So while I was jet-lagging in Greece I ran across this cool post from Em & Lo

illus. of Paraguard IUD via Med.unc.edu

Move over, Pill! According to the American College of Obstetricians and Gynecologists (ACOG), the IUD is a whole lot more effective — and safer than was traditionally thought. For a long time IUDs have been recommended only for women in long-term monogamous relationships who’d already had children — this was based on concerns that IUDs raised the risk of pelvic inflammatory disease (PID), which, left untreated, can cause infertility. But according to ACOG, the evidence does not support these concerns — meaning, IUDs do not cause PID.

When you combine this news with what we already knew — the overwhelming effectiveness of a device that you insert once every five or ten years, as compared to a pill that you have to remember to take daily — it’s kind of a no-brainer. Or, at least, the IUD is definitely a contender. Currently it’s the redheaded stepchild of the birth control world — in 2008, IUDs, were the chosen method of 5.5% of women using contraceptives (and only 1.3% in 2002). But as more and more women find out that (a) IUDs are a lot safer than they’d been warned and (b) a lot more effective than the Pill or condoms, we’re guessing that will change.

Source: Em & Lo

And since I was jet lagged... and since the rest of my family traitorously were all sound asleep, I wrote the following... which I just discovered got Em & Lo's comment of the week award a day or two later.  Here's what I said then.  And since it was only a week or so ago it's still true. :-)

It’s been, what, 45 years since sales of the infamous Dalkon Shield IUD were suspended. And virtually everything we “know” about how bad IUDs are comes from… the Dalkon Shield. It’s also been roughly 40 years since the first copper-wrapped mini-IUD was introduced.

This is still not to say the IUD is perfect for everyone, but as you say it’s more perfect for more people than The Pill or other heavy-duty hormonal contraceptives like shots or Norplant.

If the ACOG has greenlighted it a lot of caregivers who’ve been reluctant to prescribe IUDs are more likely to get on board.

For what it’s worth, one of the biggest arguments against IUDs is that they don’t protect from STIs. But since hormonal contraceptives don’t either that’s always been a wash. But with IUDs you can use condoms for what they do best: minimize risk of STI transmission, while leaving the IUD to do what itdoes best: preventing pregnancy when there are condom slip-ups.

Finally, speaking of condoms, for people who could be “fluid bonded” but still rely on condoms for contraception, the up-front cost of an IUD might be relatively high but five to ten years worth of condoms aren’t exactly cheap either.

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I ought to add that whereas I've always thought that if I was a woman I'd use an IUD it's also the case that since I'm a man I got a vasectomy at age 21, a reversal around age 42, and a second (and final) vasectomy around age 45.  What the ACOG is saying is that you no longer have to think of yourself as a risk taker or a pioneer for seeing if it would work for you.