#HayleysIUD Sparks Conversation and Controversy on Twitter

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On September 15, 2015, One Medical’s Twitter page blew up, all thanks to one phrase: #HayleysIUD. The originator of the hashtag, One Medical patient Hayley MacMillen, wasn’t just mentioning her new intrauterine device; she was live-tweeting its insertion. Reporting from One Medical’s Wall Street office, the Refinery29 editor updated her followers with every step of the appointment, providing a candid glimpse of the experience from a patient’s perspective. We followed up with MacMillen to discuss her thoughts on birth control, women’s reproductive rights, and the perks of being a One Medical member.

Q: You’ve been outspoken on social media regarding women’s reproductive rights–how did you know an IUD was the right choice for you? 

A: I first considered an IUD while living in East Africa, in Burundi, a very Catholic country. I was relying on condoms rather than the pill for pregnancy prevention at the time, and when I found myself facing a pregnancy scare, I wasn’t able to access emergency contraception right away. I never wanted to feel that panic again, so I resolved to get an IUD as soon as I got back to the US two years ago. I was initially attracted to ParaGard because I thought it might be better to forego the hormones after having some previous weepy times on the pill, but decided to switch to Mirena last month for lighter periods.

Q: When did you decide you wanted to live-tweet your experience, and what motivated the decision?

A: The day before my IUD insertion, I was discussing the procedure with my coworkers when I joked that I should live-tweet it. Then I thought, “why not? So many people are curious about IUDs.” I often write about birth control for Refinery29 and we see special interest in stories about IUDs. My tweets were intended for women considering an IUD, and I was surprised and gratified when the discussion they sparked extended beyond that group.

twitter2Q: Now that it’s been a few weeks, how’s the IUD treating you?

A: So far, so good! I’ve already experienced much lighter bleeding with Mirena than with ParaGard and no significant changes in complexion or weight–two concerns women cite about Mirena. I’ll stay attuned to how I’m feeling as my menstrual cycle stabilizes, but in the meantime I’m enjoying worry-free sex and not bleeding all over everything. I encourage all sexually active women of reproductive age to consider Long Acting Reversible Contraception (LARC) and have the opportunity to “get it and forget it.” It puts you in control. And I recommend One Medical’s professional IUD services, which I’ve used twice now, as well as One Medical in general as a one-stop shop for achieving what “health” means to you.

Q: How did you know One Medical was the kind of practice where live-tweeting a procedure would be okay?

A: As soon as I met the provider [Carrie Bowler, DO] who was going to insert my IUD, I asked if she was alright with me typing on my phone to report the entire experience, and she said yes. I feel comfortable and informed at every step of my One Medical appointments and I had a feeling that my provider this time would support me sharing information with a wider audience. Afterward, she even joked that maybe everyone should live-tweet their insertions to distract from the pain.

Q: You tweeted your appreciation for One Medical Group and said you’ve received “great/fast/convenient care” in your years as a member. In your experience, what makes One Medical unique, and how do you think the group’s approach to women’s health is special?

A: I can’t overstate the convenience of managing my healthcare primarily online, as One Medical allows. I do everything else online; why not schedule appointments and communicate with my providers that way? And I appreciate that I can address any of my disparate health priorities through a single organization, thanks to One Medical’s network of primary care providers and specialists. One Medical is there to provide counsel, but not to persuade: Female patients are considered the experts on their own lives.twitter1

Q: Your tweets painted a very realistic picture of the IUD insertion experience–do you think there is a lack of that sort of honest, play-by-play dialogue today around health care and women’s health in particular?

A: I honestly was surprised by the intensity of the responses, both positive and negative, to my play-by-play description of my insertion. A few different websites even reported on my tweets. People told me that what I did was brave, but I didn’t see it that way because I’m not embarrassed about what I shared. There is still so much stigma attached to women who have sex, even more to women who have sex and talk about it. The idea that birth control is shameful is just an extension of the idea that sex is shameful. When we get over that, we can start to talk about the health needs of humans who have sex or have female bodies or have both and how to address them.

Q: One of your tweets following the IUD insertion was about a man who responded, “we don’t understand what y’all go through so we can have unprotected sex.” You pointed out that hormonal birth control is about much more than sex – can you elaborate on some of the other reasons you think it’s an important option for women?

A: While it’s important to understand the reasons a woman might choose hormonal contraception other than staying baby-free – including treatment of endometriosis, relief of cramps and Polycystic Ovary Syndrome (PCOS) symptoms, better skin, and reduced menstrual blood flow – it’s most important to remember that a woman should never have to justify why she is on birth control. Our health decisions are between us and our doctors.twitter4

Q: Your tweets came just days before the House voted to block federal funding to Planned Parenthood. According to the organization, “this bill would eliminate all federal funding for Planned Parenthood health centers — including funding for birth control, cancer screenings, HIV testing, and more.” What would you tell lawmakers about the importance of Planned Parenthood’s services, including birth control?

A: Congress’s Planned Parenthood witch hunt would be mind-boggling if it weren’t the same game that politicians have been playing with women’s bodies, especially underserved women’s bodies, for decades now. Fifty-four percent of Planned Parenthood clinics are in underserved areas and other clinics are not equipped to absorb the 2.7 million patients Planned Parenthood serves every year. When we cut access to contraception, the result is STI and HIV outbreaks, as in Indiana, and higher rates of unplanned pregnancy. It’s that simple.

Q: What other reaction have you gotten in real life or on social media from people who heard about your experience?

A: Other than the reactions of a handful of trolls who found my tweets after Planned Parenthood’s Cecile Richards tweeted about them, the response to #hayleysIUD has been overwhelmingly supportive. I received so many tweets from women speaking out about their own IUD experiences, as well as simple appreciation for the open conversation. Women are hungry to talk about their sexual and reproductive health without embarrassment or shame, even more than I realized. We don’t want to feel alone, and we don’t have to.

Q: At any point in this process, did you have any reservations about being so public about something many people consider very personal?

A: I actually consider myself on the private side, but I view my sexual and reproductive health decisions differently than my personal relationships or emotional life. I don’t feel I have to keep quiet about what I deal with as the owner of a female body. I’m looking forward to the day when talking about your IUD insertion is like discussing your dentist appointment: routine, even boring. Reproductive health care is just health care. And women taking charge of their health is cause for celebration, not silence.

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The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.

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