NHS waiting lists for coil fitting causing unplanned pregnancies

[BlueKittens]

AIBU to think that the long waiting lists to fit the (Mirena) coil are causing unplanned pregnancies? Obviously sex and failed alternative contraception is a big factor too, but don’t women have the right to timely contraception provision?

I’m currently a few months pregnant after twice being unable to secure an appointment for a coil fitting at my surgery. There wasn’t even a waiting list for appointments, I was told to come back to check if any appointments were opening up for three months time- and both times was told to come back again. GP won’t put me on pill due to risk and depot caused a reaction. DH refusing vasectomy as he knows someone who suffers chronic ball ache.

Lucky for me it’s a happy little accident, but I can’t help feeling this might be quite devastating for some women.

It’s not just my surgery. Two friends at different surgeries have just told me they have had difficulties getting an appointment too. One is waiting 5 weeks for hers and the other is on a waiting list for when an appointment becomes available, has been told a 3+ month wait. The problem is with the high level of demand and the fact that only one person in each of our surgeries can fit it.

Nevermind the personal costs of unwanted pregnancies- they cost the NHS too in terms of abortions, care etc. It just seems crazy to me, but I guess it’s not a priority in the overstretched NHS.

I've had a coil fitted and I managed to get an emergency appointment as I needed a copper IUD as emergency contraception (which must be inserted within five days of unprotected sex). I waited for hours. I was one of the lucky ones.

I would have had to wait months to have it fitted otherwise.

The clinic was the ONLY one in North London offering emergency coil fitting.

When I last had a coil fitted, it was done within days at a clinic that has now been closed.

The decimation of sexual health and contraceptive services is absolutely shocking and a much bigger issue than most people realise. Combined with the new rules that mean that people only receive working tax credit for their first two children, it is unspeakably poor to simultaneously reduce access to contraceptive services.

While it is a bit of a scandal that the waiting is so long you got pregnant not because of that but because you had unprotected sex! Condoms are your friends here.

Family planning clinics are open and you don't need an appointment

OP here - if you read my subsequent replies, you’ll get a better understanding of my views and experience. We did take responsibility by using condoms for PIV, so I’m not sure what else we could have done to prevent the pregnancy? It happened once only and we were lucky to get pregnant. Anyway this baby is very much wanted now.

I’m literally just pointing out the issue with family planning constraints in the NHS and that it may be contributing to unwanted pregnancies at a population level which does have wider implications. People will continue to have accidents or take risks, it’s inevitable.

@PatrickMerricksGoshawk

1. Have you actually tried to find your local sexual health clinic, or book an appointment? Good luck with the waiting lists and location.

1. This is not an option open to women with abusive partners.

1. Sorry? How is deciding to use a contraceptive (e.g. a coil) not taking responsibility for oneself? The problem here is one of availability. The next time you have a health problem, would it be reasonable for me to deny you timely treatment and suggest that you "Take responsibility for yourself instead of blaming the NHS." ???

Bet you still rely on the NHS to look after you during pregnancy in labour!

I can’t get access to treatment for a life limiting condition.

Ironically, they’re tryint to fob me off with a coil despite my GP being adamant it isn’t suitable.

Although I agree the NHS is under severe strain, some choices they make are hard to take.

I went to my local (oversubscribed inner-city London) sexual health clinic and had a coil fitted the same-day. They removed it same-day when I wanted that too.

You're really not trying hard enough.

@adviceonthepox That is not necessarily true. It certainly isn't the case in my area for sexual health screening, and you also definitely need an appointment for coil insertions.

@BlueKittens

I don't understand, you say the NHS is causing unwanted pregnancies, you were using contraception and awaiting a long term contraception, you wanted DH to have a permanent contraception.

But you were lucky enough to get pregnant?

Just to be clear, this is not a failing of the NHS.

LOCAL COUNCILS are now responsible for sexual health screening and contraceptive services. That is why availability is so patchy, varies so much between different areas, and why huge cuts have been made to provision.

This article from 2016 gives a good overview of who is responsible and what has been happening. Further cuts have also since been made.

www.theguardian.com/society/2016/dec/12/council-cuts-hitting-womens-contraceptive-services-data-shows

I had a phone appointment for an IUD assessment within 2 weeks of requesting one after DC2. The actual insertion came a few weeks later, but only because it's advised to wait until 12 weeks postnatal for insertion. This was in London, a few months ago. There are appointments out there. Or I could have had one within a week at a Marie Stopes.

