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Primary Submission Category: Reproductive health
“I needed to be my own provider”: A Qualitative Exploration of IUD Insertion Pain, Patient-Provider Trust, and Healthcare Navigation
Authors: Muna Hassan, Madeline Mahoney, Asha Hassan,
Presenting Author: Muna Hassan*
In recent years, a surge of social media posts on TikTok has brought public attention to people’s experiences with IUD insertion pain, with some users documenting their procedures and sharing narratives of unexpected or severe pain. These stories may be contributing to growing mistrust in medical providers and contraceptive technology. The goal of this study is to examine how the experiences of a painful IUD insertion influence future reproductive and contraceptive decision-making and their trust in healthcare providers. We conducted semi-structured qualitative interviews (n=30) between October 2025 and January 2026 with people who experienced a painful IUD insertion between six months and two years ago. Recruitment flyers were posted in reproductive health clinics in the Twin Cities metropolitan area. Interviews were analyzed using the Sort and Sift, Think and Shift qualitative analysis method.
Interview participants were median age 26; 93% nulliparous; 57% monoracial white; 80% women or cisgender women. Majority of participants reported feeling underprepared for the pain they experienced during insertion. Direct and honest communication from healthcare providers, an established relationship with their provider, and being offered pain management options all contributed to a more positive IUD insertion experience. Factors that contributed to more negative IUD insertion experiences included multiple insertion attempts, presence of or insertion by students or trainees, and unclear or unempathetic communication. Some participants expressed increased medical mistrust and self-advocacy in healthcare settings after their experience with a painful IUD insertion. Clinicians should practice clear communication about IUD insertion pain, the adjustment period, and IUD side effects. Painful IUD insertions and negative experiences with contraceptive side effects may increase medical mistrust, wariness of contraceptive technologies, and ability to self-advocate in healthcare settings.