You know what’s fun? Meeting someone for the first time when your pants are off. I waited in a hospital dressing gown for my new OBGYN to come into the room for my first pregnancy check-up.
Across the room, a huge poster on birth control options was displayed on the wall, arranged by effectiveness. One of the most effective birth control types listed was an intrauterine device (IUD).
Yet it’s still possible to get pregnant with an IUD. No birth control, except abstinence, is 100% effective. Those who use an IUD still have a 1% chance of getting pregnant each year.
Maybe you’re one of the few who has an IUD and is still somehow staring at a positive pregnancy test. So let’s talk about what happens if you get pregnant with an IUD.
Pregnant with an IUD. Now what?
First, take a deep breath. If you had an IUD, then this is very much an unexpected pregnancy, and you’re likely bombarded with emotions. Take the best self-care advice I’ve ever been given: Feel what you feel.
Take the time you need to process what’s happening and how you feel about it.
How to Process Your Pregnancy Test Results Worksheet
The next thing to do is call your doctor and make an appointment. Your OBGYN will need to find out why your IUD failed to prevent pregnancy and help you make next steps from there.
How did you get pregnant with an IUD?
An IUD is 99% effective. So how did you get to be one of the few who still ended up pregnant?
To answer that question, let’s revisit how an IUD works.
There are two types of IUDs:
Hormonal. This type of IUD prevents pregnancy by releasing progesterone, which thickens cervical mucus to keep sperm from reaching the egg, thins uterine walls to make implantation of a fertilized egg difficult, and can even put a halt to ovulation. This type of IUD should last from 3-5 years.
Copper. Non-hormonal IUDs have the same t-shape as hormonal IUDs, but they work differently. The copper wire in this IUD is toxic to both sperm and egg while remaining safe for most women. They can last up to 10 years.
A properly-placed, non-expired IUD should prevent pregnancy in your uterus. So if you’re pregnant with an IUD and the IUD has not expired, either the pregnancy is not in your uterus or the IUD is not in your uterus.
How to check if your IUD is in your uterus?
Is your IUD still in your uterus? You can check at home to get an idea of whether or not it may have slipped out of place but will still need to visit your doctor to find out exactly what is going on.
After washing your hands, place a finger into your vagina and feel for the strings that hang from your IUD. You should not be able to feel the plastic part of the IUD. If you can, there is a problem with its placement. Don’t try to adjust it yourself.
Once you think you have an idea of whether or not the IUD is still in place, call your doctor and schedule an appointment.
Pregnancy when your IUD is in your uterus.
In rare instances, you may have a normal pregnancy with an IUD in your uterus. If this happens, your IUD may have expired or you became pregnant between the time you received your hormonal IUD and when it began to work, usually a 7-day window.
If your IUD is still in place, you may have an extrauterine (ectopic) pregnancy, which is a pregnancy outside your uterus. Most ectopic pregnancies are in the fallopian tubes, although they can also occur on an ovary or in the abdominal cavity.
It’s worth noting that an IUD will not increase your chance of ectopic pregnancy. It simply is not effective at preventing an ectopic pregnancy.
It is essential that if you are testing as pregnant and have an IUD in place that you talk to your doctor. If you have pain on either side of your abdomen and/or vaginal bleeding, you should seek emergency care.
Pregnancy when your IUD is not in your uterus.
If your IUD has become expelled, then you are likely experiencing a normal pregnancy within your uterus.
How in the world did your IUD move out of place? Although it’s fairly rare (depending on risk factors, expulsion rates are between 0.5 and 8%), there are a lot of reasons why this can happen.
What to do if you have a pregnancy with expelled IUD?
If your IUD fell out of your vagina…
It’s possible your IUD may have completely fallen out without your knowledge. IUDs sometimes fall out during menstruation. Some women are none the wiser until they get two pink lines on a pregnancy test.
If this is the case, you’re experiencing a normal pregnancy—the fact that you once had an IUD does not put you at risk for complications.
If your IUD slipped into your abdominal cavity…
Unless you regularly check to ensure your IUD is in place, it can be difficult to notice if it slipped into your abdominal cavity.
That idea might make you cringe, and for good reason. While some women never experience complications from an expelled IUD, others can suffer bleeding, scarring, perforation, and other health problems.
The presence of an IUD during an otherwise normal pregnancy can cause complications whether or not you have it removed before delivery. The good news is that statistically, rates of pregnancy complications with an IUD are only slightly higher than those of a typical pregnancy. However, each person's risk factors are different. Your doctor will process your options with you to decide what is safest for you and the fetus moving forward.
You have options.
If you’re feeling blindsided by your birth control failing, you’re not alone. Even with the most reliable birth control, pregnancy can and does happen to thousands of women every year. You still have control over what happens next.
Take some time to sit in the unknown and process your feelings.Find someone you trust who can discuss this situation with you. Maybe you’d like to talk things through with a She Might Clarity Coach.
Whatever you decide, we hope you’ll take advantage of the resources available here. It’s our goal to help you make a whole-hearted decision and move forward with confidence.