T

he day after School of Information senior Nicole Zeffer 
watched president-elect Donald Trump win the general 
election on Tuesday, Nov. 8, she placed a call to Univer-

sity Health Services to make an appointment for an IUD con-
sultation.

“It’s upsetting to me because it’s a step in the wrong 

direction, when I thought there would be a step in the right 
direction,” Zeffer said.

IUDs, short for Intrauterine Devices, along with implants, 

comprise the long-acting reversible contraceptives (LARC) 
category of contraception methods currently available. 
According to the American Congress of Obstetricians and 
Gynecologists, IUDs and implants are the most effective form 
of reversible birth control on the market — more than 20 times 
more effective than birth control pills, the patch or the ring. 

However, a study published in 2015 by international 

reproductive health journal Contraception found that just 12 
percent of women were using LARC methods of contraception, 
compared to 41 percent of female family planning providers 
and professionals. 

But in the wake of the election, that might be changing. 

Zeffer is just one of many women across the United States to 
take part in a sudden uptick of research and interest in LARC 
contraception resources following the election of Trump. In 
the hours following the election, Google saw a nationwide 
spike in searches related to IUDs (in addition to upticks in 
donations and interest at Planned Parenthood clinics and 
gynecologists).

This sudden interest in IUDs and implants may be 

explained in part by the uncertain future of President Barack 
Obama’s Affordable Care Act, which included coverage for 
contraception, under a Trump presidency.

The ACA, commonly known as Obamacare, requires 

health insurance companies to cover at least one form of 
birth control from each category of contraception, including 
LARC, hormonal and barrier methods. However, during his 
presidential campaign, Trump has alternately threatened to 
either fully repeal or modify Obamacare, taking that coverage 
away and potentially leaving women with the full cost of an 
IUD, which can range from anywhere between $500 and $900 
dollars.

Concerned over whether their health insurance plans will 

cover contraception as soon as Jan. 20, women on campus 
and throughout the country said they are seeking IUDs and 
implants in particular because, once inserted, they last between 
three and ten years — enough time to last at least one term of a 
Trump administration.

***

Susan Ernst, an obstetrician gynecologist and current chief 

of the Women’s Health Clinic at UHS, says there has been a 
clear increase in interest in IUDs on campus.

Immediately following the election, Ernst, who also works 

in the Medical Center’s gynecology department, said she has 
seen — and continues to see — a sharp increase in demand for 
LARC contraception.

“Since the election, we’ve even had patients coming in and 

saying, ‘You know I’ve really been thinking about doing this for 
the last six months to a year, but now I really want to get it done 
because I’m worried about the coverage,’” Ernst said, adding 
that she’d even seen a patient, who already had an implant 
in her arm that would last for another year, request that she 
have it removed and replaced with a new one because she was 
concerned that in the next year, her insurance would no longer 
cover the implant.

Before the election, Zeffer had been using hormonal birth 

control pills, but she considered switching to an IUD after 

experiencing unwanted side effects from them. After the 
possibility that her health insurance plan would no longer 
cover contraception as soon as January 20, Zeffer made up her 
mind and scheduled a consultation.

“With Trump now being the president of the United States, 

there’s the risk that Obamacare will get repealed at some point, 
and then hormonal birth control pills will become unaffordable 
for me and likely a lot of other people in the U.S.,” Zeffer said.

Ernst said she wasn’t quite sure whether the coverage would 

go away, but noted that the concerns were valid. 

“We don’t know what’s going to happen, but it is a little bit 

concerning,” Ernst said.

Ernst did note one positive in the situation — she said 

she was glad to see more students taking interest in LARC 
contraception because the clinic had already been promoting 
and counseling patients who use their sexual health services 
to consider IUDs and implants long before the election. Health 
care providers in the sexual health clinic favor LARC methods of 
contraception, she said, because they are highly recommended 
for adolescents by major medical organizations such as the 
American College of Obstetricians and Gynecologists. 

IUDs and implants are highly effective and require no 

upkeep from women who use them until they need to be 
removed or replaced — a term healthcare professionals have 
coined “fit and forget,” according to Ernst. She added that 
this aspect of IUDs and implants largely accounts for the 
high efficacy of LARC methods in comparison to other forms 
of birth control. The efficacy of the pill decreases as women 
forget to take it on time, whereas an IUD or implant leaves 
room for little to no human error.

