IUD waitlists balloon in BC’s first month with free birth control

IUD clinic gets 400 insertion requests in BC’s first two days of free birth control

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In just two days, a clinic in Vancouver received nearly 400 IUD insertion appointments after prescription birth control became publicly funded in BC.

Starting April 1, people in BC were able to receive free prescription contraceptives like copper and hormonal IUDs, which PharmaCare will fully cover.

Before this policy kicked in, Renee Hall, the medical co-director at Willow Clinic in Vancouver, said there was already a high demand for IUDs.

However, this birth control device costs around $400 for people without medical coverage.

So when the intrauterine device became free for British Columbians, “that’s when our phone calls definitely went up, and those who are interested but weren’t able to afford them before, or those who were interested but didn’t like the idea of committing financially to something like that, are now interested in giving it a go,” Hall said. “A lot of people find it really convenient.”

In just two days, the Willow Clinic received about 350 appointment requests and an additional 50 referrals from doctors asking for its help to insert IUDs, Hall said.

By mid-May, Hall said the clinic must have received more than a thousand appointment requests.

“The wait time used to be one to two weeks, and now it’s more in the order of two months,” Hall said. “That’s the part that’s concerning and where we’re raising the alarms.”

Consequences of long waits

Dr. Laura Nicholas, who is an naturopathic doctor at the Luna Health Clinic in Vancouver, said she saw the same demand increase at her clinic too.

“Changing the access by making it free is fantastic in so many ways. But it’s also created a bit of a bottleneck in the system,” she admitted.

She explained that patients who need an IUD as a form of emergency contraception or folks that need the device taken out, are having trouble finding a timely appointment.

“We’re having to triage … they aren’t getting access if I’m not going above and beyond what I have in my schedule,” she said.

People who are looking to get pregnant now can’t get their IUD removed for three or four months which is delaying their ability to conceive.

“We want to be able to protect people from getting pregnant when they don’t want to get pregnant, but rapidly assist them in falling pregnant when they want to,” Nicholas emphasized.

Free IUDs in a box are useless without doctors to insert them

Hall explained that over the past few years, there had been an increase in IUD clinics and, “unfortunately,” many doctors and nurse practitioners are dropping the skill of IUD insertion.

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She said the reason for the decline of doctors able to insert IUDs is because “It’s not very well remunerated.”

“It is a skill, and it takes time to get trained, and it takes time to master,” she said. “Regardless of how good you are at it, there’s always going to be ones that are difficult. So doctors would find that they are spending a lot of money on the equipment and sterilization of the equipment and not being paid well enough for the insertion.”

“So it started to become more convenient to send them to specialized IUD centres that do it all the time,” Hall said.

However, clinics around the region are reporting demand and long waitlists too.

While it’s “wonderful” to have access to free contraception, “an IUD in a box that’s free is not very useful. We need to be able to have access to the people who insert them,” said Hall.

Hall suggests IUD insertion should be incentivized so more doctors would be willing to train to do it or expand some of those IUD specialized clinics as well, and funding them might help so that women can get the IUD they want when they want.

Nicholas also suggests the College of Naturopathic Physicians of British Columbia (CNPBC) shorten the experience needed to certified to insert an IUD.

“Somebody has to be practicing for a minimum of three years prior … to have more younger doctors or doctors or newer doctors offering the service,” she suggested but added she understands why the years of experience is also expected.

“This is a very high level of service,” she said. “So if we were to change the regulations, there has to be like adequate training in place and mentorship programs.”