Contraception: Case Not Closed

It is difficult to overstate the impact of the hormonal contraceptive pill in the United States since its introduction in 1960. The Pill is currently used by more than 100 million women worldwide and by almost 12 million women in the United States, often at the recommendation of doctors who prescribe it for everything from contraception to menstrual irregularities to acne. Prescribed to women young and old, sexually active or not, the Pill has practically become standard-of-care for being a woman. But some people are starting to wonder if the Pill is really all it’s cracked up to be.


Ricki Lake and Abby Epstein, the same film producers who brought us The Business of Being Born, a documentary examining traditional hospital births, are now turning a critical eye to the hormonal contraceptive pill in a Kickstarter-funded documentary, Sweetening the Pill. The new film asks the simple question: “Is the Pill really what’s best for women?”


The Pill was a revolutionary invention that liberated millions of women from traditional gender roles. It was more effective than any contraceptive previously on the market, and it allowed women to directly and privately control their own fertility. Shortly after the introduction of the Pill in 1960, women’s college attendance and graduation rates skyrocketed. For the first time, women were able to effectively delay childbirth and marriage in order to invest in their education and careers. To this day, the Pill continues to be the most popular contraceptive used in the United States. The trend is clear: Giving women control over their fertility is good for womankind and the march toward equality.


But one step in the right direction is no reason to become complacent. Many women are unsatisfied with the contraceptives available on the market today, and with good reason: Currently, 63.7 percent of women who discontinue use of the Pill do so because of unwanted side-effects. These side effects range from minor nuisances like headaches and breakthrough bleeding to severe medical complications like blood clots and strokes. While many women use the Pill without issue, a significant portion of pill-users suffer decreased quality of life on the medication. In a world where the Pill is the standard, women are not sufficiently educated on the side effects of hormonal contraception and are rarely presented with alternatives.


Sweetening the Pill advocates the Fertility Awareness Method (FAM) as an effective non-hormonal alternative to the Pill. The Fertility Awareness Method involves monitoring a woman’s daily fertility signs, including her basal body temperature and cervical fluid, to identify when she’s fertile and when she is not. A couple may use barrier methods or abstain from sex during the woman’s fertile phase. FAM is up to 99.6 percent effective when used correctly.


The documentary has received criticism for advocating this method. With its common mis-association with the ineffective Rhythm Method, it is little wonder that uninformed feminists lash out against FAM in defense of the Pill. But FAM does not deserve the scorn of feminists. These misconceptions about fertility awareness are outdated and deserve thoughtful review.


The Fertility Awareness Method is not anti-choice. FAM does not have an agenda. FAM simply allows women to read their bodies’ physical signs to know exactly when they are capable of conceiving and when they are not. What each individual woman does with this information is completely up to her. Some women choose to abstain from sex when they’re fertile to avoid pregnancy. Others choose to use barrier methods. Many women aren’t aware that there are effective options for avoiding pregnancy other than using hormonal contraception. Women deserve the opportunity to consider all their options and make truly informed decisions about birth control.


The Fertility Awareness Method is not anti-science. On the contrary, FAM is an example of evidence-based science at its finest. FAM has been studied extensively in scientific literature and the results of these studies echo the same chorus: FAM is a highly effective contraceptive method when used correctly. FAM is not hard to learn and is a viable alternative to hormonal contraceptive methods.


The Fertility Awareness Method is not anti-woman. FAM is about believing in women’s intelligence, empowering women to take control of their health, and giving them the tools to make informed decisions about reproduction. FAM is about improving attitudes about menstruation and natural bodily functions, which can impact women’s self-esteem, sexual agency, and even improve safe sex practices. In a society where women’s bodies are harshly judged and regulated, taking ownership of your own body is daring.


Sweetening the Pill is a reminder that contraception is not a “case closed” 50 years ago with the advent of the Pill. The world’s contraceptive needs are not being met. We need more education, more access, better options, and more options for men. We need to inform more women about all the options that are available to them right now, including effective non-hormonal options like the Fertility Awareness Method. We need more documentaries like Sweetening the Pill encouraging women to learn about their bodies and understand their fertility so they can make informed decisions about birth control. And we won’t stop until every woman has access to a method that keeps her happy, healthy, and safe.

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