How to get an IUD in New Brunswick and for how much

Dr. Karen Desrosiers's office has the number ready.

People call the private clinic where she works in Moncton looking to get an intrauterine device (IUD) inserted or removed.

She can offer it, but so does the Family Planning Clinic at the Moncton hospital — both faster and minus a consultation fee. All that's needed is a Medicare card and the device.

"They don't need to have a referral, which is something I don't think people know, because I see people coming in my office to see me and a lot of the time they're not aware of that clinic," said Desrosiers, who's been part-owner of the ReConnect Health Centre & Physiotherapy for a couple of years.

An IUD is a t-shaped device that goes inside the uterus.

Desrosiers said it's a good form of birth control for people who want something that's both effective and long-lasting — there's no need to take a pill every day, and the device itself lasts around three to four years.

IUDs, which Canadian pediatricians said in 2018 are the most effective birth control method for sexually active teens, can also help with heavy bleeding and severe period pain.

When people call looking for an insertion or removal, Desrosiers often gives them the number of the Moncton centre, where she also works. She said staff can sometimes do 12 in an afternoon. People can usually get in between four and six weeks.

There's another clinic in Moncton at the Dr. Georges-L.-Dumont University Hospital Centre where a patient doesn't need a referral for an IUD insertion or removal, but the wait can be six months.

A Vitalité Health Network spokesperson said the long wait is due to a lack of nursing staff to assist general practitioners during the procedure. The spokesperson encouraged patients to talk with their family doctor to see if they can get it done at a private office instead of the hospital.

As of March, there are 54,000 active registrations on Patient Connect N.B., the province's registry for patients without a primary care provider, with approximately 80 per cent with no provider access.

Though for Desrosiers, if someone did want to have an IUD insertion or removal at ReConnect, she said she likely wouldn't be able to see them until September due to demand.

People are coming from all over the region for services at ReConnect. It's not  just for IUD insertion and removal, but a range of gynecological issues.

She said about 40 per cent of her patients, if not more, come from Fredericton, and she also sees more patients from Saint John than Moncton.

Around 60 per cent of her patients, many of whom moved to New Brunswick within the last year, don't have a family doctor — that's one of the reasons they come to see her, she said.

If a patient doesn't have a family doctor and wants to get an IUD insertion or removal at other clinics in the province, they can get a referral from 811 or eVisitNB. They can also self refer to their local sexual health centre.

Desrosiers said she doesn't like to charge for something like an IUD insertion or removal, especially since a Medicare card will cover the service at a clinic.

"I feel bad when I say, 'OK, you have to pay an extra $40 for me to insert the IUD.' So as much as I can, I send them to the family planning clinic."

The device: 'The cheaper place is Costco'

While Medicare covers the insertion or removal, it doesn't cover the cost of the device.

There are three devices on the market, according to Desrosiers — one with the hormone progesterone, one with copper, and one with copper and silver.

Most health and drug insurance plans cover the device with progesterone; since it's a device that has a hormone on it, it's considered a form of medication.

Desrosiers said the cost of the progesterone device varies, but the cheapest place to buy one is Costco. The Mirena device, one of the older progesterone devices, runs about $360 to $380 there, she said, but can go up to around $420 at a pharmacy.

The copper devices go for around $70 to $140, Desrosiers said. Since they don't have progesterone, they're not considered medication and aren't covered by insurance, though Desrosiers said she thinks they should be.

"If you want to decrease the amount of unwanted pregnancy and abortion and all of that, I mean, you should make sure that people can have options for contraception that can be covered," she said.

The procedure

Desrosiers acknowledged the procedure can be painful, but she said pain management is available.

She said the clinic prefers to insert IUDs into teenagers who are already sexually active since it makes the procedure easier, but it's not necessary, and there is a smaller device available.

Teenagers, she said, usually come in for the procedure anxious and afraid because of stories they've read online.

"I'll be honest with you, like more than 85 per cent, they will be like, 'Oh, it's not that bad,'" Desrosiers said. "It's not as bad as it looks on the internet."

A nurse is available to stay with the patient throughout the procedure, and there's a room to rest in afterwards. Patients can also book followup appointments for three months later to make sure there aren't any issues.

If a patient really can't tolerate the pain, freezing is available, and on certain days, staff can also offer the same sedation they offer patients who receive an abortion at the clinic.

In that case, though, the patient will need someone to take them home afterwards, since they'll be unable to drive.

"It's an option, but to be honest, most of the time, [patients] do super well. And we have some tricks after that to help them with the pain," Desrosiers said.

She added that Canada approved a new form of birth control during the pandemic called Nexplanon, which is available at the Moncton family planning clinic.

The device, a single rod that's inserted into the fat of the arm, lasts for three years and is less invasive.

"For people who have fear of having an IUD and they're afraid of the pain or they're not sexually active, that's another option that is even a tiny bit better than the IUD," Desrosiers said.