Stuff You Missed in History Class · iHeartPodcasts

The IUD: A History

March 18, 2026·45 min·4 clips

Early intrauterine pessaries made of metal caused infections and required frequent, painful doctor visits for insertion.

1. Stuff You Missed in History Class covers the full history of intrauterine devices, from ancient pessaries to the 2025 WHO pain management guidelines. 2. Host Tracy Wilson says the episode was inspired by internet conversations that have reduced IUD pain to a meme — 'they don't even do pain management' — that she argues now scares people away from seeking care. 3. The episode traces a device used by an estimated 160 million people worldwide whose popularity varies dramatically by country, partly due to its history. 4. Two common origin stories — stones placed in camel uteruses by nomadic peoples, and references to Hippocrates — are examined and found to be unsupported by documented primary sources; classicists Rebecca Follis and Helen King traced the Hippocrates claim to a passage in Diseases of Women that describes opening the cervix, not inserting a contraceptive device. 5. The pessary is identified as the most likely precursor to the IUD: a vaginal support device with documented use going back more than 2,000 years, made historically from materials including hammered brass, waxed cork, gold, silver, sponges, wax, and what may be half a pomegranate. 6. By the late 19th century, intracervical and intrauterine pessaries were in use, with stems that extended through the cervical canal into the uterine cavity; gynecologist Mary Halton — the only woman doctor mentioned in the episode — was considered the leading US expert and reported using them on more than 700 patients. 7. The first published description of a true IUD was by physician Richard Richter in 1909 in the German Medical Weekly, describing a silkworm gut loop attached to a bronze wire for X-ray visibility; his longest-using patient had kept one in place for four years with no complications. 8. Ernst Grafenberg developed a flexible silver ring in Weimar Germany, presented it at Margaret Sanger's 1928 course and the 1929 International Sexual Reform Congress, and published results showing a 1.6% failure rate in 1931 — but was denounced by other gynecologists who associated it with infection risks. 9. Grafenberg was Jewish and was fired from his Berlin hospital position in 1933 after the Nazis came to power; arrested in 1937, he was released with Margaret Sanger's help and fled to the US in late 1940 — and the G-spot is named after him based on a 1944 publication. 10. In parallel, Japanese gynecologist Tenrei Ota developed the Ota ring in 1933, combining a Grafenberg-style loop with a central gold ball based on a story about gold balls preventing pregnancy in cows; the Japanese government banned IUDs in 1936, and Ota had to go into hiding under an assumed name. 11. Two 1959 papers — by Dr. Willi Oppenheimer in Israel and Dr. Atsumi Ishihama in Japan covering 18,000+ patients across 150 hospitals — helped revive IUD research by showing failure rates below 2% and no pattern of serious side effects. 12. The Margulies spiral (1959) and Lippies loop (1962) were the first IUDs made from polyethylene, enabling thinner insertion tubes; the Lippies loop added nylon strings exiting through the cervix for patient self-checking. 13. Dr. Howard Tatum developed the Copper T-200 with scientist Jamie Zipper after Zipper discovered in 1968 that copper wire had a contraceptive effect in rabbit uteruses; this was the first copper IUD. 14. Dr. Antonio Scomegna, born in Italy and a Fulbright scholar who first came to the US in 1954, developed Progestisert in 1970 — the first hormone-releasing IUD — intended to reduce the heavy menstrual bleeding associated with copper devices. 15. The Dalkon Shield, introduced in 1968, sold 2.2 million units in the US by 1974 but was linked to at least 18 deaths and more than 300,000 lawsuits due to its multi-filament string design facilitating infection; a $2.5 billion trust was established in a 1989 settlement. 16. After the Dalkon Shield scandal, US IUD use dropped from about 10% of contraceptive users in 1970 to less than 1% by 2000; the Medical Device Act of 1976 placed IUDs in the highest FDA risk category. 17. In the rest of the world, IUDs became more popular: by 1985 an estimated 60 million people used them, with 40 million in China, largely because China's 1979 one-child policy required IUD insertion or sterilization after a first child. 18. Tracy notes the coercion-liberation contradiction: an IUD can be empowering for someone with full bodily autonomy, but it can also be imposed — she cites Britney Spears's 2021 statement to a probate judge that her conservatorship team would not allow her IUD removed. 19. A 2023 study in the European Journal of Contraception and Reproductive Health Care found that 2.5% of patients had no pain during IUD insertion and 49.7% had intense pain; CDC guidelines since 2016, WHO guidance updated in 2025, and a 2025 ACOG clinical consensus all require providers to offer multiple pain management options and create a patient-centered plan. 20. Tracy argues that the internet shorthand 'they don't even do pain management for IUD insertion' grew from real medical sexism but has become counterproductive, discouraging people from seeking care when the situation has changed.

As heard by us

A compact history of the IUD that follows contraception through medicine, taboo, repression, and cross-border advocacy.

The IUD: A History frames contraception as medical history shaped by politics, taboo, exile, and repression. Its strongest thread follows the device across borders, from Weimar-era sex research and the Nazi destruction of the Institute of Sexual Science to Ernst Grafenberg's…

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