Birth Control: Back in the News

Laurie and Debbie say:

We were very impressed by this article by Valerie Tarico at . Tarico couches excellent contemporary birth-control information in the context of Rick Santorum’s recent attack on birth control (“It’s not okay. It’s a license to do things in a sexual realm that is counter to how things are supposed to be.”).

Good news: Even if you feel hazy or muddled right now, you likely have access to technologies your parents could only have dreamed of. Bad news: The confusion is no accident.

Although the headline implies that she is simply writing about birth control misinformation coming from the right wing, the article is much more nuanced than that. She covers five things the right wing doesn’t want you to know about birth control, five that big pharma doesn’t want you to know, and five that the medical gatekeepers don’t want you to know. One thing all of these groups have in common is that they don’t want women to be able to control our bodies. Here’s one from each group:

Right wing: IUDs work by preventing eggs and sperm from hooking up. Opponents of abortion and contraception would have us believe that virtually all modern contraceptives are abortifacients. They especially have targeted the most effective contraceptives available, IUDs, with this accusation. In reality copper IUDs like the Paragard work primarily by inhibiting sperm motility, thus preventing fertilization. Hormonal IUDs like the Mirena work primarily by thickening a plug at the opening to the cervix —another means of preventing fertilization–and secondarily by decreasing ovulation. …

Pharma: The best contraception is also the cheapest. The most effective contraceptives on the market have the potential to kill some of Pharma’s big profit streams. The Paragard copper IUD, which is top tier from an efficacy standpoint (over 99%) offers the cheapest month over month contraception. The problem for Pharma: you put it in once and then don’t spend any money on contraception for the next 10 years. The Mirena hormonal IUD (99.8% effective once established), is more expensive, but has the side benefit of reducing menstrual bleeding and cramps over time by an average of 90%. Family planning practitioners who promote LARCs joke about putting themselves out of business. In contrast, Tarico says that one in twelve women on the pill gets pregnant each year, a higher number than we would have guessed.

Medical gatekeepers: The FDA lags behind. European women have an array of contraceptive options that either never make it to market in the U.S. or are delayed by anywhere from 5-20 years. American regulators are influenced by a litigious environment and by religious fundamentalists, which skew the equation toward inaction. For example, Nexplanon, the latest iteration of the implant, only just became available in the U.S. Similarly, the Mirena IUD has a long track record with women of all ages in Europe but is not yet approved for childless women here. By the time it was officially sanctioned in the US to regulate heavy menstrual bleeding (2009), it was already in use for contraception or bleeding by 15 million women worldwide. A frameless IUD optimized for small women is approved in the E.U., but hasn’t yet reached the U.S. market. If you want to know where contraception is headed, take a look at what Europeans are doing.

Many of the other fifteen points are just as rarely discussed.

So it got us to wondering why birth control has gotten so little attention and discussion over the past couple of decades.

One answer is obvious: the three groups that Tarico singles out are happiest if there isn’t a lot of conversation.

Another is that abortion is getting so much attention and is under such intense attack. This means that the heroes fighting to keep abortion safe and legal are too busy to look at birth control, and that the anti-abortion warriors are really busy with their main campaign. The war on abortion has pushed some of the truly fine birth control resources under the radar: Planned Parenthood (link below) not only has to spend energy fighting it enemies, it has to do what it can to stay out of the public eye, because every time it shows up in the news, the attacks get more fervent. Tarico’s other recommended resource, Bedsider (a new site launched by the National Campaign to Prevent Teen and Unplanned Pregnancy), is one neither of us had even heard of, and it looks excellent.

But why aren’t feminists talking much about contraception? Our guess is that it’s generally thought of as a “solved problem.” In most places in the United States, women who want contraception can get something. And feminists, with so many hot-button issues to concentrate on, may have been too busy to notice that that something is served with large doses of preconception, misinformation, and monetary gain. So wrong-headed Rick Santorum is, for the worst possible reasons, calling attention to something we need to look at more closely.

So, to close with more of Tarico’s words,

You really can manage your contraception. A decision about contraception can shape the rest of your life—your happiness, your ability to contribute to the world around you, the wellbeing of your children. Only you can weigh the risks and benefits of any given contraception against each other in the context of your lifestyle and life goals. To make the best decision possible, you need accurate information, and that means knowing what questions to ask, who to ask, and what factors may be biasing answers. An hour on the internet can fill your mind with rubbish about almost any medical technology. Alternately, an hour spent on sites that are rigorously fact based could mean you have more up-to-date information than your peers or even your doctor. ( and Planned Parenthood are among the best.) Tarico doesn’t mention Scarleteen’s excellent birth control bingo interactive site, so we will.

Thanks to F.S.J. Ledgister, who linked to this on Google+