NYC’s “Maybe the IUD” campaign aims to redress decades of misinformation about the contraceptive.

There’s a new set of PSAs on the New York City subway, and they speak directly to sexually-active women:

(New York City Health Department)

“You spent the night in Queens...but you left your birth control in Brooklyn. Maybe the IUD is right for you.”

That refrain, “Maybe the IUD,” is part of the New York City Health Department’s latest effort to raise awareness of and eliminate barriers to contraceptives. These bold, colorful ads, posted in subway cars and bus shelters across the city in English and Spanish, are adapted from a 2010 campaign by the National Institute for Reproductive Health and designed to reach women between the ages of 18 and 30, who are most at risk of unintended pregnancy. According to the Guttmacher Institute, roughly half of pregnancies in the U.S. are unintended; in New York, 6 in 10 are.

Rebranding the IUD

“What we like about it is the ‘maybe,’” says Dr. Deborah Kaplan, assistant commissioner of the city’s Bureau of Maternal, Infant, and Reproductive Health. She stresses that the campaign doesn’t push the IUD specifically. Each poster encourages women to visit the health department’s website and join the #MaybeTheIUD conversation on social media to learn more about different birth control options. “We know that the most effective contraception for any woman is the method that she chooses, that fits best with her lifestyle and any factors related to her health and her partner,” Kaplan adds.

Roughly the size of a quarter, the IUD, or intrauterine device, is a plastic, T-shaped contraceptive that is inserted into a woman’s uterus and prevents sperm from fertilizing an egg. It can stay in place for 3 to 10 years, depending on the type. It’s more than 99 percent effective at preventing pregnancy—significantly more effective than condoms (82 percent), since IUDs eliminate the possibility of imperfect or inconsistent use.

The IUD needs the extra publicity. In focus groups, the health department found that one of the most effective methods of birth control is also one of the most misunderstood. Many women didn’t know that IUDs are removable, covered by the Affordable Care Act, and safe for most women and teens, regardless of a history of pregnancy or STIs.

(New York City Health Department)

New York’s “Maybe the IUD” campaign aims to reverse these misconceptions. “We are by no means saying that this is the right method for everyone,” Kaplan says. “Our goal is to remove barriers to all contraception methods, and we know there's been particular barriers to this method because of cost and because of misinformation, so many women don't know where they can go.”

Awareness and reproductive justice

New York isn’t the first city to embark on this type of project. Baltimore and Tulsa have launched similar awareness campaigns for long-acting reversible contraceptives. But unlike those campaigns, New York’s is aligned with the conceptual framework of reproductive justice. The city partnered with national reproductive justice organizations SisterSong and SisterLove to develop an outreach program that acknowledges the fraught social history of birth control for women of color.

Racism is inseparable from the history of birth control in the U.S. From eugenics laws and forced sterilization to targeted family planning and welfare reforms such as family caps, some U.S. policies have historically functioned as de facto population control for racial minorities. Women of color have worked to uncover these legacies of abuse since the 1970s, even as the national conversation revolves around the struggle, historically led by white women, to defend the legal right to abortion.

For many women, there are issues of trust based on their lived experiences, based on their knowledge of the history, that can be as much of a barrier as not having accurate information in their accessing services such as contraception,” says Kaplan.

Moving forward, the city will work with more than 30 local organizations to engage the community in policies to improve women’s health. “Maybe the IUD” is just the first part of this five-year initiative. Kaplan says that the long-term goals involve “undoing injustice, and particularly looking at the issue of racism and institutional racism on health outcomes.”

The campaign offers a cool-headed counterpoint to the ongoing legislative histrionics over federal funding for women’s health care. In recent years, “there’s been more and more information and training of providers around the country” in birth control options for women, Kaplan says. “But I think we have a long way to go.”

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