Ainsley DS- My Story.

Ainsley Duyvestyn-Smith. Image by David Dunham Photography.

TW: This story discusses details of an IUD insertion and medical trauma.

Throughout history, women have been conditioned to please. To not complain. To not be a bother, cause drama or cause a scene. We are supposed to grin and bear the pain. Don’t draw too much attention to yourself. Get on with it, be strong, or be a warrior. Somehow, surviving incredibly painful medical procedures without pain relief is seen as virtuous and not barbaric.  

Suck it up buttercup.  

There I was legs spread, sweating, crying, swearing, screaming, shaking, gripping the table so hard my fingernails started to hurt, at one point I thought was sure I was going to throw up in my mask. I had visions of suffocating on my own vomit, and as I did, I started to pray for it, because at least it would be better than this. “Stop... Stop! Take it out! I can’t do this anymore”. It was the nurses second attempt at getting the Mirena IUD inside my cervix. A process that felt like a red-hot poker being shoved deep in a place where nothing should ever go. I felt her take the rod out, but something was still gripping my insides, pinching and pulling on me in unbearable pain. She eventually released the tenaculum attached to my cervix, and then the speculum. I closed my legs.

I couldn’t stop shaking and crying. Tears were screaming down my face. My partner looked at me with worry deep in his eyes. I could tell he didn’t know what to do. And to be honest neither did I.  

I had taken 7mg of prescribed morphine and received four anaesthetic injections into my cervix (which I of course was told would not hurt. Spoiler- It did) – and nothing was working. I felt every single movement, scrape and touch, but apparently, this was not enough to dissuade the nurse from going ahead with the procedure anyway.

“It’s going to hurt anyway” she shrugged at me before the procedure when I said I couldn’t feel the morphine working.  

After a few minutes, she asked, “do you want me to try again?”  

“I don’t know, I need a break” I replied meekly.  

She said, “okay how about I just do some swabs while you’re there. Is that okay?”  

“Yes” I nodded and winced as she put the speculum back in. The swabs I could handle, I knew that.  

Then, before I knew what was happening, she was reaching for a new Mirena, apparently, we were trying again.  

Ironically, the only reason I was getting the bloody thing was to help with my debilitating period pain and endometriosis (getting that diagnosed is a whole different story). Mirena’s were supposed to be a godsend for people who suffered bad periods, and as a bonus, they double as an extremely effective form of contraception.  

I felt the clamp go back on and my stomach dropped, the horrific, blood curdling pain began again as she started to try and insert the rod again.  

It would not go in.  

I don’t know how long she attempted it for. I don’t know how long I was lying there crawling out of my skin, screaming in a pain I had never felt before. Eventually she said, “Hmm it won’t seem to go in. I have a smaller version which does is almost the same as a Mirena it just lasts for 3 years instead of five. Would you like me to try that one?”  

“Yes - Fuck - Anything but this” I panted through my tears.  

She ripped open a new box and I felt the pain of the process begin again, this time, the pain however seemed to have reach a crescendo, and suddenly, the instruments were out. She held up the bloody insertion tools with pride, showing the comparison between to two different sized sticky red covered rods that had just been shoved through my cervix.  

Amazingly, this was not my first and traumatic experience in getting an IUD.  

Seven years before, I had had a copper IUD put in as a form of birth control before I went travelling. The insertion was reasonably quick, but the most intense, shocking pain I had ever experienced. The pain was so shocking that I passed out immediately after standing up. I had to sit in the waiting room for an hour before I could drive myself home. Then it took several days of heavy painkillers and bed rest for me to recover. A year later, I had to get it removed because it was making my periods worse.  

So, it’s fair to say that I was extremely nervous and terrified about the thought of going through the process again. But I thought this time, I was going to do it right. And the Mirena with its slow release of low dose hormones hopefully would solve my ongoing period problems that wipe me out for a couple of days every month. To be honest, it was my last hope.  

I went through my GP who referred me to a gynaecologist for a consultation appointment. 

During this first consultation, I carefully and calmy communicated all my fears, expectations and requirements for undergoing such a daunting procedure again. I clearly communicated that I could not go through it with that level of pain again and that I was going to require some strong pain relief. 

