Could an IUD be the best emergency contraceptive around?

The use of intra-uterine devices (IUDs) never took off in the USA as contraceptives, the way they did in the rest of the world. But a new study might change that.

Researchers tracked 35 years' worth of data and found that the copper-T is not only an effective long-term birth control tool, but arguably the most effective emergency contraceptive there is.

Top image: IUD paperweight via Lobstar28/Flickr.

Adoption rates of IUDs only just hit around the 5% mark in the USA in 2008. But the rest of the world relies on them much more heavily: 10% in the UK, 24% in France, 43% of contraceptive-using women in China — and thanks to the 10+ years of birth control the implant can provide, it's also a tremendously popular one-off surgery.

What people might not have realized is that the IUD is also an effective emergency contraceptive. A copper IUD can be used up to five days after intercourse, while the morning after pill generally has a window of just 72-120 hours depending on the formulation, and is more effective the sooner you get it.

The big difference for the IUD is the rate of effectiveness. The emergency contraceptive pill generally has a rate of around 80%+, meaning 80% of women who would have gotten pregnant from the sex won't. Various formulations of the pill also have issues where they're less effective for people with higher BMIs. So, how does an IUD stack up?

A new meta-study has analyzed 35 years of data from 42 studies across six countries — an enormous analysis that shows an incredible final statistic. For the 7034 cases, the pregnancy rate (barring one outlier study) was just 0.09%.

These studies were purely for copper IUDs, and it hasn't been studied if the same holds true for hormonal ones, too. The one huge other advantage for using an IUD as an emergency contraceptive is that afterwards, you're sorted for a decade of being baby-free — or less, if you get it removed.

So, why isn't it used more widely? The two obvious drawbacks are the fact that it's substantially more expensive than Plan B, and also that it requires a medical procedure. You can just pick up some pills at a pharmacy, where an IUD needs to be inserted by a medical professional, a time-consuming and often expensive procedure.

Nonetheless, this research shows that as an emergency measure, an IUD is very effective, and one that needs to be offered more widely.