Little information
Sun Xiaoming, an expert on demography at the Nanjing University of Posts and Telecommunications, said that around 25 percent of the women living in rural areas never had their IUDs removed.
The family planning services offered by local governments at the grass-roots level used to stress reducing fertility and did not bother to tell women to eventually remove the devices, said Sun, adding that "[Many women] missed the best time [to remove their IUD]."
Women of childbearing age enjoy four free services as part of the family planning policy, including taking the IUD out, but only those who meet certain requirements - women who are allowed to have another child or cannot continue to have the IUD for health reasons. Those who do not meet this requirement cannot have their IUDs removed for free.
Hai said that women who lose their only child can also get a free operation to remove the IUD but the suffering they feel is not only physical but also mental.
"Many of these women are around 40 years old or even 45. They have to stand the pain during the removal operation, get pregnant and some may have several miscarriages," said Hai.
Chen Suwen, an obstetrician and gynecologist from Beijing Obstetrics and Gynecology Hospital was quoted by The Beijing News as saying that the medical services in some places are poor and many women who cannot get their IUD removed locally come to Beijing. Scans can cost more than 1,000 yuan ($144) and follow-up treatments can cost even more.
Sun said that these fees are not included in most places' medical insurance policies and many poor women cannot afford the operation.
Sun conducted a survey into the main problems and requirements of women after their menopause for the NHFPC, during which he found that the average fee to remove the IUD is around 100 to 150 yuan, around 150 to 200 yuan for those whose have uterine damage, and 1,000 to 3,000 yuan for those whose IUDs have become embedded in their uterine wall.
Sun and his team estimate that there will be about 26 million women in China that need to have an IUD removal operation in the next 10 years after hitting menopause, which could cost these women around 2.6 billion yuan in total.
Dealing with the legacy
Some local governments in the country's more developed regions are taking action.
A district in Yancheng, East China's Jiangsu Province has included IUD removal operations into their family planning service and notify those who are registered with their system to have the operation after they begin menopause, Xinhua Daily reported.
People working in the family planning bureau in Jinan, East China's Shandong Province have also conducted a series of activities on this issue, including publicizing this kind of information and offering women operations, according to The Beijing News.
Sun said that the central government has also attached importance to the IUD issue in recent years and has set aside funds to deal with it.
"But the obstacle lies in how to get local governments to push the publicity and operations actively, especially in central and western regions," Sun said, mentioning that these regions have promoted IUD removal operations among women of childbearing age after China announced it would get rid of the one-child policy in October 2015.
The NHFPC also said in December 2016 that local governments would offer free operations to remove IUDs for more than 18 million women who want to have a second child.
"We should not only pay attention to improving medical services for those who want to remove the IUD to have a second child. Women who received the IUD for our family planning policy and entered menopause should not be forgotten. It's our responsibility," Sun said.
