family planning rant

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Dawn Eden notices that the MSM hasn't got a clue how contraception and abortion are linked.
I work in an aggressively secular environment. I stay here because I think that I am able to be a little bit of leaven. Maybe I'm fooling myself. The facility gets a fair amount of funding from Title X federal family planning funds. There is a full file cabinet drawer of info on contraception. When I came here, there was nothing in it on NFP except for a 1970s vintage booklet on fertility awareness that had been photocopied so many times that it was almost unreadable. That drawer now has some basic info, brochures from 3 local teachers, the front and back copied from a non-sectarian NFP book and info on lactational amenorrhea for childspacing.
I make the effort to tell women just how hormonal contraceptives function. (three mechanisms, one of which is abortifacient -may suppress ovulation, but not reliably;usually alter cervical mucous to inhibit sperm transport;render the uterine lining inhospitable to a developing embryo, and slows embryo transport through the tubes to the uterus such that the embryo can not survive the transport time). I remind them that fertility is a state of health and that to make ones self infertile is to create a biologically unhealthy state. They listen and then usually go on using their pills or their depo.
I keep hearing news stories about how we are increasingly the most obese nation around, especially our women. I wait in vain for some one to link the prevalence of hormonal contraception (especially depo and until it was off the market, norplant) to this problem. I wince thinking about the women now in their 30s who will have osteoporosis in their 50s from prolonged use of depoprovera. Yes, the obesity from the depo might partially offset the calcium depletion, but still.....
I still need to do my research, but I am convinced that there is a double standard about the approval of unsafe drugs - my impression is that the death risk (heart attack et al) from Vioxx, the muscle wasting risk from Baycol are actually much lower than the risks of serious consequences from hormonal contraceptives. The Pill kills 0.3 to 1.9 women annually in every 100,000 users ages 15 to 29. (If you click on this link, you will notice it is info on the patch, but scroll hafway down to find the mortality table (table 3) for contraceptives of all kinds). This table is a little deceptive - for those methods that have a direct risk of death, they list the actual deaths occuring during the usage period - but for other methods they list the death risk from the theoretical pregnancies that would occur if the method did not succeed at preventing conception/implantation. There is also no consideration of possible excess mortality and morbidity related to increased risk of obesity, hyperlipidemias, hypertension, delayed childbearing, or breast cancer. To be fair, there is some good research that taking combination OCPs for more than 5 years does reduce the risk of ovarian cancer - but so does pregnancy followed by breastfeeding such that there is a prolonged natural amenorrhea.

Yes, pregnancy can also be a cause of mortality and morbidity. I won't deny that. Abortion can also kill the pregnant or recently pregnant woman. Maternal mortality in women aged 21 - 29 was 7.4 to 7.9 deaths per 100,000 live births. If the choice was strictly between hormonal contraception and pregnancy/birth, it would seem that the risks are higher with pregnancy - but there is a flaw here - the flaw is in an assumption that one women using a contraceptive for one year equals one pregnancy, and the other logical flaw is to assume that the only way to prevent pregnancy is to use hormonal contraception. NFP properly used can be as effective (as hormones) at preventing conception if that is the desire of the users. NFP is more effective than barrier methods and spermicides. As I see it, the major health risk of NFP is that the users may decide to have relations on a fertile day, and then have a pregnancy. That is why communications and joint decision making are key to effective practice of NFP if the intent is to delay or avoid pregnancy. It is not a good method of family planning for women who are in abusive relationships, for example. If a woman has no power to say NO and have it respected, then NFP will probably not help her to delay or prevent childbearing. But that is not the fault of the method, it is the fault of a culture that denies women the right to say no, a culture that has so separated sexuality from procreation that women are literally surprised that they got pregnant without planning to.


Very good post! Years ago I used depo for 1-2 years (before reverting) and boy, they sure didn't tell me about the weight issue. I gained between 25-35 lbs. during that time with no other obvious factors of weight gain.

Right on, alicia! I wish doctors would beleive me when I point this stuff out. It really irks me how they write "no reliable contraceptive method" on my charts when I tell them I use NFP.

As for weight gain...tell me about it. I put on 35 lbs. with the Pill.

(BTW, Anne Shirley, I love the Anne of Greden Gables reference. How many times have you read it?)

One of my daughters used a depo insert. Instead of gaining weight, she lost weight, and lost it and lost it and lost it. Her breasts withered up to nothing, a little crinkle of skin around the nipple. She had no appetite. She couldn't make herself eat. People asked her if she were anorexic, meaning did she have anorexia nervosa. But she knew she was too thin, she was upset about it, she went to doctors about it. They told her to eat more. They told her it couldn't be the contraception, they had never heard of that. However she did some internet research and found that a few other people at least have had this reaction. She had it removed, regained her appetite, and a normal weight. And later had a normal pregnancy. Thank God.

Down to your last sentence-I first remarked upon this a long time ago. A friend of mine who had used the pill since age 14, got a blood clot at age 18 or 19, and was told to go off the pill. She was given a diaphragm but didn't use it consistently. She was totally amazed when she got pregnant. She just didn't really believe at the feeling level that her sex life had anything to do with making babies and that such a thing could happen to her without her intending it. Imagine, she said, if I didn't do anything about this, I would actually have a child in 7 or 8 months. Sadly, she went to Puerto Rico and had an abortion. (This was 1969.) This was a very intelligent girl; there was no actual factual ignorance involved. I am not in touch with her any more. I hope she has kids now.

Hey, Cin! Oh man, I've read the series too many times to count as a child. As an adult, probably only once or twice but it's been awhile now. I just love the series and the movies are good too.

weight gain on contraception

I remember back in 2001 when some co-workers and I were talking about contraception. They were going around the circle, to see what everyone was on.

Everyone complained about mood swings on the pill, breast tenderness and severe pain on the pill, and one girl (who I knew was physically very active) said she had gained 40 lbs in the last year since she started taking the injection.

When I suggested "why not just wait to have sex until you're ready to have children?" they took it as a joke, and laughed.

One girl said whistfully, though, "Like the man would like that idea..."

What is wrong with women today? Grr!

Oh boy, does the Pill cause weight gain! The first time I was on the Pill (in my old pre-reversion days) I gained about 45 pounds in a year. Since I was taking it secretly as a teenager, I couldn't tell my Mom, but I told Planned Parenthood (where I got it) and they laughed and offered no advice for that or other side effects.

The Pill I took then was later outlawed for being too strong (could it have been called Demulen?) I shudder at the damage it may have caused my body, but nobody took any side effects seriously.

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This page contains a single entry by alicia published on November 24, 2004 6:15 PM.

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