Zeffer said for her, the last aspect was the most important. 
“An IUD is really nice because it’s just one of those things 

that you can put in and most likely not have to worry about,” 
Zeffer said.

Because LARC methods of contraception have been 

increasingly promoted for adolescents by major medical 
organizations, Ernst added, UHS has increased its LARC 
insertion training over the past few years so that there are 
currently six different providers within UHS certified to insert 
implants and IUDs.

“We already increased our capacity with the hope that 

people would pick up or accept this method more readily,” 
Ernst said.

She pointed to a report published in 2014 by the National 

College Health Assessment and the American College 
Health Association that found that just 6 percent of 
undergraduates used LARC methods of contraception at the 
time of last intercourse. Now, she says the number is around 
15 percent, simply by the word of mouth about their safety and 
effectiveness.

However, she also noted that campus would not be immune 

from the possible elimination of contraception from many 
health insurance policies that would come with a repeal of the 
ACA.

Currently, women using the Sexual Health Clinic at UHS 

have all services, such as consultation appointments and STI 
labs related to IUD insertion, fully covered by their tuition. 
Students are only responsible for paying for the IUD, which 
can be several hundreds of dollars if not covered by their 
insurance.

“I’m really disappointed and concerned and hope that, 

as a group, women can make their voices heard to the new 
administration that we think this is something important for 
the health of women,” Ernst said.

She added that this election cycle has affected more than just 

women’s sexual well-being, noting she has seen an increase in 

depression scores among women visiting UHS. 

The University’s Counseling and Psychological Services 

has similarly experienced an increase in stress and anxiety 
surrounding the election. 

“We’ve seen a number of patients who have had higher 

depression scores or even refused to fill out the depression 
scoring sheet because they say they’re so upset about the 
election they just can’t even go there,” Ernst said. “They know 
that it would look like they have depression if they filled it out 
because they’re so upset about the election.”

***

LSA senior Shannon Stone got her IUD from UHS last 

year after she decided hormonal oral contraceptives were not 
for her, mostly because of her busy schedule and a fear that 
she wasn’t taking the pills at the right time. She said she’s 
concerned about the current policy climate surrounding ACA, 
especially because her IUD will be removed one year before 
Trump’s term ends.

Since Trump’s election, she said she’s served as a resource 

for many of her friends who are looking into getting an IUD. 
But while she is glad she decided to get an IUD, it angers her 
that many women are making the decision to get an IUD not 
out of choice but out of fear.

“I love my IUD, but I don’t want someone who doesn’t want 

one to get one,” Stone said. “It’s an option and I’m glad that it’s 
the option that I chose, but it makes me sad that other women 
have to choose it out of necessity or out of fear. I think that 
making decisions about our bodies out of fear is a horrifying 
reality.”

Nursing senior Rachel Cannon obtained her IUD two 

months before the election, mainly because of negative side 
effects she was experiencing as a result of hormones in oral 
contraceptives. She said she felt comfortable undergoing 
the insertion procedure at UHS because she was referred 
to a provider by a friend, who told her this specific provider 
inserted roughly four IUDs per day.

As the reality of a Trump presidency became clear to her 

on election night, she felt relieved that her IUD would last for 
the next 10 years — enough time to cover a two-term Trump 
presidency. However, she said she remains concerned for the 
future of family planning and birth control coverage in the 
United States.

“Taking away free contraception is just going to result in a 

lot of unintended pregnancies, in my opinion,” Cannon said. “I 
think that seems like a logical conclusion to draw, and I feel 
like if it was very expensive or not covered through insurance, 
some people just wouldn’t use birth control at all.”

•••

Reflecting on these past few weeks, Zeffer said although 

she is upset by the sense of urgency she feels to protect herself 
following Trump’s election, she is most frustrated by the fact 
that there are others who don’t have the resources to protect 
themselves.

“As much as it upsets me that I have to watch out for my 

own personal health, it upsets me more that there are so many 
other people out there that aren’t as fortunate as me and that 
are being affected more by this election,” she said, citing those 
who currently may not have health insurance and therefore 
can’t afford an IUD. 

As she prepares to take a step many other women nationwide 

are considering as well, she said she is both comforted and 
bothered by her upcoming IUD consultation appointment at 
UHS. 

“I still have the option of going to my doctor and getting a 

free IUD before Trump becomes president.”

Wednesday, December 7, 2016 // The Statement
6B

Getting Covered: Before a new White House, women turn to IUDs for security

by Lara Moehlman, Deputy Statement Editor

