Don’t want kids? The FDA, Mirena IUD and Health Insurance don’t care

It’s that time again…..much to my severe anxiety. I need to revisit birth control options. For the last 5 years I’ve been on the Mirena IUD. The decision that led to it was that my blood pressure was elevated and my OBGYN was convinced it was caused by my hormonal birth control. Specifically, the estrogen. Unfortunately, they were right. It could have been tied to my weight, but I was unable to lose enough weight to go back on it without my blood pressure going back up. My body wasn’t happy with that, but that’s not at all the point to this post.

When I was given the Mirena it was 5 years ago and new-ish to being prescribed in the US. The doctor I was seeing was head of a department that did clinical trials at their hospital and so I was able to not only get birth control options before they were officially “out” (like Nuvaring and the patch) but if I qualified I could be in studies and get free birth control. Unfortunately, I didn’t qualify for the Mirena study because I’d never birthed a child. Ok…..I wasn’t happy about that, but fine. Except that when it came time for me to be able to have it prescribed, that little fact cost me money.

A lot of money.

You see, because the FDA only approved Mirena for use in women who’ve carried a pregnancy to 20 weeks (my doctor didn’t further elaborate if it had to be a successful, live birth), it’s considered “off label” by health insurance companies when women like me want to use it. Off label usually means it either won’t be covered at all, or I’ll have to pay a huge portion of the cost.

Except, here’s my complaint: The FDA has laid down the law and is limiting my choice. Shouldn’t women be allowed to say “You know what, I waive whatever I need to waive and I don’t ever want children of my own, so the small risk of a sterilizing infection is of no matter to me” to their insurance companies so that it’s not considered off-label and therefore, quite costly. Other IUD’s do not carry this same stipulation; but my doctor feels that I would have better uterine/ovarian health & less issues being on Mirena as opposed to a non-hormonal IUD.

As I approach the procedure date I am not only sick with the anxiety of the level of pain & discomfort the procedure brings me but worried that we’ll have another huge bill. The last time we were able to go on a payment plan directly with the makers of Mirena, but given our low income it practically took as long as paying off a goddamn car.