Opinion Today: Why many doctors are in denial about IUD pain

It's not because they're heartless automatons.

View in browser|nytimes.com September 14, 2024 By and large, I don't hear my patients asking for pain-free IUD insertions. I hear them asking for their voices to be heard and believed. Xinyue Chen By Christine Henneberg Dr. Henneberg is a doctor and writer. When I was a medical student about 12 years ago, I inserted about a dozen IUDs, and by graduation I felt ready to get my own. At the student health center, I brushed off the nurse practitioner's offer to inject lidocaine around my cervix to reduce pain. "I'll be fine," I said, stepping out of my underwear and lifting my feet into the stirrups. When she slipped the IUD through my cervix, the pain tore through me like a knife. I yelped and reared back on the table, almost kicking her in the face. Even before graduation, I had committed what we now know is a widespread error: Doctors and other health care providers (although not the kind nurse practitioner who cared for me that day) tend to underestimate the pain of IUD insertion. In news reports and on social media, patients are insisting that their provider didn't prepare them for how excruciating the procedure can be. This is part of a larger cultural conversation in our country about women's pain and how it is often undertreated, dismissed or downright ignored by doctors. In my Times Opinion essay this week, I argue that this isn't a problem of doctors being heartless automatons, but of succumbing to the grueling pace of modern medical practice, which doesn't allow us time to have honest, personalized discussions with patients about pain and how best to treat it. Such discussions are known as "informed consent," and they are crucial, especially before gynecologic procedures. When a doctor fails to prepare a woman for IUD insertion pain, rushes through the procedure and dismisses or ignores her pain afterward, it is a deep violation of the trust that is supposed to be the bedrock of the doctor-patient relationship. The consequences of this betrayal are particularly damaging for patients who may already have good reason to distrust the health care system: American medicine bears a long history of reproductive coercion and forced sterilization of Black, Indigenous and incarcerated women — a history of which our patients are often well aware. When doctors make false assurances to patients, when we minimize or neglect their pain, we sow the seeds of distrust and reproductive injustice with our own hands. READ THE FULL ESSAY HERE Guest Essay I'm a Doctor. The Conversations About IUD Insertions Are Long Overdue. Doctors underestimate the pain of IUD insertion. By Christine Henneberg THE WEEK IN BIG IDEAS Sam Whitney/The New York Times Guest Essay Elizabeth Warren: Don't Be Fooled. Donald Trump Has a Plan. It's to kick millions of Americans off their health insurance. By Elizabeth Warren Eleanor Davis Jessica Grose Parenting Has Always Been Hard Accepting that is the first step toward making it more tolerable. By Jessica Grose Win McNamee/Getty Images Guest Essay Harris Can Win on the Economy, but She Needs a Stronger Message Optimistic words and some admirable proposals aren't enough to overcome the discontent and anger that a large majority of Americans feel about the economy. By Jedediah Britton-Purdy The Opinions Charging Parents Won't Stop Mass Shootings Focusing on parental responsibility allows the state to shift blame from weapons laws to families. 8 MIN LISTEN We hope you've enjoyed this newsletter, which is made possible through subscriber support. Subscribe to The New York Times. Games Here are today's Mini Crossword, Wordle and Spelling Bee. If you're in the mood to play more, find all our games here. Forward this newsletter to friends to share ideas and perspectives that will help inform their lives. They can sign up here. Do you have feedback? Email us at opiniontoday@nytimes.com. If you have questions about your Times account, delivery problems or other issues, visit our Help Page or contact The Times. Need help? Review our newsletter help page or contact us for assistance. You received this email because you signed up for the Opinion Today newsletter from The New York Times. To stop receiving Opinion Today, unsubscribe. To opt out of other promotional emails from The Times, including those regarding The Athletic, manage your email settings. To opt out of updates and offers sent from The Athletic, submit a request. Subscribe to The TimesGet The New York Times app Connect with us on: Change Your EmailPrivacy PolicyContact UsCalifornia Notices The New York Times Company. 620 Eighth Avenue New York, NY 10018