My Doctor Lied So She Could Deny My Contraception

In 2021, I became a domestic violence survivor after finally escaping my abuser of 5 years.

Without getting too graphic, this was a relationship during which I didn’t have the autonomy to say no to sex. While I couldn’t protect my body from the assaults I regularly endured, I was at least able to protect myself from unwanted pregnancy by employing effective birth control. Without this ability, I may have ended up bound to my abuser for the rest of my life due to the child custody laws of my state.

Contraceptive Access

When the abuse first began to escalate, I researched the forms of available contraception that would be the best for my circumstances. I decided on the Mirena Intrauterine Device (IUD), a hormonal IUD.

This small, t-shaped piece of plastic is inserted into the uterus where it releases a small amount of hormones to prevent sperm from fertilizing eggs. It can remain inserted for several years and is over 99% effective at preventing pregnancy.

As with any form of birth control, the potential side effects are daunting: pain, bleeding, infection, and ovarian cysts to name a few. Rare but serious complications can also result in hospitalization, loss of fertility, and death.

I, like so many sexual abuse victims, had little choice but to take on these risks. Despite horror stories of the many victims forced to share custody with their abusers, the justice system in the United States remains skewed in favor of the abuser. This knowledge was reinforced time and again during my time in law enforcement and in my personal life.

Roe v. Wade

In May 2022, information leaked that the U.S. Supreme Court planned to overturn Roe v. Wade, a case that originally legalized abortion in the U.S. in 1973. I knew this right being taken would only embolden pro-lifers to target other reproductive rights.

As a woman, the fear and danger of sexual assault is always present. The risk of abuse is even higher among those who have been victimized previously. To those who would deny these victims protection: how exactly do you justify calling yourself pro-life?

Although I’d escaped my abuser by this point, the fear of enduring an unwanted pregnancy without access to abortion services left me feeling as trapped and out of control of my body as I’d been within that relationship.

By the time of the Supreme Court leak, I’d had my IUD for nearly 4 years, with 5 being the recommended maximum for Mirena (at the time, more on that below). I was grappling with a recent diagnosis of CPTSD in the wake of the trauma and violence I endured. I was also in a vulnerable position financially as a result of being forced to flee the home I shared with my abuser. I certainly wasn’t in a place to provide for children.

On top of all this, I wasn’t sure I even wanted children at all.

With abortion access in jeopardy, I decided to take preventative action for my health by getting a new IUD implanted early. This would give me a few extra years of protection in case of any future restrictions that may arise. I called my doctor and made the soonest appointment possible in order to get my current IUD replaced with a new one.

The Procedure

For those who haven’t gone through the exquisite torture that is getting an IUD implanted, allow me to explain the unpleasant process. Patients lie on an exam table, where a speculum is inserted into their vaginal opening. The device is pushed into the cervix using a special applicator which allows the arms to extend once in place.

If you research this procedure, many medical sites leave out the part where doctors use a horrifying device called a tenaculum to hold the cervix in place. Patients are not anesthetized, despite widespread complaints of extreme pain. This is likely due to the fact that the pain of people with uteruses is systemically dismissed.

When I tell you my right to choose is so vitally important to my sense of safety that I was willing to undergo this procedure a full year early, knowing how badly it hurt the first time around, I hope it punctuates the sense of urgency I felt.

Denial of Autonomy

When I arrived at my consultation and was able to be seen by the doctor, she informed me of the “good news”: Mirena had recently approved the extension of use from 5 years to 7 years, meaning my current one would actually be considered effective for 3 more years.

That was great news for sure, but I still wanted to get my current one replaced. When I told her this, the doctor declared that my insurance wouldn’t authorize that because it was too early.

What?

Confused by this turn, I asked what would’ve happened had I come in requesting only that my current IUD be removed. She said that was fine. I then asked what would happen if I called back later and asked to get a new one inserted. Bizarrely, she said this would potentially be approved.

So just not on the same day? What is this stipulation?

This conversation occurred between myself and a close friend before I discovered the doctor lied about calling my insurance. Photo by author: Reality Trekk

Did you catch the bit where I asked the doctor to contact my insurance to double-check this nonsensical rule?

