Inclusion Criteria:  Provision of signed and dated informed consent form Nulliparous adult females age 18 years or older (nulliparous is defined as no prior pregnancies greater than or equal to 20 weeks of gestation) English-speaking patients Undergoing insertion of a copper or levonorgestrel intrauterine device Willing to comply with all study procedures  Exclusion Criteria:  Non-English speaking patients Patients with a support person in the room during IUD insertion Patients desiring a paracervical block for analgesia