UNC Women's Health provides numerous paths to contraception for students

The first intrauterine device (IUD) was introduced almost 50 years ago, providing a safe and reversible contraceptive alternative to traditional oral hormonal medication, commonly known as the pill. Today, Women’s* Health Services at UNC offers four different IUDs and a variety of other long term and short term reversible contraceptive services, and students are taking advantage of it. 

Visha Burkart, the Women’s Health nurse for Campus Health Services, has noted a growing trend in students asking for IUDs and Nexplanon, the hormone-releasing implant placed in a patient's upper arm, rather than the pill.

“We go through phases where everybody who comes in wants a Mirena (a type of IUD), and then everyone wants Nexplanon,” Burkart said. “It’s always interesting to see the different ones each week. A lot of times, it’s word of mouth. Implants and IUDs are most popular, however we do have a large contingent of patients who still use oral hormonal contraceptives.” 

In her experience, Burkart has noticed that college students who had previously used the pill in high school want to switch to a contraception that does not require daily attention. 

“I was on the pill and wasn’t taking it every day, so my mom made me switch to the shot. I had to get it every three months and it was getting too complicated,” junior Jenna Dunsmore said. “When I came back to school, I got an IUD because it lasts three years.” 

Some patients already have preferences in mind when they consult Women’s Health for their first form of birth control. 

“I’m way too irresponsible to take the pill so I have Nexplanon. It’s my first form of birth control," junior Charity Taylor said. "If I happen to not use a condom, I’m not worried anymore."

Despite the increased effectiveness of long acting reversible contraception, Burkart said it can sometimes lead to a lack of care toward STI prevention. 

“Something I do is a lot of STI screenings,” Burkart said. “There are so many fantastic methods of contraception that are almost failsafe, that sometimes I feel like our student population might not use barriers as often as people in my generation because everyone was terrified of AIDS. Now people are less concerned, so I would encourage people to keep using the barriers that we have here for free.” 

In every room on the third floor of Campus Health, home to Women’s Health, there are baskets filled with condoms. Some providers will give patients brown bags and encourage them to fill it with the many free, one-time contraceptive options provided. Some students rely solely on condoms for birth control, either out of feasibility or from negative experiences with hormonal contraception. 

“I started the pill my sophomore year of high school, and it made me throw up a lot so the doctors recommended me to go off of it,” sophomore Cameron Thompson said. “I use a condom instead. I’m not that concerned.” 

Thompson’s experience with negative side effects is the primary reason patients ask to switch methods or be taken off of them completely. These effects typically take three to six months for the body to adjust to, and Burkart typically advises her patients to wait at least six months before discussing removal of long-term methods or altering short-term ones.  

Despite the increasing desire from patients for an IUD or implant, Family Nurse Practitioner Margaux Simon said the pill is still the most widely used form of contraception among students. While there are numerous types of other methods, the pill has seemingly countless varieties and carriers. 

“I take the pill. I like how I still get periods, and every month I know I’m not pregnant," sophomore Madeline Gautreaux said. "You don’t have to buy a pregnancy test. It also regulates and clears acne."

Regardless of the patient preference or fears, the team at Women’s Health welcomes discussing any concerns patients have about the medication or the process. Some first-year students who come to Women’s Health seeking contraceptive options have fears about their parents knowing details of their sexual health. 

“A lot of parents are very supportive of their children having safe relationships, safe sex and the best sexual health care in terms of contraceptive options,” Burkart said. “For the few parents that have a lot of pushback, the kids come in and say my mom said, ‘If I start birth control, I’ll be a slut.’ That’s our opportunity to educate them.” 

Women’s Health also works with Counseling and Psychological Services to support the wide range of needs for students seeking broader support for their sexual health. 

“It’s whatever works best for the student, so as long as they have what they need,” Burkart said. “I just want to support them and educate about everything we have to offer.”

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