“It might not be that bad again.” The doctor had replied “It depends on a lot of things… Like the person who inserted it, what your cervix was like that day, where you were in your cycle, the type of IUD. You might just breeze through it. If you want, we even have an appointment free this afternoon… Shall I book you in?” 

Admittedly, this should have been my first red flag.  

Did he not just hear me say it was incredibly, traumatic and painful and I was very anxious about it? And he wanted me to just spread my legs and pop it in this afternoon? Was he listening to me at all? 

“Um no, that’s definitely not going to happen.” I replied. “I need time to mentally prepare for this, and as I said... I’m absolutely not going to do it without adequate pain relief this time.”  

“Okay” he replied, “If you like I can give you a prescription for some morphine. Just take it a few minutes before you go in for your appointment. It usually kicks in quickly.” 

I walked out of there feeling somewhat proud of myself for standing my ground. I actually, felt grateful that he was kind enough to give me morphine… as though 7 milligrams of pain relief for an invasive medical procedure were somehow an act of kindness and not him actually doing his job.  

I genuinely thought this time would be better. That maybe that last nurse was just inexperienced, or that the pain relief would make a huge difference, and I wouldn’t feel a thing. Maybe my cervix was slightly wider now. Maybe this time I would be one of the lucky ones.  

I was not. 

At the insertion two weeks later, when the smaller IUD finally went in, and my body had stopped convulsing, the blood eventually returned to my face and I could finally stand on my jellied, shaking legs, my partner called me a warrior. He said that I was strong and brave. I could only smile meekly in return. The truth was, I didn’t feel like a warrior. I didn’t feel strong or brave or like I had conquered anything. I felt like a weak, empty vessel of hurt, but apart from the obvious physical issues, I couldn’t quite put my finger on why. 

Once I was home and resting, I felt woozy all afternoon. It could have been the only effect I had from the ineffective morphine, or it could have been my mind piecing together the trauma and my adrenaline calming down. Either way, I felt overwhelmingly awful, and I lay there tossing and turning all night, trying to get the images and pain out of my head. Until eventually at some ungodly hour of the night with a hot water bottle on my stomach in an attempt to ease the cramping, it hit me.  

I didn’t feel strong because I was weak. I was weak because I didn’t stand up for myself and insist that she had stopped sooner, I felt weak that I had not stood my ground and insisted on sedation from the get-go. I felt weak that I had trusted the medical system, knowing all too well that it was not catered to women’s comfort, or physical or mental wellbeing.  

I felt weak. And I felt violated.  

I even apologised for screaming as we were leaving the room.  

What the hell was wrong with me?  

The next day I looked up the amount of morphine I had been prescribed. Knowing nothing about drugs or doses, I wanted to know why this supposedly good pain killer had had no effect. Quite quickly that feeling of weakness turned into stone cold rage. The amount of morphine I had been prescribed was so little, it was effectively a placebo. It was less than the amount suggested to give to a child in severe pain. Certainly not enough for an invasive and previously stated highly painful procedure.

I was furious.  

A week later, I ended up in hospital after calling an ambulance for pelvic pain that was through the roof, I was also bleeding heavier than I ever had before. It felt like that IUD was trying to crawl its way out of my uterus, turns out, that was pretty much what was happening. Apart from the insertion, it was the most intense and long-lasting pain I had ever experienced. My uterus was attempting to give birth to a foreign, metal object with no pain relief, and none of the naturally occurring hormones that you would get in childbirth. I spent what felt like hours screaming into a pillow in the emergency department begging to be sedated. We found out then that I have an adverse reaction to morphine. It actually made my pain worse. It wasn’t until I was prescribed a heavy morphine alternative that the contractions stopped. It took hours, and it didn’t seem like there was an easy solution. I asked if I could have it taken out under sedation but I was told that that wouldn’t be possible. Instead I was given an ultimatum, you can have it taken out now without meds or we will send you home with it in. Obviously going home risking a repeat of this process was not an option, so I again went against every instinct in my body and though sobs of tears and crying “no” had to put my legs in stirrups under bright hospital lights and have strangers fondle my genitals.  

I broke down into a pool of inconsolable, weeping, bloody mess.  

