How were Ivana Trump’s children conceived while she had an IUD?

Could Ivana Trump Have Conceived All Three Children While She Had an IUD?

Could Ivana Trump Have Conceived All Three Children While She Had an IUD?

Health and medicine explained.
Dec. 5 2017 1:54 PM

Could Ivana Trump Have Conceived Three Children While She Had an IUD?

The device has failed before but statistically speaking, this is extremely unlikely.

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Donald Trump Jr., Ivanka Trump, Eric Trump, and Ivana Trump.

Photo illustration by Slate. Photos by Leigh Vogel/WireImage, Chip Somodevilla/Getty Images, Joe Raedle/Getty Images, Cindy Ord/Getty Images For NYFW: The Shows

Ivana Trump’s recent memoir Raising Trump is a breezy account of her central role in bringing up three of America’s most powerful children. As she tells it, her life was a series of ski trips and interior redesigns packed between working at her husband’s company and raising her kids. Her ex-husband and our current President Donald Trump seems largely absent, stopping in only to worry whether his namesake might grow up to “be a loser.” But even with that, the most horrifying part of her autobiography is undoubtedly her assertion that she conceived all three of her children while having an IUD.

It all starts on Page 59 of the book when Ivana makes mention of the circumstances surrounding the conception of her first child, Donald Trump Jr.:

Incredibly, I got pregnant on the honeymoon. Why so incredible? At the time, I had an IUD implanted in my uterus. The odds of conceiving with the coil were miniscule. I always thought I was a one-in-a-million woman, but this was ridiculous.
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Within five pages, she’s gone through two more IUDs—and two more children:

For birth control, I considered going on the Pill, but I knew I’d forget to take it at the same time every day. With some misgivings, I had another IUD put in. Three years later, the same thing happened! I got pregnant with Ivanka despite having the device
[…]
A new IUD went in, and the doctors swore up and down it was going to work this time. ‘Ivana, you will not get pregnant!’ they said.
A year and a half later, Eric was conceived.
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That’s right—every single one of the Trump triad apparently exists in spite of their mother’s repeated efforts to shut down the factory. That seems alarming regardless of the form of birth control to which you subscribe. But if, like Ivana, you have an intrauterine device or rely on one, these stories are only that much more terrifying. Indeed, you might be screaming how is this possible?

So, I called Dr. Jen Gunter, the internet’s favorite OB-GYN, to get some answers. She says that what Ivana Trump describes in her memoir is certainly possible—but it is statistically improbable. “Obviously, IUDs aren’t perfect, they have a failure rate,” Gunter says. Back in the 1980s, some European IUDs, which Gunter suspects is what a wealthy woman like Ivana Trump would have likely chosen for herself in that time, could have failure rates in the neighborhood of 2 percent. “But you’re still looking at less than 2 percent. A 2 percent failure rate in your next pregnancy, and a 2 percent failure rate in your next pregnancy,” Gunter says. “That’s a little weird.”

By describing it all as a “little weird,” Gunter is being generous: If the IUDs were not compromised in some way, and if we generously round up to a firm 2 percent failure rate, the statistical chance of Trump experiencing three pregnancies while using this form of birth control is 0.0008 percent, making it the kind of statistical disaster that would befall no more than 8 in every 1 million women—or at least, that would be the expected rate 30-plus years ago. Modern American versions of the IUD have dramatically lower failure rates—we’re talking between 0.1 and 0.8 percent—making Ivana’s dramatic childbirthing triptych even more improbable today.

Another thing that could explain Ivana’s situation is that her IUDs were not working perfectly. In a blog post on the very topic of Ivana Trump’s pregnancies, Gunter writes about women who have IUD failures and notes that this can happen multiple times before the cause is discovered. In cases where women’s IUDs repeatedly fail, doctors first wonder if it’s the result of a physical abnormality: Fibroids, benign tumors, and even curvatures of the uterus can knock the IUD out of its ideal resting place. Other times, women suffer from “expulsions” where the uterus kicks the IUD out, sometimes without its owner even realizing until she finds out she's pregnant. But whatever the cause, we can all agree that, as Gunter puts it, “After two failures you’d think, ‘Are you sure this is what you want to continue with?’ ”

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There are, of course, many alternatives to IUDs. But it seems that Ivana might not have had another good choice that she wanted to try. Gunter writes in her blog that Donald Trump apparently “hates condoms.” Regardless of whether that’s a fair inference to draw from the president’s “jokes,” it seems safe to infer that the couple didn’t want to solve their problem through condom use, which, to be fair, is also not fail-safe. As Ivana notes herself, she wasn’t interested in taking on the daily tedium of the pill. And ultimately it seems the couple was actually happy about each pregnancy, so perhaps she didn’t switch because she wasn’t actually that bothered by the situation. As she writes in the book, after she had Eric, she decided to have her tubes tied, which is by far the most reliable—and permanent—form of birth control.

Still, the improbability of Ivana Trump’s claims, combined with their very public nature, has pushed Gunter to propose some alternate theories. Perhaps the stories were framed in such a way that stressed the family’s commitment to keeping unplanned pregnancies. “It’s possible it’s an anti-abortion dog whistle,” Gunter said, who admits that she also hasn’t read the book and has “a thousand other books” she’d want to read before this one. Or maybe they are just there as an attempt to flatter her ex-husband. Gunter’s blog post is titled “Does Ivana Trump want us to believe The Donald has super sperm?” In it she writes, “The other [theory] is, ‘My god, Donald has the best sperm ever. He’s just shooting the best sperm out of his Trump tower.’ ” Knowing our president, this explanation, while disturbing on multiple levels, does not seem implausible.

Ultimately, Ivana Trump’s uterine dramas are great fodder for a memoir, but they’re no reason to freak out about the efficacy of IUDs. It’s still the most reliable form of birth control, and the statistics are in your favor. Plus, here’s a useful tip from a Broadly article explaining a similar situation, in which a woman got pregnant after her IUD failed and took a photo of the resulting baby holding the device: Spend the money you save on tampons and pads (IUDs often stop your period) on a stock of pregnancy tests for peace of mind. And if the type of birth control you are using fails or turns out to not be ideal, there are still numerous other options (pills, patches, condoms, spermicides—you name it) that might work better for you, and it’s your doctor’s job to help you find the method that’s best for you.

While we may never know exactly what was going on with Ivana Trump’s uterus, one thing does seem clear: Her ex-husband has always been out to undermine birth control.

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Eleanor Cummins is an intern at Slate. Her reporting interests run the gamut of science. Follow her on Twitter.