Piece by: Manny Anyango

06 October 2022

• The device is inserted in a woman's uterus in a procedure that takes less than five minutes.

• Copper IUD is over 99 per cent effective within the first year and once correctly implanted, it starts working immediately

Tales of birth control methods 'backfiring' leading to whoops pregnancies have been told time and again but one city lawyer never imagined it could happen to her.

Pamela - not her real name - opted for the Copper IUD (intrauterine device) as her contraceptive of choice.

After a visit to her gynecologists and several tests later, the 30-year old was all set for the nonhormonal birth control method.

The T-shaped device contains a stem wrapped with copper wire and two copper sleeves.

The device is inserted in a woman's uterus in a procedure that takes less than five minutes.

It prevents pregnancy by stopping sperm from meeting an egg. The copper sleeves release copper ions which make the environment of the uterus less hospital to sperm.

When the sperm nears the uterus, the copper ions make it to change direction and swim away from the uterus.

Copper IUD is over 99 per cent effective within the first year and once correctly implanted, it starts working immediately and it can prevent pregnancy for up to 10 years.

But this was not the case with Pamela. She got pregnant after four years of use.

"When I got the IUD, things were going on perfectly until I learnt that I was pregnant, with my now eight-year-old daughter. I panicked and went to the hospital," Pamela said.

"We went to the hospital and the doctor removed the IUD, the baby had moved the device on the side and the doctor approved its removal," she added.

Less than one per cent of women globally get pregnant while on the IUD.

Mark Otieno, a gynecologist, said a woman should go through a uterus measurement test before having an insertion of the IUD.

He said slight variation in the measurement may result in the IUD falling out of place leading to pregnancy.

"The uterus has to be of a certain length for one to have an IUD, as there are cases of it falling off. Some women have shorter uterus, while others have elongated ones."

Otieno said the length between the uterus and the vagina should be between 2.5 cm and 3.5 cm, but there are other women who measure 2 cm.

"I have experienced cases of IUD falling off, meaning the patient didn't go through the uterus measurement test, and their uterus measures 2.5 cm and below," he said.

Pamela said after the pregnancy experience, she sought for another form of contraception as she had lost trust in the IUD.

"That was my turning point. I couldn't continue with the IUD. I now opted for Mirena Coil which I have had for the past eight years," she said.

Unlike the Copper IUD, the Mirena coil is hormonal. It prevents pregnancy by thickening the mucus in the cervix which stops the sperm from fertilising the egg.

It also thins the lining of the uterus thus suppressing menstrual bleeding.

Mirena coil is a bit expensive compared to Copper IUD.

It goes for Sh21,000 as compared to Copper IUD whose price ranges from between Sh3,500 to Sh7,000 depending on the issuing facility.

"The only downside of the Mirena coil is the cost. Insurance doesn't cover that part and I think it is high time they took it up, this way women won't have to dig into their pockets," Pamela said.

When on Mirena Coil, one is required to go for check-up once a year for the doctor to examine whether the coil has moved or is still in its right position.

"Right now, I can't complain, the coil is working effectively, no side effects, such as weight gain, mood swings, I am happy," Pamela said.

Njeri, on the other hand has been using the Copper IUD for four years now. She says this has been her best contraceptive yet.

"The Copper IUD has really served my partner and I, for the last four years, we haven't had a pregnancy scare," she said.

In an interview with the Star, Njeri said that she first went for the Depo-Provera popularly known as Depo shot.

The Depo shot is an injection women get every three months to prevent them from getting pregnant.

"When I went for the shot, the first two months were good, except for the third and last month when I started spotting. I thought was pregnant, it worried me and I had to see a doctor," she said.

The 31-year-old teacher said that when she visited a clinic, she first went through several tests including pregnancy test.

"One thing about changing contraceptives is the gynecologists can't give you another before confirming one is not pregnant. That's one thing I appreciate the most."

Njeri said she parted with Sh3,500 for the procedure.

While on the IUD, Njeri said she goes for check up after every six months as advised by her doctor.

"After my first six month check up, I now go early until five years elapses."

She was keen on the side effects that came with the certain contraceptives.

"One thing for sure, I don't like gaining weight, and there are people who go through weight gains with the IUD. As I was going for that, that was my biggest worry, I'm grateful I have remained the same," Njeri said.

The only side effect she has been experiencing is heavy cramping and irregular periods which she said became stable after a while.

"The first three months of having the IUD changed my cycle, my periods became irregular, but I understood since I was warned prior to.

"As time went by, they became stable and I'm now happy," Njeri said.