Since the procedure and its removal I have suffered PTSD, severe anxiety, flashbacks, nightmares and a non-existent libido. For weeks I couldn’t go anywhere near my own vagina, let alone bear the thought of trusting anyone else near it again. It became an ‘it’- a separate entity that I had to dissociate from my body in order to carry on living. It no longer belonged to me, it became a burden, a place of trauma, pain and suffering that was controlled, manipulated and used by other people. I wanted to seal myself up and never have to deal with it again.  

I was even resentful of my partner, that he had been there to watch me suffer. But he was not to know. How could he? He was not a medical professional. He did not have a vagina, uterus or cervix. He was being supportive of my decision. He trusted the medical professionals. We both did.  

And of course, the mental health care options available for people who have suffered trauma are almost non-existent. Nowhere could I find a practitioner who was available to help. I scoured the internet for counsellors, contacted ACC, spent hours emailing and ringing to be told nobody was available.  

It has now been almost four years since my procedure; it has taken me almost four years to have the strength to write about this. I was lucky in the end to get a counselling appointment. I am still in counselling. And the tricky part of it is that I can’t just put it behind me and move on. I still need to go for smears, I still need help for my painful periods, and I can’t even begin to think about childbirth and all the possible things that can go wrong with that.  

Ever since, any gynaecology appointment has felt like walking into a firing squad.  

And my story is unfortunately not unique. All over social media, there are stories and stories of women suffering horrific IUD insertions, LEEP procedures and biopsies. I shared a status on twitter, and I was flooded with replies from people wanting to share their own experiences.  

One of the main issues with IUD insertion is the variation of pain scale that people feel when getting an IUD inserted. Despite old misogynistic claims that the cervix has no nerve endings therefore cannot feel pain, the sensitivity in the area varies widely, and the size and angle of the of the cervix greatly affects the ease in which the IUD is inserted. For women like me who are unlucky enough to have both a narrow, curved cervix, and a highly sensitive one, there are no real options offered for pain relief as the procedure is largely modelled on the idea that people receiving the treatment have little to no pain. The current recommendation is to take a couple of paracetamols or ibuprofen before the procedure (even though in recent studies been proven to be completely useless).  

Some people do absolutely fine with that. Some barely feel it.  

However, this largely ignores a huge population of people with cervixes who find any manipulation agonising and have found IUD insertion incredibly painful. Some have been fortunate enough to been given general anaesthetic for the procedure, however the only ones I know of in New Zealand either had to fight with doctors for months to get it or go privately and pay through the teeth.  

On top of this, there is very-little-to-no care or advocacy for survivors of sexual assault in the gynaecology world. It’s hard enough having to spread your legs in a clinical environment to allow people to perform invasive procedures on you without the past trauma of assault. The numbers of women, non-binary, and trans people who have been sexually assaulted are enormous, so why is more care not being given to those who might find these processes invasive and terrifying? 

Finally, now we are starting to be given more options for self- smear tests, a move that will undoubtedly save the lives of many women whose fear has prevented them from getting tested. But what next? What happens to survivors having to deal with their mental trauma on top of a stressful and painful physical procedure? What happens when those smears come back abnormal, and people are expected to go through colposcopies, LEEP’s (LLETZ), and biopsies without any pain relief?  

Why are we leaving this to chance? A surgeon wouldn’t start operating just “hoping” that their patient was anaesthetised enough that they don’t feel anything. A dentist doesn’t even remove a tooth without making sure that your whole face is numb. So, what the hell are we doing to people with uteruses?? 

Many of us already live with pain every month for most of our lives. We literally give birth to tiny humans in an excess of agony. Isn’t that enough? Have we not done enough to deserve adequate pain relief for invasive medical procedures?  

As we watch the rights of body autonomy crumble in countries like the United States, it’s time for us to lead by example and begin to take gynaecology health seriously.  

This change can only come about from us putting pressure on our government and healthcare system to do better. Because of this I am launching a petition to change the way IUD and other invasive gynaecological procedures are done in Aotearoa NZ.  

The issues surrounding gynaecological health care are complex, serious, and potentially life-threatening. It’s time for something to change.  

We deserve better. 

Ainsley x

PS. I am also working on a photography project documenting the stories of women and AFAB people who have had traumatic or extremely painful procedures. The project aims to give a face to the many stories of the people who have been affected by medical misogyny. You can support it here.