Andrea Poppy had been casually dating someone for a few months when she suspected she was pregnant. This came as a surprise, since she was using a Mirena IUD to prevent pregnancy, having heard it was one of the most effective forms of birth control. But she'd been pregnant twice before and knew what the early stages of pregnancy felt like. For her, the signs she was pregnant with an IUD were unmistakable.
"I felt this twinge in my ovary — the same feeling I had with my other pregnancies, and I knew," Poppy tells Romper. "I went to the doctor for a blood test, and literally argued on the phone with a nurse that I knew I was pregnant. The following week, my test was positive."
According to the Guttmacher Institute, IUDs have one of the lowest failure rates of available birth control methods — about 1% for both hormonal and copper IUDs — which makes them a popular choice for people who want to prevent pregnancy. But a 1% failure rate also means that one in every 100 people who use an IUD will get pregnant.
If you have an IUD and think you are pregnant, it's important to see a health care provider right away. Research published in the journal Contraception found that people who get pregnant with IUDs can experience higher rates of ectopic pregnancy. Also, even if your pregnancy is inside your uterus, you can have complications like miscarriage, premature rupture of membranes, preterm birth, and intrauterine growth restriction. If you decide to continue your pregnancy, that risk can be reduced by having your health care provider remove your IUD.
To learn more about signs of pregnancy with an IUD, Romper spoke to Dr. Huma Farid, MD, an OB-GYN at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, Massachusetts, and a few people who've experienced an IUD pregnancy first-hand.
Farid explains that getting pregnant with an IUD often causes the same symptoms as any other pregnancy. "Women may experience signs of pregnancy, such as breast tenderness, morning sickness, fatigue," she tells Romper.
This was definitely the case for Poppy. "I suffered with hyperemesis gravidarum with my previous pregnancy, too, so when I had the same symptoms at four weeks, I just knew," she says.
A Missed Period
Unfortunately, and according to Planned Parenthood's website, menstrual side effects like irregular bleeding and spotting are relatively common with both hormonal and copper IUDs, and if you have a hormonal IUD you may not get a period at all.
That was definitely Jessy Gregg's experience with a Paraguard copper IUD. "My periods were sort of weird with Paragaurd," she tells Romper. "You spot for awhile and then you might skip a cycle, so I wasn't really tracking my periods at that point."
Gregg was seeing a new acupuncturist, and was being asked all the standard medical questions during her initial visit, one of which was the date of her last period. "She asked if there was any possibility that I might be pregnant," she said. "I laughed and said 'no.'"
You Can't Feel The Strings
Per the Mirena website, if you can't feel your IUD strings there may be a problem, and that "problem" might be an unplanned pregnancy. "If you ever have trouble finding the threads or feel more than just the threads, Mirena may not be in the right position and may not prevent pregnancy," the site reads.
For Poppy, her IUD becoming dislodged was one early clue she was pregnant. "My cervix began to get very irritated. I found out my body was starting to reject my IUD, when I found out was pregnant," she says.
One sign of pregnancy that absolutely shouldn't be ignored is pain, especially in your abdomen, Farid says. "If you are having abdominal or pelvic pain that does not go away with over the counter pain medications, or you are having heavy vaginal bleeding, you need to be evaluated immediately."
Farid says that although the overall chance of pregnancy is very low in women who have an IUD, women "who do get pregnant while using an IUD have an increased risk of an ectopic pregnancy, which is very risky for a woman's health."
The American College of Obstetricians and Gynecologist (ACOG) website warns that signs of an ectopic pregnancy — vaginal bleeding, low back pain, and cramping on one side — can be mistaken for your period or an intraunterine pregnancy, so it's best to go in or call your doctor if you think you might be pregnant with an IUD.
For Tif Franzen, fatigue was the first sign she was pregnant with a Mirena IUD, but she didn't attribute it to pregnancy. "I had an 18 month old and was always exhausted," she tells Romper. "I went to visit my mom and just slept for like 48 hours straight. She actually gave me a test."
Positive Pregnancy Test
For Gregg, she didn't know — or quite believe — she was pregnant until she had a positive test. "I started hyper-analyzing every symptom that I had with pregnancy in mind until about two weeks after that when I still hadn't started anything like a period and I decided to take a pregnancy test," she says. "I called my partner at work and told him that he needed to come home right now and bring a pregnancy test. Then I locked myself in the bathroom, peed on the stick, saw the lines."
While the ideas of getting pregnant with an IUD is understandably frightening, Farid doesn't want these stories to dissuade people from choosing one. "The chance of a pregnancy is extremely low with an IUD; it is still an excellent form of birth control," she says. "In my career, I have seen far more pregnancies, including ectopic pregnancies, in women using other methods. I continue to recommend it to my patients."