We Have to Stop Stigmatizing Birth Control
It shouldn't be an incomprehensible, mythical beast.
Much of the conversation around abortion rights inevitably morphs into a discussion about birth control, and without fail swarms of people in congress (and on Twitter) decide to take it upon themselves to explain why access to certain types (or all types) of birth control should be restricted. This has always baffled me, since abortion medication and birth control are not the same thing, and access to affordable birth control has been proven to reduce abortion rates. Apparently the high of rummaging through people’s medicine cabinets makes that information seem irrelevant.
Recent conversations have brought birth control alternatives to light, specifically vasectomies. The vasectomy is not a new idea, but women have been bringing it up more frequently as part of the Pro Choice perspective. The argument is that if men were really concerned about preventing abortions they would all get vasectomies, and the fact that they aren’t all racing to the doctor to do so proves that they only care about the bodily autonomy of men.
Kamau Bell went public about his vasectomy in an effort to normalize it among men. There isn’t anything inherently wrong with this, and I am glad more men are taking the initiative in family planning discussions. It would be great if more men would get on board with the FDA approval of male birth control pills, too. This should not, however, be at the expense of encouraging women to discuss birth control options with their doctors.
Some women suffer terrible side effects from birth control, yes. Being on birth control for a long period of time can be harmful. Preventing unwanted pregnancies, and therefore reducing abortion rates, should not fall solely on women. We can agree to all of that. But if we start promoting the idea that birth control isn’t an ideal option, or that people shouldn’t be using birth control at all, we run the risk of stigmatizing it’s usage altogether. That stigmatization leads to tweets like this:
This discourse will only open the floodgates for those who want to reduce access to birth control through legislation. We can’t afford to let that happen.
Perhaps if more people were open about their birth control usage, it wouldn’t be seen as an incomprehensible, mythical beast. This is my birth control story.
Birth control was first recommended to me by my dermatologist. That’s right, my dermatologist. Puberty turned me into a very oily, greasy human, which led to more acne than I could handle through drugstore skincare products. My primary care physician did not recommend seeing a dermatologist until after high school, because sometimes oil production lessens over the course of puberty, and there was a chance it would correct itself naturally. That did not end up being the case for me, so finally at 18-years-old I saw a dermatologist for the first time. The first question out of her mouth was whether I was on birth control.
It never occurred to me that I might have just had over-active hormones, and that birth control could solve my skin. My dermatologist said it was one of the first things they tell people to use alongside topical medication, so off I went to my first gynecologist to get a prescription.
Even though I was 18, my mom came with me to my birth control consultation, because she had a mixed history with taking the pill. She initially went on the pill to prevent pregnancy, and it ended up helping her a lot with symptoms of endometriosis; regulating her periods had significant health benefits for her. Unfortunately, she developed the common birth control side effect of blood clots, and for her ongoing health she had to stop taking it. Needless to say, my mom wanted to hear about the various birth control options available in the 21st century, and whether her side effects could be hereditary.
My gynecologist said it was going to be a balancing act. The family history of blood clots needed to be kept in mind, but the family history of endometriosis was even more concerning. When I explained that my periods had been irregular, heavy, painful, and sometimes migraine-inducing, endometriosis prevention became a primary reason to be on the pill, along with period regulation. Helping with my skin was now an afterthought.
I started taking Seasonique, and subsequently the generic versions, Camrese and Daysee. It is a combination progestin/estrogen pill that allows the body to only have four periods a year. Four. Periods. As someone who had never been able to track her period, who sometimes had multiple periods a month (or in one awful case, a 30-day-long period) the idea of only having four periods a year was music to my ears.
After a few months on the pill, my period was regulated perfectly, but my skin didn’t follow suit. I returned to my dermatologist, and we began the process of taking Isotretinoin, or Accutane. While Accutane does wonders for acne, it can lead to extreme birth defects, so if you are a person with a uterus, and you want to take Accutane, you are legally required to engage in at least two forms of birth control. Even if I hadn’t gone on the pill to regulate my periods, I would have had to start taking it before starting Accutane anyway.
My skin responded very well to Accutane, and my time on the drug came and went. My dermatologist indicated that I didn’t have to stay on the pill after the Accutane had cleared from my system, but I had no desire to stop taking it. I was not in a relationship or sexually active, so pregnancy prevention wasn’t the goal. Without the constant stress of having an unexpected, debilitating period, I regained control over my body and my life. Other than moderate weight gain (which also could have just come from metabolic changes as I got older,) I hadn’t experienced any side effects from taking it, and I was fully prepared to be on the pill forever.
Five years later, that became an impossibility. I began to experience severe breast pain, which I quickly sought treatment to remedy. My gynecologist assumed it was a natural fibrocystic change, but without a clear cause there wasn’t a clear solution. I was too young for a mammogram, so I had a breast ultrasound that came back clear. Physical exams indicated nothing. I cut back on caffeine, I bought different bras, I stopped sleeping on my stomach. I started taking Evening Primrose Oil, which helped as long as I remembered to take it, but if I ever missed a dose the pain came back as if it had never left.
Because I was so happy on my pill, I was willing to try all the alternative treatments first, but our last resort came to taking me off the high-dose hormones. Endometriosis prevention was still an important factor for my healthcare, so my doctor and I decided to switch over to Lo Loestrin, a lower-dose combination pill.
On Lo Loestrin, I stopped having periods altogether. My gynecologist assured me this was normal, and I certainly didn’t have a problem with it. The problem was the cost. On the generic forms of Seasonique, I only had to pick up my prescription once every three months, and the prescription was completely free. Lo Loestrin only came in monthly packs, and because there was not yet a generic form of the pill, I had to pay for it out of pocket. For those wondering, yes, I have health insurance. Non-generic forms of birth control aren’t covered by most insurance companies. Some months my pill pack cost around $25. Some months it was $80. The last month I paid for it, it was $117. This simply wasn’t a sustainable option for me, and I doubt it would be for anyone.
I discussed my alternative options with my doctor, and we landed on the Mirena IUD. My mom was even more concerned about me getting an IUD than she was when I wanted to go on the pill, but IUDs have come a long way since the 70s. I had friends who had gotten along swimmingly with Mirena, and I was willing to give it a go. The device and insertion was covered by insurance, and I wouldn’t have to worry about taking (or paying for) a pill anymore.
The insertion process was painful, but not as bad as it had been described to me. My doctor was very conscious of telling me what she was doing, when I would feel waves of pain, and how to handle recovery. Two days after insertion, I was pain free, and ready to roll. I’m not completely period free like I was on Lo Loestrin, but my periods are far more regulated, and I have traditional pre-period PMS symptoms that let me know when one is coming. I’m in a position to manage the light periods I get, and I am set for preventing pregnancy for the next five years.
People take birth control for all sorts for reasons. My reasons have changed over time, and the type of birth control I’ve used has changed over time. While I am open and willing to publicly share my medical journey, we need to get to a point where justifying medical treatment isn’t necessary. If we don’t want reduced access to healthcare, we have to stop questioning why people choose certain healthcare treatments.
It is truly no one’s business why a person with a uterus might make the decision with their doctor to get birth control. Period.