Miannica Frison was in the throes of labor in 2020 when a nurse entered her room at UAB Hospital in Birmingham, Ala. Frison was screaming in pain. But rather than see how she could help, Frison recalls, the nurse said she heard Frison was having her third baby, and asked if she wanted to be sterilized immediately after she gave birth. Outraged, Frison kicked the nurse out of the room.
Doctors eventually told Frison she needed an emergency C-section. As she lay on the operating table, just moments after her son was pulled from her belly, a doctor entered the delivery room. “We can go ahead and put an IUD in right now, since you’re already open,” the doctor said, according to both Frison and her husband.
Frison was woozy from her epidural, but had experienced a traumatic birth, and at that moment, she didn’t think she wanted more children. So she allowed the doctor to insert the Mirena, an intrauterine device (IUD) that would prevent pregnancies for up to eight years. In the months that followed, she didn’t like the way the IUD was making her feel. But Frison says she couldn’t persuade her gynecologist to take it out. The doctor told her she needed to lose weight first, Frison recalls, and that there were medicines to offset the side effects she was experiencing, such as nausea.
It would be three years before Frison could get the device removed. Even then, she had to undergo three procedures, one lasting seven hours, she says, because the device had migrated to the lining of her uterus. It left her with four thumb-sized scars on her belly from where a doctor inserted an instrument to try to find the IUD. The experience caused Frison, a 32-year-old hairdresser, to have a profound mistrust of the medical system. “I don’t have faith in doctors anymore,” she says. “I can’t trust any of them.”
Frison’s experience was more common than one might expect. In the last two decades, doctors have encouraged women to choose long-acting reversible contraceptives, or LARCs, because they are the most effective method of preventing unplanned pregnancies. Doctors and many patients like that LARCs–either IUDs, which are inserted in a woman’s uterus, or implants, which are inserted in a woman’s arm–allow women to “set it and forget it” for years. But an increasing body of evidence indicates that an important public health tool intended to give women agency over their bodies is at times deployed in ways that take it away.
“I don’t have faith in doctors anymore,” Frison says. Nydia Blas for TIME
A TIME investigation based on patient testimonials, medical studies, and interviews with 19 experts in the field of reproductive justice, including physicians, researchers, and advocates, found that doctors are disproportionately likely to push these contraceptives when treating Black, Latina, young, and low-income women, or to refuse to remove them when requested. This pattern, reproductive-justice experts say, reflects the race and class biases plaguing the U.S.