When I got one after baby #1, nearly 4 years ago, though, I had to go to a walk-in sexual health clinic and wait there for the best part of 5 hours. That was in a different London borough; I'm not sure if that reflects changes in the last few years or differencss across boroughs, but evidently there isn't a squeeze on everywhere.

@Charlie97 read my post again. I clearly stated the alternative is condoms. If you are under 25 lots of areas give you some free

Unfortunately other barrier methods such as caps, diaphragms and sponges aren't generally offered anymore on the NHS.

I'm a contraceptive and sexual health nurse. Our services are being cut which is extremely concerning for our area considering the levels of sexual exploitation, but that's another issue. Gp's in our area are loosing the long acting reversible contraception funding meaning our appointments are filling quickly, the wait for a coil in our service is 4 weeks this is because we need to be able to reliably exclude a pregnancy and infection before fitting. In all the years I've worked in this speciality I've never had a lady I couldn't cover with another form of contraception whilst she waited for the fit. I've also never had a lady fall pregnant whilst waiting for a coil, it is all explained fully at pre counciling and enforced that the responsibility to avoid a pregnancy lies with the patient, If you are unable to take a mini pill I would be checking a Mirena is suitable as it is progesterone based, the same goes for the MAP.

DH refusing vasectomy as he knows someone who suffers chronic ball ache.

I'd overcome this objection by giving him the chronic ball ache anyway, and stopping once he had the vasectomy.

And I wouldn't let him in same room as me unless he was wearing a condom. I bloody hate men who won't share responsibility for contraception.

And this excellent piece by Gaby Hinsliff further outlines the current situation. If you are not shocked and angered, you should be when you realise what has been happening and who is at risk here.

www.theguardian.com/commentisfree/2018/sep/14/contraception-services-cuts-councils-clinics

"But there’s a broader principle at stake, for women both rich and poor, and it’s that contraception is the foundation stone on which so many female freedoms are stacked. Turn back the clock even a fraction, and there are potentially serious implications for young women’s (and young men’s) lives, hopes, education and ambition. We shouldn’t have to wait until the damage is done before acting."

This is not an option open to women with abusive partners.

Most people aren't with abusive partners.

People will continue to have accidents or take risks and that is their responsibility 100%. There is absolutely no need for it to happen.

@serbska

Most people aren't with abusive partners.

Domestic abuse affects one in four women in their lifetime.

The NHS is absolutely falling apart.
I have a progressive, horrible illness.
I constantly have appointments cancelled the day before due to lack of doctors.
I managed to have one course of treatment that really helped, only to be told that I can't have any more unless/until I can no longer walk/breathe.
Too expensive. So I had a few weeks out of the last 2 years when I could actually have a bit of a life and that is my lot.

So I think there are many things that can't be prioritised, not just contraception.

I say that with my 4th baby in my arms who is only here because I couldn’t get a coil appointment for 6 months.

Your baby is not ONLY here because you couldn’t get a bloody appointment - your baby is here because you didn’t use other contraception. Wtf is wrong with using condoms whilst waiting for the appointment? I despair at the lack of personal responsibility and the blame placed at the feet of the NHS which is struggling.

@DaveyouareanuttertwatDave yes they absolutely can replace it at removal

@BlueBug45 your post read like you were arguing with pinklady, the only non viable method she mentioned was the pill!

OP could've used condoms or no PIV (it's a limited time and not all relationships are based on if I can't get my dick in you I'm off somewhere else for it!! Some are based on the long term and understand that things don't always go 100% the way you want! But you're a partnership and a few months non PIV is a non issue£

I can’t go on any other contraception due to health issues so coil, condoms, sterilisation and vasectomy are the only choices.

What about a diaphragm, or are they not a thing any more? Worked fine for me for 20-odd years, but you never seem to hear of people using them these days.

@Charlie97 (un)lucky ... whichever way you look at it. We want the baby now and are happy about it (so lucky). But it wasn’t planned and we weren’t Ttc (so unlucky).