Generation Coil

Although the contraceptive coil is no longer common in many countries, it remains popular in Britain. Portsmouth-based student Isabelle Bilton recounts the experience of having one fitted in a Portsmouth hospital in uncompromising detail.

My hands shook as I typed the number for the clinic; the January cold had crept under the doors and filled our student house. I pulled my blanket tighter round my shoulders and stared at the screen, breathing deeply to calm myself. I reread the script I had written out one last time. Just do it. I pressed dial and waited whilst it rang.

‘How may I help?’ a woman’s voice whined down the phone, probably for the hundredth time today. I was shocked at hearing an actual human not an automated message and it threw me off slightly.

I went to spurt my prewritten script, staring back at me, but veered off after ‘hi I want to book… Um, an appointment…’

‘For what?’ she said with an air of impatience.

‘Oh, I, uh, sorry, for um… I want a coil.’ I stuttered.

After a stream of invasive questions, I had myself an appointment at the end of March. I sighed, half with relief at having finally booked it, and half trying to expel the dread which was settling in my stomach.

I had been on the contraceptive pill for around five years, along with approximately 3.5 million other women, but I had eventually decided that user-dependant contraception was too much for my overactive imagination. The success rate of the pill is advertised as 99%, but in reality the figure is much closer to 92%. Vomiting, diarrhoea and forgetfulness all affect the likelihood the pill won’t be as effective. The Mirena coil, on the other hand, is more than 99% effective. With the recent controversy surrounding the links to depression and the pill, it’s not surprising that more women like me are keen to move on. Soon I would be using, according to the NHS website, ‘one of the most effective forms of contraception in the UK.’

A few months later and I was sat on my childhood bed feeling my insides churn with nerves. Naturally, I did what any intelligent (stupid, very stupid) woman does when she is in doubt about something medical and I Googled it. I was met with a plethora of horror stories, mainly residing on parenting forums. A personal favourite was a thread named ‘how painful is the coil fitting on a scale of 1 to 10’ which was met with a ’10,000’ by one woman and details of blood and gore.

I had read and reread the letter I had received compulsively. I was advised to eat a bit before and have taken pain killers. I was soon crying over a tin of ravioli I thought was out of date (it wasn’t) and telling my sister she doesn’t care about me (she does), and finally storming off to my old bedroom like a stroppy teenager.

Moments later, I was presented with the now-hot ravioli and its empty tin, which clearly stated October not January. I sniffed and reluctantly accepted it. I began to pick at it, but managed less than half because with each mouthful I felt increasingly more unwell.

‘I don’t want to do it, but I know I have to,’ I told my mother as we parked the car up outside the doctor’s.

‘No, you don’t have to do it, if you don’t want to,’ she assured me.

‘But I do. I do want it; I just don’t want this bit.’

She stroked my arm and we made our way inside. My body was slick with cold sweat. There was a tight feeling in my chest, pressing down; the dull ache of anxiety. Thick artificial heat swamped us. The waiting room was long and thin. The walls were dull; shades of beige and faded duck egg blue. I glanced at the other people waiting – a teenager tapping on her phone, heavily made up; a woman in a suit, her hair slicked back; a man frowning at his book, glasses slipping off his face; a couple with a small sniffling baby. Tatty posters clung to tired staples on the walls. The unmistakably clinical smell of disinfectant drifted around us.

‘Isabelle?’ A woman entered the room, clipboard in hand, smiling.

I had felt like looking around at the other patients, pretending it wasn’t me. Is there an Isabelle here? I could have just shrugged my shoulders and left. Instead, my mother began to stand, collecting my stuff, as I forced a smile at the doctor.

‘Firstly please don’t worry,’ the woman said, leading us through into the appointment room, ‘I’m the queen of coils!’

I felt a slither of worry drain from my body. Any woman who uses the phrase ‘queen of coils’ in her opening statement before fiddling around inside your uterus is clearly of good humour. ‘Now you want an IUS, right? The hormonal coil?’ Queen of Coils smiled at me, reassuringly.

I nodded. I had done my research. My mind flicked back to the dog-eared leaflets and countless webpages. I knew the three different kinds of coil: copper, Mirena and Jaydess. The latter two release hormones and are classed as intrauterine systems (IUS). The copper coil is an intrauterine device (IUD) with no hormones whatsoever.

‘Yes, um, I think it’s Mirena I want?’ I looked to my mother.

‘Yes,’ my mum confirmed, ‘it’s Mirena.’

I nodded again. I opted for Mirena as it releases a progestogen hormone, similar to the natural hormone progesterone produced in a woman’s ovaries, at a very low level into the blood stream. This was the same hormone in the pill I was taking at the time. It also remains in for two years longer than Jaydess.

‘Brilliant! I have a Mirena as well!’ Queen of Coils chimed, ‘aw, it’s ace! It doesn’t interrupt sex and you won’t have to think about contraception every day anymore. Do you know how it works?’

‘Yes, kind of…’ I trailed off, figuring she probably had to explain it anyway.

‘That’s okay. Well, it thickens the mucus from the cervix… Uh, the opening of your womb, making it harder for sperm to move through it to reach an egg. It also thins the womb lining which makes it less likely to accept an egg if it had managed to be fertilised. They really are fab. I’ve never looked back. Do you have one too?’ she turned to my mum.

‘Yes, I’m with you on that. I told her to get one but didn’t really think younger women tended to have them… Certainly not before children.’

