women's reproductive agency and choice, I hope sharing this experience will empower other women to advocate for themselves within the healthcare system --

Knowing my family has a history of reproductive longevity and late-in-life pregnancy, three years ago, at age 40 and a mother of three, I decided to get an IUD as a more permanent form of birth control. A few months after having the IUD inserted, I experienced significant cramping and bleeding and decided to have the IUD removed. At my OB appointment, my health care providers (a male physician, and female nurse-midwife) couldn’t find the IUD threads. They explained that they were likely tucked behind my cervix and ultimately assured me that the IUD was still in place. They suggested I come back for a follow-up visit to see if they could locate the IUD threads and remove it. A few weeks later, the cramping subsided and I decided to leave the IUD in, having received no indication that the IUD may have become dislodged.
 
Fast forward to last year, my husband and I found out we were unexpectedly pregnant, news that immediately came with fear as pregnancies with an IUD can be ectopic or otherwise high-risk.  An ultrasound confirmed a healthy pregnancy, but no IUD could be located. It was assumed that the IUD must have fallen out. We were relieved that it was a visibly normal pregnancy but also frustrated that my early symptoms of IUD migration weren’t taken seriously.  We were also very anxious about what it would mean to have a fourth child in our mid-forties.
 
We were lucky to have an uncomplicated pregnancy, and our beautiful and healthy daughter was born this past December. At my 6-week post-partum OB visit, I had an x-ray to confirm that the IUD was no longer in my body and had simply fallen out. To our absolute surprise, the x-ray revealed that the IUD had previously perforated my uterus and migrated to my upper pelvis and would need to be surgically removed.
 
In researching more about IUD migration, my symptoms three years ago (heavy cramping, bleeding, no IUD threads visible), are clear signs of IUD displacement, perforation, and migration. However, at that time, my OB providers shared nothing about this possibility. There was no urgency and no warning, despite the fact that IUD perforation and migration into the abdominal cavity can cause adhesions, bladder damage, serious infection of abdominal organs, and complicated or high-risk pregnancy.      
 
As I prepare for surgery this week, I feel such a mix of emotions.  First, I am grateful that the outcome of all this is our beautiful daughter.  But I am also deeply disappointed that my OB providers didn’t take my symptoms more seriously. The lack of education, care, and concern around IUD complications reinforces the need for more rigor and consistency in women’s health care, something that the health care system overall continues to struggle with.
 
There are also significant health disparities when it comes to outcomes with IUD complications. Not all bodies easily recover from IUD migration. Not all women are able to sustain an unexpected pregnancy - physically, emotionally, or financially. Not all women feel empowered to advocate for themselves within the healthcare system. Not all women’s health providers are aware of critically important and relevant information to share with their patients.
 
I share this because --

I believe strongly in women making informed choices about our own bodies. I also know there continues to be silencing and shaming around women's reproductive lives, which cause women to feel isolated at the very moments when we need the most support and validation.

​My hope is that my vulnerability in sharing this contributes to meaningful conversation and brave sharing, which is the beginning of any kind of systemic change.

Click HERE For more information on IUD migration, complications, and outcomes.

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