Wednesday, June 19, 2013

Let's Talk About Birth Control: A Guide For Those Without Ovaries



It has recently come to my attention how little people who are capable of impregnating women actually understand about ways of avoiding pregnancy. This is quite frankly, a shame. These men aren't complete idiots or woman-haters. Most of them are well-meaning dudes who don't want to father children, but don't know shit about women's bodies, because no one has ever tried to teach them. It's okay guys. I'm here for you.

As a graduate of Oberlin College's SexCo, a psychology student, a writer and a woman, I feel that it is important to try and educate people about birth control instead of just complaining about it to my roommates.
So here goes.

First Thing's First
For this article to make any sort of sense, you must first acknowledge that we as humans are biological creatures. Our bodies know things about survival that our brains feel are pretty outdated. Pretty much everything we do is about survival of the species. Especially having sex.

So what does this mean? Well, first of all, it explains why it's incredibly easy for people who don't want to get pregnant, like teenagers, to get pregnant, and more difficult for a 35 year old woman with the emotional capabilities and the means necessary to raise and support another human being. It's because in cavemen times a 16 is the perfect age for fertility and women didn't necessarily live past their mid 30s. That's because they probably died in childbirth at age 25.

This is not to say that all teenagers are bad moms and that all middle-aged ladies are good ones. That's obviously not true. But our evolutionary abilities and desires to reproduce usually come before the societal stability that will make it easy for us to provide for our young.

Evolutionarily, women get the short end of the stick. Think about it. Men can just spread their gametes* wherever they want. They provide sperm and bam it's done. Women on the other hand, carry their gametes inside them and must gestate their offspring for ~9 months. Inside of their bodies. Afterwards, they provide food for the baby for pretty much as long as is practical and culturally acceptable. This is a ton of work. It takes a toil on our bodies. It is what our bodies are built for, but it's a long-term commitment.

Pregnancy and childbirth are a beautiful, necessary thing. It's amazing that women can grow babies inside of their bodies. Eventually, I want to have children myself. It's what biology is telling me I should do. Plus I'd probably raise some pretty kick-ass kids. But now is not the time.

So lets review:

  • We want to have sex because we're trying to ensure survival of the species!
  • It's easy to get pregnant when you're young because that's what biology wants us to do!
  • Men can do whatever they want and women gestate and nurse the offspring. I know most men don't just run off, but a lot of them do. It's not right, but that's how their bodies work.

How To Not Get Pregnant
So now let's talk about how women prevent pregnancy. Most of the methods I'm going to talk about do absolutely NOTHING for prevention of sexually transmitted infections. So don't be a dumbass. Wear condoms or don't have sex, because that's really the only way to guarantee that you don't spread STIs around.

"But Janney," you're probably thinking, "condoms suck."

I mean yeah. Using condoms isn't as pleasant as letting your body do whatever the hell it wants and impregnate everything you touch, right? Again, biological trickery at work.  But as my gynecologyist told me, "Condoms are good at preventing disease, but bad at preventing pregnancy." If you've ever done any reading on cumulative contraceptive failure, you'll know that the small statistical chance you have of getting pregnant while on any form of birth control gets bigger and bigger the more often you have sex. So it's a good idea to use more than one form of protection against pregnancy.

Hormonal Birth Control
Most people know about birth control pills. It's really ideal, right? Take a pill once a day, don't get pregnant. Hormonal birth control comes in many forms, pills, patches, rings, shots, implants, and intrauterine devices. It basically tricks your body into believing that it's already pregnant. If taken correctly, hormonal birth control is pretty darn effective. The advent of hormonal birth control gave a lot of women a control over their reproductive systems that made it possible for them to do things with their lives besides pop out babies all the time. Hormonal birth control is a great thing for women.

But it's not ideal for everyone. This is why I find it pretty offensive when men suggest that women go on the Pill. There are a lot of side effects of tricking your body into thinking it's pregnant. For many people, the side affects are nice ones. Fewer cramps, lighter periods, less acne, positive mood changes, bigger breasts.

 But sometimes people will experience side effects like weight gain, lack of sex drive, bigger breasts, and being bummed out all the time. Not to mention that some people, myself included, are really bad at remembering to take pills every day.

Of course there are other hormonal options for people who can't remember to take pills. These can be a really great option for people like me who are dumbasses. I have a friend, let's call her Fanny, whose personal favorite form of birth control was the Nuva Ring. There were no negative affects on her mood or physical appearance. Unfortunately after over two years of ringed bliss, she started getting horrible migraines on the first day of her period, that rendered her unable to do anything besides vomit and sleep. It's ridiculous to expect a person to lose a day of their life every time they menstruate. So Fanny went off of the Nuva Ring and onto a birth control pill that didn't give her migraines, but when she remembered to take it made her lose all interest in having sex. An effective form of birth control indeed!

