Sungold has a great post up at Kittywampus about the little known use of the copper IUD as emergency contraception. I wrote a reply, and figured I would share it here:
No one seems familiar with this whenever I bring it up, and that includes ob/gyn clinicians. In the US, IUDs are supposed to be just as acceptable to insert in nulliparous (never had a baby) women as parous (has had a baby) women. As Sungold pointed out, that is not the reality for all women. I was actually told by my ob/gyn that I wasn’t a good candidate, even though I had already had a baby, because I was divorced. (!!)
According to a midwife who taught me about birth control, the reason why IUDs were not recommended for nulliarous women were because so many of them successfully sued over the Dalkon shield. The company had to pay a much higher settlement to women who never got to have children due to their injuries than they did to those who already had children. The indications for the newer IUDs, including the copper T, originally said the ideal candidates were parous women, but that is no longer the case. New recommendations say that pretty much any woman who does not have active pelvic inflammatory disease is a good candidate.
The Dalkon shield was a completely untested, unresearched, unregulated piece of scrap metal. The copper IUD is a much more carefully created and substantiated device. It has a higher rate of continuance of use than any other form of birth control. Not only do I have an IUD, but the IUD is an incredibly popular form of birth control among female ob/gyns I have very unscientifically surveyed.
The main issue I can see with using IUDs as emergency contraception is that the standard of care is to screen for and treat STDs, particularly gonorrhea and chlamydia, before insertion. With conventional screening, time for results, and then treatment if necessary, you are probably running over the 5 day window. So, even if USian practitioners were comfortable with using the IUD as emergency birth control theoretically, this protocol may be a barrier.