So I emailed Dirk Wildemeersch, the Belgian gynecologist who invented the GyneFix. I attached my ultrasound records and asked if it had actually been embedded in my uterus. The IUD was completely within my uterine cavity, he replied, and not at all embedded. Wildemeersch told me that I’m still a good candidate for the GyneFix, and I could visit his clinic in Belgium to get another. Canada was no longer an option because I’d been part of a clinical trial that had since ended, and the GyneFix isn’t yet commercially approved there.

One in 15 women have a uterine abnormality, which typically affects the walls and shape of the uterus. And even “normal” uteruses are different. “Individual variations in the size and shape of the human uterus are probably greater than variations in the size and shape of the human foot,” wrote the late OB/GYN Harrith Hasson, who invented the surgery that removed my GyneFix. For instance, uterine widths range from less than 10 millimeters to more than 50. Women who haven’t given birth average 27—a millimeter smaller than the narrowest IUD available in America, the Skyla. Women can use IUDs that are wider than their uterus, but they come with a higher risk of side effects like failed and difficult fittings, pain, abnormal bleeding, expulsion, embedment, and pregnancy. Just 30 percent of women who haven’t given birth opt to keep in a standard 32-millimeter width copper IUD, such as the ParaGard, after one year. By contrast, 70 to 90 percent stick with narrower IUDs or rods like the GyneFix even after three years.

Countries around the world accommodate women’s biological variations and personal preferences with IUDs of different mechanisms, designs, sizes and costs. There are IUDs shaped like balls, loops, omegas, and snakes, and ones made with steel, gold, and even anti-inflammatory drugs. In Britain, there are 22 types of IUDs available, including several short variations for women like me. In Canada, there are nine.

But not in America. In the U.S., there are only five types of IUDs, all with the same T-shape: four hormone-releasing IUDs, which vary only in their size and how much hormone they emit daily, and the copper ParaGard, which has been on the market since 1988. Though the American College of Obstetrics and Gynecologists regards long-acting reversible contraception like IUDs as the gold standard of birth control, America’s IUD options lag far behind other countries’.

* * *

The prevailing explanation for the U.S.’s limited number of IUDs is the Dalkon Shield. In the early 1970s, before the FDA regulated medical devices, this plastic, beetle-shaped IUD caused thousands of injuries including infections, infertility, and even death. Americans filed 300,000 lawsuits–the largest product liability case since asbestos–against and bankrupted the manufacturer, A.H. Robins Company. After the Dalkon Shield, market demand for IUDs died. In the 1980s, contraception innovation nearly halted, and the manufacturers of four of America’s five remaining IUDs pulled their products from the market. Some think that, nearly 50 years later, the Dalkon Shield explains why still just one-in-ten American women use IUDs, compared to several times that many in Europe and Asia.