British ColumbiaFor some, IUD insertion is no problem. For others, it’s extremely painful. One patient recalls crying out loudly during the procedure from the level of pain it causedCourtney Dickson · CBC News · Posted: Nov 20, 2025 8:00 AM EST | Last Updated: 2 hours agoListen to this articleEstimated 4 minutesThe audio version of this article is generated by text-to-speech, a technology based on artificial intelligence.AccessBC is calling on the provincial government to improve pain control for IUD insertions. (AccessBC)When Sarah Anthony, a farmer and bookkeeper in Metchosin, B.C., had an IUD inserted, the pain was unbearable. “I was crying out so loudly from the pain that the doctor told me to be quiet or I would scare the other patients,” she said. “I just remember the feeling, like my cervix is not meant to be shoved open like that.”IUDs, or intrauterine devices, are small T-shaped devices inserted into the uterus by a medical professional to prevent pregnancy. There are hormonal IUDs and copper IUDs, both of which change the way sperm cells move so they can’t reach an egg, according to Planned Parenthood. IUDs have become more popular in B.C. after the province made some contraceptives free, according to AccessBC, the group that campaigned for free birth control. When IUDs are inserted, health-care providers first put a speculum into the patient’s vagina, which widens the vaginal walls, and then a tenaculum — a scissor-like type of forceps — is used to stabilize the cervix. Then, they use a special inserter to put the IUD in through the opening of the cervix and up into the uterus. For some, IUD insertion is no problem. For others, like Anthony, it’s extremely painful. A tenaculum is one of the tools used during IUD insertion, which can cause pain for some patients. (AccessBC)A paper from AccessBC researchers Sana Sunderji, Anahita Seraji and Victoria Greene found there are three main sources of pain during IUD insertion: tenaculum placement, which pinches the cervix; cervical manipulation, as the cervix has to stretch to allow the IUD to pass through; and uterine contractions caused by prostaglandins released during the insertion.But there are other things that cause pain too, the paper points out, including speculum insertion and if the patient is anxious. That’s why AccessBC has launched a new campaign, called Not Just a Pinch, calling for better pain management for people having IUDs inserted. “The goal of AccessBC is to ensure universal accessibility of contraception as well as reproductive and sexual justice,” Sunderji told CBC’s The Early Edition. WATCH | Sunderji explains why better pain management is needed:“One of the things that we have to work on, because it does pose a barrier for many individuals accessing contraception, is pain.”The group says some specialized clinics offer enhanced pain management for IUD insertion, but most British Columbians getting IUDs are simply told to take pain medicine like Advil or Naproxen. Sunderji said the lack of pain management for IUD patients comes down to long-standing misogyny in the medical world. “Women are expected to tolerate pain, especially when it surrounds gynecological procedures,” she said. “The reality is, this is a procedure that occurs in sensitive tissue. And just like any other procedure, pain relief must be offered. That’s the bottom line.”The campaign is calling for the province to create guidelines around pain management for IUD insertions, MSP billing mechanisms for pain control, mandatory training requirements for practitioners and equitable access to pain management across regions. In an emailed statement to CBC News, the Ministry of Health responded to the campaign saying that access to reproductive care is a priority for the province. It said it made changes to the Medical Services Commission payment schedule in 2023 increasing compensation for IUD insertions, including a new $25 fee for cervical block — a local anaesthetic — for pain management. ABOUT THE AUTHORCourtney Dickson is an award-winning journalist with CBC News based in Vancouver, B.C.With files from The Early Edition
Advocates calling for improved pain management for IUD insertions in B.C.