She claimed she did, even leaving the room for a few minutes (during which time I can only assume she took a little snack break from the girl whose rights she was infringing upon). In case it wasn’t obvious, this later turned out to be a complete lie.

When she returned from definitely not bothering to contact my insurance, she claimed they’d confirmed they wouldn’t authorize a new IUD this early.

We went back and forth a little, with me inquiring as to why the practice had let me make a consultation knowing I wasn’t going to be able to actually get the new IUD.

I also tried to explain my trauma history and the reason I was so anxious about contraceptive access in light of Roe being overturned. The doctor flippantly dismissed my concerns, saying there was no way conservatives would go after birth control.

To this day I am dumbfounded at this ludicrous statement, made even more ridiculous by the fact that it came from a woman working in women’s reproductive health. How privileged of a position are you living in to not see our rights being attacked at every opportunity?

It’s been about a year since this whole fiasco went down. In that time, we’ve already seen many attempts at legislation restricting contraceptive access since the overturning of Roe v. Wade. According to PowerToDecide.org, over 19 million women of reproductive age in the US are currently living in areas lacking reasonable access to health centers offering the full range of contraceptive methods.

Exasperated and desperate, I asked if insurance would approve me getting my tubes tied (also known as tubal litigation) instead of an IUD. In the moment it truly felt like the only option to protect myself. Hesitantly, she said they would cover the procedure.

Again, what?

It’s beyond absurd that I even have to argue this, but insurance shouldn’t be a limiting factor when it comes to doing what’s best for one’s health. No one should have to undergo major surgery and permanently alter their ability to choose to have children when there’s another, much less permanent option available.

In response to my request for information about sterilization, the doctor began asking intrusive questions about my relationship with my partner at the time and whether they’d have an opinion about the matter.

This interrogation was maddeningly inappropriate and irrelevant, considering it was not my partner I wanted to sterilize. Would these questions have been asked if I were a man? What must it feel like to have a body that you’re able to actually make your own decisions about?

I wish that were the most outrageous part of this saga, but that isn’t even it, y’all.

Blatant Lies

I left the consultation in tears. Not only was I still processing the loss of women’s right to safe abortion access, I was now being told there was nothing I could do to ensure I remain protected in the case of other contraceptives being restricted, something that was very much a worry nationwide.

I decided to call my insurance to check the policy myself and see if there was any way to appeal it due to extenuating circumstances. Like anyone who’s been bullied by the healthcare system in the past, I had little faith that it’d make a difference. However, I was fortunate enough to reach a representative who was an incredibly kind and badass ally.

And because I’m a wily lil’ traumatized former investigator who’s tired of being stepped on, I recorded the entire conversation.

Women Supporting Women

I’ve quoted segments of our conversation below. Please note that I did redact some things for privacy. Long pauses, holds, and crutch words (ex. “ums” and “likes”) were also removed to make it readable.

Insurance: …Hi ___, how can I help?

Me: I’m not sure exactly how you can, but I had some follow-up questions about an appointment I had the other day with my OBGYN? I have an IUD, currently, the Mirena, and it was supposed to expire in August of next year, but I was trying to get a new one early because [my state] is actively trying to ban [contraceptives]. But they said insurance would refuse because it’s too early? I just wanted to see if that was accurate and if there was any way around that.

Insurance: Alrighty, I can definitely take a look into the benefits for contraceptives and see if there’s any timeframe for the Mirena… So I went ahead and double-checked and yeah we’re not finding anything to where we verify or process coverage by timeframe when it comes to the Mirena. The only difference is where you’re picking it up could change the pricing and coverage. Other than that there’s no timeframe that we see.

With a quick search, the insurance representative was able to confirm that not only would my insurance indeed approve a new IUD, but there was in fact no existing policy establishing a minimum restriction on the amount of time an IUD must be inserted before being eligible for replacement.

I could get a new one every week if I felt like paying a copay to get stabbed with a tenaculum (I did not, but it was good to know).

Me: Ok, that’s the best news I’ve ever heard first of all thank you. Second of all, is there any way to send that to my provider that I went to last week? Because they told me that it wasn’t going to be approved.