‘No, no. That appears to be a common misconception!’ Queen of Coils exclaimed, ‘The youngest girl I’ve fitted one in was 13! We’re getting more and more young people in now, I think a lot of them keen to get away from the pill.’

I felt I was becoming part of a movement for young women to leave behind the pill and move on to more long-term reliable contraceptives.

‘And my periods?’ I queried.

‘Well, it could make your periods, lighter, shorter or they could actually stop completely. So your one, Mirena, is much more likely to stop periods altogether than Jaydess. I don’t know if that’s a positive for you?’

It certainly was.

‘Okay, well if we’re all ready… I’ll draw the curtain and you just slip your knickers off and lie down on the bed there for me, please?’ Queen of Coils instructed, pulling the curtain to. I glanced at my mum as we were separated.

As I pulled my dress up and laid down on the cold surface Queen of Coils began to speak again, ‘Are you okay if we are joined by a doctor training to do coil insertions and a student nurse?’

I propped my legs up and laughed at how bizarre the situation was as I heard the room fill. I had been given a blue piece of tissue to place over my crotch. This seemed rather pointless considering they were going to be looking into my vagina, surely the rest of my pubic region didn’t really need hiding?

The three women checked I was ready and then entered the little makeshift cubicle. I closed my eyes tight, opening them slightly only to see the women gelling up an interesting looking instrument. I’d rather not see and certainly rather not know I had thought to myself.

It didn’t last long as my eyes snapped open when that gelled up instrument was inside of me and freezing cold. Queen of Coils clutched my hand and talked to me about university, my hobbies and anything other than what was going on down in my bottom half with Trainee and Student Nurse. The instrument was being used to open me up so they could measure my cervix. I whimpered almost immediately, my mum still on the other side of the curtain. There is something unsurprisingly uncomfortable about having a cold object inside of you, forcing your insides further apart.

‘Do you want mum?’ Queen of Coils asked.

‘Mmhmm,’ I stammered, feeling waves of panic for what was coming spread through my chest, ‘yes, yes please.’

She was there immediately, stroking my forehead, providing a comfort only a mother could give.

‘Now, you’re going to feel a tiny scratch,’ Queen of Coils began to say.

I interrupted her, ‘no, no, I don’t want to know what you’re doing, just do it and don’t tell me what or how or anything. I just want to know when it’s done!’

The scratch, I later learn, was the anaesthetic. Trainee was struggling to measure my cervix. I could tell this wasn’t going as smoothly as we had all hoped. She soon gave up, deciding the instrument was too big. Once again, she tried, this time after locating a miniature version as Student Nurse observed. After a few failed attempts, they managed to get a measurement.

‘Don’t look so worried,’ Student Nurse said soothingly, ‘I know it’s scary but we know what we’re doing – promise! We’ve all had coils fitted. They’re brilliant… In fact I think we’ve all had our coils fitted by people in this very room. I trusted them to do it to me, so don’t you panic.’

The coil was in, then my body rejected it, then it was in, then my body rejected it once more. I was blissfully unaware of what was going on; my eyes pressed closed, my mother soothing me. I felt tiny waves of what felt like numbed period pain. Queen of Coils watched Trainee try and fail, before taking over herself. There was a snipping noise and she looked up at me smiling.

‘There! All done!’

‘That’s it?’ I asked, ‘that’s it?!’

‘That’s it! It’s in!’

I had been waiting for the pain and felt almost a little underwhelmed. It didn’t seem as dramatic as I’d pictured it.

‘Now, don’t sit up too quickly,’ Trainee advised. ‘We’ll bring you some water and painkillers and you just sit up in your own time and pop your knickers back on.’ She began to close the curtain. ‘Oh, I almost forgot!’ She plonked a wad of what looked like stuffing on my lap before drawing it closed.

Upon further inspection I could see it was a sanitary towel, so thick I could hardly believe it was designed to stick to my underwear.

I sat up gradually, feeling a little lightheaded. As I angled myself upright, I felt the rush of wet and grabbed the tissues beside the bed to soak between my legs. There was a small trickle of blood and the gel leaving but little else. I downed the water like a shot and stuck the pad to my pants. It was like having a wad of loo roll shoved in my underwear.

On the way home my stomach cramped. The pain came in waves, which spread all through my lower abdomen. At home, I lay on my bed, moaning and trying to find that nice safe little position which usually eradicates cramps… but I never found it. I ended up fishing out an old microwavable lavender scented heat cushion to press to my belly and, a few minutes later, they subsided. I think it coincided with the pain killers kicking in, but then that was it. I had no more bleeding, nor pain, at all and now it’s in for a minimum of 5 years.

‘Can’t you like… feel it?’ My friend asked me in horror days later.

‘Not one bit.’

‘But aren’t you worried about being able to have kids and stuff in the future?’ She asks, her brow furrowing.

‘Nope, apparently your fertility returns to normal after it’s out, and literally any trained doctor or nurse can remove it really easily. I’m not worried at all.’

Months later and I am convincing friends to transition over from the pill. I am kicking myself for not doing it sooner. Ten months ago I was so scared I cried over a tin of ravioli and almost ran out of the waiting room. Now, however, I am period and pregnancy free for 5-7 years. If you’re feeling (not even that) brave, then book your fitting. Wave goodbye to the pill, say hello to generation coil.

Photography by Moshe Tasky.