Questioning the Birth Control Conversation

The Pill and Feminism

Access to birth control is a long-standing feminist issue. The argument is that women have the right to make decisions for their own bodies, which includes planning, postponing and preventing pregnancy. Advocates for robust sex education push for discussion of birth control options in the classroom, in an effort to prevent unplanned pregnancies (and abortion and poverty). I support every woman’s right to access the birth control options she feels are appropriate for her.

But there’s a problem with this conversation.

Does the way we think about birth control contribute to the cycle of oppression of women? Is the real feminist issue being completely overlooked?

The fact is, sex education as it currently stands has very little to do with detailed fertility education. Most women graduate from high school, and go through college, without ever learning exactly how their cycles work. I have no study to back that statement up. But in my work as a pregnancy, birth and postpartum consultant; in my conversations with my mother, my sisters and my friends; in my years teaching young people at a large university; and by listening in on the media discussions and the discussions in my community around this subject, I have assessed that hardly anybody — male or female — knows exactly what is going on every month.

For decades we have been basing our fertility and sex education around one particular fear: the fear that women will get pregnant — too young, before finishing school, or before getting married. We have been ignoring the right that every woman has, young and old, married and unmarried, educated and not, poor and wealthy, to information about her own body.

An example of where fear-based sex education leaves us: The biggest myth that would be stomped out by a basic fertility education remains a prominent belief — that a woman can get pregnant any time of the month. (Please read this article which I recently shared). The truth is, there are roughly two days in which a woman’s egg can be fertilized. When you add in the lifespan of a sperm, a couple’s fertile window stretches to about 5 days every month. Why do we not tell girls and boys the truth about this? Because we’re afraid they will then feel permission to have unguarded sex during the other three weeks? We’re afraid of teen promiscuity as much as we’re afraid of teen pregnancy — and for some sound reasons. But those fears are not themselves sound reasons for withholding the truth from girls about their bodies. Doing so impacts their health and fertility decisions for years and maybe decades after they become adults.

Four generations of women who deserve all the information

Four generations of women who deserve all the information

We have been cutting women off from information, on a lifetime basis and on a monthly basis. On a lifetime basis, many women have no idea that they can chart their cycles by observing cervical fluid and daily base temperature — that they can know when they are fertile and when ovulation has occurred with no guesswork. They have no idea that irregularity in these symptoms can point to other problems: maybe an underactive thyroid, maybe a vaginal infection, maybe cancer. They have no idea that they can use this information both to avoid pregnancy, and to try to get pregnant.

On a monthly basis, women who rely on hormonal birth control cut themselves off from information their bodies are constantly sending about their fertility, their hormones, and their general health. Sadly, many women experience side effects from their birth control that negatively affect their lives and their relationships, but they don’t know there are alternatives. Some decide to endure. Others decide they’d rather risk getting pregnant, and go off birth control without knowing they can still avoid pregnancy — 100% — with what we call “knowledge-based methods.” (My husband had been in several long-term relationships before we met. When I discussed with him my desire to chart my fertility and not use hormonal birth control, he said, “Thank heaven. I’ve lived with women on the Pill before. I don’t want you to be crazy.” This isn’t everyone’s experience, but just start talking to women and you’ll find out it’s very common. My husband also expressed that he didn’t feel it was fair for me to shoulder the burden of month-long birth control, when my body is only fertile for two days.) Back to the case: birth control can block the woman’s body from performing its regular healthy functions, but it also can block important messages to the woman about her health. It withholds information.

I will clarify again that I am not anti-birth-control. I am pro-information. Knowledge, as the saying goes, is power. Information empowers women to make, well, informed decisions. It gives them confidence. It gives them freedom. In this light, is fear-based restriction of information oppressive?

One more thought on oppression. Getting back to feminism, think about this: our society generally expects women to alter their chemical make-up to prevent pregnancy, no questions asked. I’m asking questions myself here, and I don’t pretend to have a background in sociology, gender politics, or any relevant discipline. But this all hints at a system oppressive of women: one that restricts them from informed choices, one that doesn’t trust them as decision-makers, one that expects them to self-contain and self-alter.

A student came to my office one day at the conservative university where I taught. She said, “I’m getting married. I know you know a lot about birth, and that you’re married yourself. I don’t know what to do about birth control. I don’t want to mess with my body, but I don’t want to get pregnant yet.” I told her about Toni Weschler’s book Taking Charge of Your Fertility (the book whose contents should be standard sex-ed for the girls and the boys). I suggested that she take a class on fertility awareness and charting (I recommend the Creighton Model because of its detailed analysis of cervical fluid, but I use this model in combination with temperature charting, also known as the Sympto-Thermal method).

She told me she had never heard any of this before. She left my office relieved, empowered, and armed with resources to make an informed decision. I don’t know what she chose and I don’t care!

The Pill, as we all know, is just another political football. When people talk about it, they often aren’t really talking about women’s rights. But next time the conversation comes up, let’s pull it around and talk about the right women have not only to birth control, but to information. The bottom line on birth control? Women should be in control of all the decisions surrounding their bodies, and women should be in control of all the information about their bodies. (And although this is for another day, since we’re on the subject of birth control, women should be in control of their births.)

A final anecdote that displays the sad state of things: My first ever visit to a gynecologist resulted in me explaining to him that it is possible to identify the fertile period by observing cervical fluid and charting temperature. He laughed me off, and told me he’d see me later when I came crawling back for conventional birth control. He never saw me again.

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