When Sarah Anthony went to get her first intrauterine device (IUD) inserted, she didn’t know birth control could hurt so much.
“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 had no idea it would be like that.”
Anthony’s is one of the testimonies provided from AccessBC as it launches a provincewide campaign calling for improvements to pain management for IUD insertions.
The Vancouver Island farmer is not alone in her experiences. Some Reddit users have described it as “the single most painful thing I’ve ever experienced.” “I felt like my uterus was going to fall out,” said another user; “I passed out for the first time in my life,” said another.
Research shows that an IUD insertion can be a painful procedure for many patients, and providers cannot reliably anticipate which patients will experience severe discomfort and pain, highlighted Jenna Saffin, AccessBC testimonial coordinator.
A study from the journal Contraception, for instance, found “high pain scores”, reinforcing the “need for interventions to reduce pain for adolescent IUD insertion.”
While some specialized clinics offer cervical blocks or enhanced pain management options, most British Columbians typically only receive or are recommended pre-procedural nonsteroidal anti-inflammatory drugs such as Advil or Naproxen.
“Defaulting to little or no pain management, minimizing the pain IUD insertions can cause, is not evidence-based care, it’s a systemic failure,” Saffin said. “Patients deserve options, informed consent, and dignity during all reproductive procedures – and that includes appropriate pain management.”
AccessBC was co-founded by two Greater Victoria residents: Saanich Coun. Teale Phelps Bondaroff and Devon Black, who has worked in the sexual and reproductive health field for over 15 years and recently served as secretary and president of Island Sexual Health Society’s board of directors.
After past success bringing free contraception to B.C., they are calling on the province to take several actions on IUD pain management.
That includes asking B.C. to adapt province-specific clinical guidelines for addressing IUD insertion pain management planning; create MSP billing mechanisms for pain control; work with post-secondary and training institutions to start mandatory training requirements for practitioners; and implement strategies for equitable access to pain management during IUD insertions.
This follows suit to broader global efforts. In summer 2024, the Centers for Disease Control and Prevention recommended that health providers have more upfront conversations about potential pain during the procedure. The American College of Obstetricians and Gynecologists also issued guidelines in May 2025 that echo this approach.
However, AccessBC asserts that much more needs to be done. The organization claims that national guidelines, serving as the primary reference point for B.C. providers, either omit or downplay pain management recommendations.
Sara Sunderji, a researcher and provider liaison with the campaign team, said that patients shouldn’t have to self-advocate to get the pain management they require.
“Pain control should be routine in IUD care, not dependent on location, how busy a clinic is, or insider knowledge,” she said.
“A system that normalizes suffering only continues the long history of misogyny in medicine,” added Anahita Seraji, pain management campaign coordinator.
AccessBC invites British Columbians to join a coordinated letter-writing campaign. Participants will send letters directly to their MLAs calling for provincial guidelines, appropriate billing structures, mandatory training, and equitable access for all communities. More information can be found at https://www.accessbc.org/not-just-a-pinch-campaign.