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Millions of women today take advantage of IUD use with little serious risk. IUDs are the most popular form of reversible female birth control in the world. One advantage is that the devices are effective immediately upon insertion. Conversely, one of the greatest advantages of IUDs over other long-term hormonal treatments is the speed with which a woman may become pregnant once the device is removed. IUDs can be used sooner after giving birth than oral contraceptives for mothers who are breastfeeding. Additionally, the hormones in Mirena IUDs can reduce a woman’s menstrual cramps as well as menstrual flow, which may taper off by 90 percent. IUDs may also serve as emergency contraception: ParaGard IUDs can reduce the chance of pregnancy by 99.9 percent when inserted within five days of unprotected vaginal intercourse. Oral emergency contraception, in contrast, works with only 75 percent success and must be taken within 72 hours of unprotected sex.

This is not to say that ParaGard and Mirena IUDs have no potential side effects. Spotting between menstruations, an occurrence that many women find disturbing, is common within the first few months of IUD use. Menstrual flow can actually increase by 50 to 75 percent with ParaGard. More serious complications are very rare, but can include unwitting expulsion of the IUD, accidental perforation of the uterus during insertion, and bacterial infection during the first three weeks of use—infection after this period is generally caused by exposure to a sexually-transmitted infection (STI). Despite these risks, however, worldwide surveys indicate that IUD users are slightly happier with their method than women using any other form of birth control: IUDs boast a 98 percent rate of satisfaction, while oral contraceptives and condoms claim rates of 92 and 88 percent, respectively.

Such encouraging numbers allow us to predict that even if American women are never fully comfortable with IUDs, this contraceptive method will continue to spread worldwide to the women who need it most—the women for whom the advantages of reliable long-term birth control far outweigh the costs of short-term discomfort. “As far as the rest of the world, especially the Third World, they embrace anything that saves them from more children they cannot feed or protect from AIDS, wars, Ebola, and other horrors, or the 1-out-of-500 maternal mortality in the developing world,” Dr. Richman comments, “and for sure American women are sheltered from that sense of desperation.”

Betsy Boutelle is a junior History major at Yale University.