Other forms of hormonal birth control, like the shot or the Nexplanon implant, are sometimes forced upon women in homeless shelters, with drug addictions, or with legal trouble. Because the shot doesn't need to be given daily or monthly, it is a quick fix for people who can't afford monthly co-pays (although thanks to Obama Care, birth control is free). However, despite the well-meaning practitioners and providers who administer the shot left and right to women who may not have the ability to advocate for themselves medically, it is problematic to take away reproductive autonomy from women just because they are poor. Plus, people still seem to get pregnant a lot on the shot. End rant.

Let's review again:

  • Hormonal birth control tricks your body into thinking it's pregnant
  • It's great for some people
  • But not for everyone

Intrauterine Devices
Intrauterine devices, or IUDs are really cool. They are little metal "Ts" that a doctor implants in the uterus. They basically turn the uterus into an inhospitable environment for sperm with or without hormones. IUDs can be effective for up to 5 or 10 years, and removed when a person feels ready to have children, which makes them a good option for women like Fanny and myself, who don't want to even think about children for 5 to 10 years. IUDs are very common in Europe, and pretty much everywhere besides the United States. We'll discuss why in a second.

Like birth control pills, there are side effects of IUDs, both positive and negative. Unlike birth control pills, IUDs are rarely suggested to women in the United States who are looking for birth control. Part of the reason for this is that the US was pretty scarred by an IUD in the 70s called the Dalkon Shield. Contemporary IUDs, like Mirena, an IUD with a low dose of hormones, and Paraguard, an IUD without hormones, are shaped like "Ts," a shame that mimics the natural form of the female reproductive organs. The Dalkon Shield was shaped like a crab and had little arms that in many cases did lots of messed up things to the uterus. A lot of people had medical complications as a result of the Dalkon Shield, and to this day, IUDs are somewhat of a dirty word for many people and practitioners in the US. But we've come a long way baby, and IUDs are safer and more effective than ever.

Unfortunately, due to the bad rap of the Dalkon Shield, and the patriarchal beliefs regarding the female reproductive system that run rampant in this country, many practitioners won't prescribe IUDs for women who haven't had children yet.

After her bad experience with the Nuva Ring, Fanny went to a doctor in Northeast Ohio attempting to get an IUD. The female (I might add) doctor refused to prescribe her one because she was unmarried and not in a monogamous relationship. Fanny is no moron. Fanny knew that IUDs didn't prevent STIs and planned on getting an IUD mostly for her peace of mind regarding pregnancy. Unable to convey her fear of STIs that meant she rarely had sex without condoms even while in monogamous relationships where both parties had been tested, to this particular doctor, Fanny left the office in tears and off of any form of birth control. A week later, she became pregnant.

Just kidding.

Fanny just felt horrible about herself because she wasn't in a relationship for a week until I pointed out that the doctor had essentially slut-shamed her.

Let's Review:

  • IUDs (intrauterine devices) are a semi-long-term, but not permanent, form of birth control
  • IUDs must be inserted by medical professionals, so they require quite a bit of planning on the part of the woman
  • Not all medical professionals in the US are down to give a woman who hasn't had children an IUD. If you encounter one of these medical professionals, please e-mail me. I'd like to start an online resource for women seeking family planning in the US, of doctors who will and will not respect our right to act on our biological impulses, like men do ALL THE TIME, without getting pregnant. Of course, I will phrase it better than that.


Shew. This Post Got Really Long. I Must Feel Very Passionate About This Subject
There are of course, other forms of birth control besides hormonal forms and IUDs. That would be another 10 pages. But the least physically intrusive**, if a woman is not already on hormonal birth control, and the one that is most readily available is the condom (I'd say abstinence, but that's no fun). So roll one on and get to having wonderful, consensual sex where you respect your partners' bodies.

Relationships, sexual or otherwise, cannot work unless there is good communication. I hope that having a better understanding of how birth control works will help you have more educated communication regarding birth control with the women in your life. Education is power. I hope that by learning about birth control, you can be empowered to be a more considerate and better partner.


*I'm saying "gametes" because it's slightly less graphic than "seed" although in my personal life, I'm more likely to say "seed" because it's more fun.

**I should also note that there's a reason I don't talk about natural family planning. It's because that's also no fun at all. It's really hard to not have sex when your body is at its most fertile, because that's what biology is TELLING YOU TO DO! Responding to what nature wants you to do is not being weak. It's being a living creature on this Earth. 

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