WHY isn’t sedation standard for IUD insertion?

I got my IUD replaced today in preparation for the incoming administration, and the difference between today’s procedure and the one I had six years ago with my first IUD were completely night and day.

My first IUD was a Mirena. I loved that thing and 10/10 recommended it to everyone it was appropriate to. But the insertion of it was a complete nightmare. The only thing I was given for pain relief was topical lidocaine on my cervix and it HURT when they put it in. I could feel absolutely everything and it was miserable. The nurses were kind and gave me snacks after, and until now I just sort of assumed that the pain was a necessary evil.

And then we come to today, where I went to Planned Parenthood to get it replaced with Liletta. They were also kind to me and very reassuring when I told them I was nervous, but then the nurse doing my intake asked me if I wanted nitrous oxide (aka laughing gas) for sedation. I of course told her I would love some, but I had driven myself there and had to drive home.

But y’all. Nitrous leaves the system so fast you CAN drive yourself home! I signed that consent form so fast it was astounding. They gave me a little plastic hose thing attached to the gas bottles to puff on, and I was high as a kite in like five minutes. I was awake and conscious for the whole procedure, but the sedation dulled the pain and made it so that I didn’t care! It was sooooo much more pleasant than my first IUD insertion, and that was especially amazing because evidently I have a very oddly positioned cervix and they had to call in a second NP just to help find it, grasp it, and get it ready for the procedure. Meanwhile I was just laying on the table chilling and talking about my job to the nice nurse that was holding my hand. After it was over, I sat there for a few minutes to wake up fully, and then drove myself home.

It was great of them to sedate me but it does really make me angry that even light sedation like that isn’t the norm. It’s an absolute game changer in terms of comfort and ease of the procedure. The stupid myth that IUD insertion is only slightly uncomfortable needs to die, and hopefully more doctors will offer sedation until it becomes the standard of care, period. With all the complications from my insertion today, I’m not sure I would have been able to finish the procedure if they hadn’t given me the nitrous.