I am grateful for the endorsement in respect of intracervical local anaesthesia (LA) for intrauterine device (IUD) fitting that has been offered by both medical and nursing colleagues.1 2

Intracervical LA is easy to do, easy to teach and can make a very significant difference to both the procedure and the patient experience. While it may not be necessary for all, my contention is that it is a technique that should be both available and offered to all women contemplating an IUD fitting. I would agree with Ann Eady2 that this can be available to nurse fitters just as to doctors.

I remain uncomfortable with the ethics of not being prepared or able to offer an option that will reduce pain if this can be anticipated. I propose that LA should become an integral element to the practical aspect of training. I do however feel that the e-SRH module 18 pertaining to this needs some modification and would ask that this be considered.