The only reason I ever got my Mirena IUD was that it was the first month Obamacare kicked in for mandatory birth control coverage and my insurance covered it. Before then, I wasn't willing to entertain the idea of an $800+ option when I was doing okay with other things (mostly nuvaring). Mirena was by far one of the best forms of birth control I had ever used though :)
There are definitely problems with the procedure and the IUDs themselves for plenty of women, too, let's not ignore that. But it is hard to screw up and it is a pretty easy method. I hope that better coverage leads to more IUDs and less unwanted pregnancies :)
All IUDs can perforate a uterus. Any form of birth control can cause side effects. Any medication can cause problems in general. Hell, pregnancy has side effects and can potentially cause death :P
You just learn to know what to look for and you get it looked at, that's all. And your doctor can tell you if you're not a good candidate for a particular medication (i.e. smokers shouldn't use hormonal contraceptives), like you should be doing already.