Ten weeks after giving birth, a woman steps into my consulting room. 'Once a Kyleena IUD,' she says, laughing. She is an acquaintance to me and gave birth to her first son. 'Will do,' I cheerfully say back. After admiring the baby photo shoot at length, she comes and lies down on my examination couch. I then first make an ultrasound of her uterus to determine its contents and position. After I visualise her ovaries, she asks: 'Can this IUD come out earlier than the prescribed five years?' For a few seconds, I look at her questioningly. 'Yes of course it can. After 5 years it is advised to remove it or change it but if your desire for children is itching earlier or you have complaints you can always come earlier.'
Six months after I placed the IUD, she made another appointment at my surgery. 'It has to come out,' she says as she sits down in my consulting room. 'Do you have any complaints,' I ask her. 'No, just my desire for children is already itching,' she says with a smile.
This lady suffered 4 miscarriages before having her son. Before that pregnancy, she spent a long time in the fertility programme with her husband. I want to explain to her that a second pregnancy can happen faster than her first. I myself had my 2 children pretty much in quick succession. The second pregnancy was no fun and the first period after the birth of the second can also be called spicy.
'Are you sure? It could also be faster now huh?' I explain to her. She nods. 'Yes I am sure but I don't tell my husband this. That way we are not in a hurry and then once it happens he is surprised. I would like to protect him from such a tough preliminary process and I also think it would be nice to make a baby without a doctor's intervention,' she says firmly. I nod understandably.
Three months after IUD removal, she reports for pregnancy. After a few weeks, she comes to me for a term ultrasound. This time under the company of her two husbands. Her son is asleep in the Maxi-Cosi that her husband carries in under his arm. 'Congratulations!" I say as I clean her belly again from the gel after the ultrasound examination. 'You are already 11 weeks pregnant and it all looks good.' She smiles and deftly steps off the couch. 'That did go a bit faster than expected,' her husband says dubiously.
Pregnancy is harder on her than expected. The eldest son is learning to walk and is constantly exploring. A home renovation was planned earlier and is now in full swing. After the little boy can walk independently and the house is finished with a new bathroom and dormer, she gives birth to a healthy second son. At the end of the first week, I visit her in labour. After we discuss all the check-ups and I look at the new loft where they now sleep, I start talking about childbearing, sexuality and contraception. 'Just do another IUD for her,' her husband says, laughing. 'This time like one with GPS tracker so I can check its location on my app every night!' We all laugh.