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What Happens When You Get Pregnant While You Have an IUD?

After a photo of a baby holding the IUD that was supposed to prevent it went viral, we asked an expert to explain how the hell that happens.

Gabby Bess

Gabby Bess

Thank God for birth control. Modern medicine has given women have the ability to choose when they become pregnant, and the IUD in particular has made it simpler than ever to control our reproductive system. If you can endure some of its annoying side effects, all you have to do is pop that sucker in and forget about it for up to 10 years. With yesterday's House vote to repeal the ACA and many of its protections for women's health, it may be more important than ever to have this longterm solution.

But as we all witnessed in horror when a new mom's Instagram of her baby holding her failed IUD went viral, there is a possibility that the birth control method can be unsuccessful at preventing pregnancy. According to reports, Lucy Hellein gave birth to a nine-pound, one-ounce boy on April 27, even though she had a Mirena IUD—which works by releasing a low level of levonorgestrel into the uterine system—inserted last year. To capture the irony, she placed the IUD in her newborn's hand for a photo after it was removed from her placenta. She captioned the image, "Mirena fail!"

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Hellein told the Independent that she was shocked when she found out that she was pregnant. Reading her story, I was shocked, too. I don't want this to happen to me! Going through several different disaster scenarios in my mind, I also started to wonder: What do I do if it does?

"All methods of contraception have a failure rate," Dr. Colleen Krajewski, a consultant at Bedsider, a non-profit birth control support network operated by the National Campaign to Prevent Teen and Unplanned Pregnancy, reminded me to calm me down.

But a "Mirena fail!" is rare. "To use rough estimates, about one out of four women using condoms become pregnant, about one in ten women using birth control pills become pregnant, and about two in 1000 become pregnant on Mirena," she said. "In other words, if a car full of women were all using condoms as their only contraception, one is likely to become pregnant; one woman out of an elevator full of women using pills; and one out of a concert hall full of women using IUDs."

The fact that IUD pregnancies are so rare is part of why they're shocking to hear about, Dr. Krajewski adds. But in Hellein's case, her IUD was still inside of her when she gave birth, which is the part that disturbed me the most. Her doctor thought it had fallen out since it didn't show up on her initial ultrasound, but it hadn't. What's up with that?

"In the very, very, very rare event that a woman becomes pregnant with an IUD in place, on the ultrasound the IUD often appears 'displaced'—and in fact it is—by the pregnancy," Dr. Krajewski explained. "When a pregnancy is growing in a uterus, the IUD moves. It's hard to say which came first."

Dr. Krajewski says it's not harmful to your health to have an IUD and a pregnancy at the same time. If you decide to remain pregnant, it's not harmful for the fetus, either. "The hormone in Mirena is progesterone. It's not harmful to a pregnancy," she said. "In fact, your body produces high levels of progesterone in pregnancy—it's 'pro-gestational.'"

It can be hard to tell when you've missed a period when you have an IUD since Mirena lightens menstruation. Hellien says she didn't know until she was 18 weeks, when she went to the doctor. "This delay can be very scary for patients to think about, which is understandable," Dr. Krajewski says. So if you're paranoid about the small risk and are definitely not interested in carrying a pregnancy, she recommends that you "use the money saved on tampons and pads to buy a few tests to keep at home for peace of mind."