Insurance: There’s nothing I could send. I mean, I can call them and let them know that I don’t see anything?…

Me: Would you? Would you mind? I just don’t think they’re going to listen to me. I tried to talk to them about it and they just kept saying insurance wouldn’t approve it and kind of shoved me out the door.

Insurance: Alrighty! Do you have a phone number for them?

I profess my undying love to this representative. She deserves an Edible Arrangement and a free vacation. This absolute angel agreed to call the OBGYN’s office with me on the phone and call them out for lying.

She totally had my ovaries during a time no one, not even my country, did.

I’m not sure what the job title was for the woman who answered the phone at the medical office, so she’ll be referred to as OBGYN Employee.

Insurance: Hi ___, this is ___ I’m calling from ___. I also have the patient, ___, on the line as well. And she stated that she was looking to get her IUD removed and to get another one replaced and she said that you guys stated that we wouldn’t cover it, so I was just wanted to give you guys more information based off of our benefits?

OBGYN Employee: Ok, just one moment ok?… Ok so I just looked at her chart and its saying that the IUD is good for 7 years so it’s not being authorized because it doesn’t need to be replaced.

Insurance: OK… So is that… That’s a policy through you guys is that correct?

OBGYN Employee: Um, one moment, please…

She forgot to put us back on hold, so at this point in the recording, you can hear her in the background talking to someone.

OBGYN Employee to Unknown: Is that a policy through us? No? No? No.

OBGYN Employee to Insurance: Um no. That’s not a policy through us. It’s saying insurance won’t authorize replacement unless there’s a recall or a problem with the current device.

Insurance: Where do you guys see that? Because I went ahead and took a look at the code in our medical coverage guidelines and I don’t see anything. Then I spoke with my supervisors as well, and they said they’ve never heard of that either to where we’re saying it needs to be through the full timeframe.

OBGYN Employee: Alright, give me one moment… Alright, I just talked with them and they said they can get the prior request sent through and wait for the authorization.

Insurance: Alright. Perfect, perfect. Thank you. Sorry, what was your name again?

…

Insurance: Alright, perfect… So we’re gonna let them go ahead and submit that authorization. Basically they’re gonna submit the codes and medical records to see if we’ll cover it before they actually do it for you. But like I said, my supervisors, they’ve never heard of that before to where there’s a specific timeframe on what we have to allow. So there shouldn’t be any reason why we don’t approve that authorization for you.

And just like that, I was approved. I could hardly believe it. I choked up with emotion as I thanked the representative for helping me advocate for myself, promising to rave about her in the survey after the call.

But the worrying question remained… Why had that doctor lied multiple times about my coverage, even in my chart?

After: Now What?

I’m happy to report that I was able to get my new IUD soon after this incident, shielding me from unwanted pregnancy for 7 additional years. The insertion wasn’t any less painful the second time around, although I was relieved to find that the doctor who’d denied me was conveniently not the one who performed the procedure.

To this day, I have no idea why the doctor was so adamant in refusing my new IUD. Was she maliciously forcing her political opinions about contraceptives onto women who entrusted her with their health? Did she truly believe she was correct and arrogantly refused to consider an alternate possibility, even when checking was in the best interest of her patient? Was she simply being lazy and didn’t feel like making the phone call?

Whatever the reason, her decision to deny me was reckless and destructive. No one should be denied the right to make decisions about their own body due to the beliefs, ineptitude, or outright negligence of others.

While this incident fortunately ended in me receiving the protection I was legally entitled to, many in our country don’t currently have access to the same care. In a wild twist, on July 13, 2023, the day I completed this article, the FDA approved the first over-the-counter birth control pill in the U.S.

The option to purchase contraceptives without a prescription in-stores and online is expected to be available by 2024. This could be a life-saving move that puts the decision back into the hands of the patient.

This is an incredible announcement, don’t get me wrong. But I can’t be alone in wondering why, during a time of such contention over reproductive rights, anti-abortion groups have been suspiciously silent about the news. Are they finally beginning to come around to the idea that accessing sexual healthcare and education is vitally important? Somehow, I’m suspicious.

While I am hopeful that this new option moves our country in a more positive and equitable direction, I definitely recommend remaining vigilant for strings attached to this news.

It’s more important than ever to advocate for access to sexual health care and education. Learn more about your rights by visiting PowertoDecide.org.

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