I had my IUD inserted by Kendall Adams at NOVA Physicians to Women, and she rx'd misoprostol the night before to soften the cervix and did a lidocaine injection the day of. I get the impression that this is something they do at their practice as a matter of course, and they offered it before I even asked about pain management. I appreciated that they were proactive about bringing it up, which gave me the option to opt out instead of putting me in a position where I had to ask (or worse, beg). It felt very validating and empowering. Also, she's just a very kind and patient doctor with a great bedside manner.

(FYI, my insurance did not cover the lidocaine, but the practice was very clear that might be the case in advance.)