Thursday, July 21, 2011
Blog Carnival: We've Got You Covered (Birth Control)
We’re happy to take part in the National Women’s Law Center’s blog carnival campaign about the importance of access to contraception for all those who want it. It’s great that the National Women’s Law Center is bringing this important issue to attention, because unfortunately, access to birth control information – and birth control itself – isn’t readily available to all.
There are lots of different views on how to provide birth control counseling and information during the time of abortion. One view is that all women seeking abortions must/should have birth control counseling (whether they want it or not). Under this category, some feel that all women should leave the abortion clinic with some form of contraceptive because if the client ends up returning for an abortion, the providers/society/clinic/counselor somehow “failed” her. Others feel more that it’s a fluid subject and should be one driven by the client herself: she requests the information, the clinic provides it, and the clinic gives the type of method she’s seeking/asking for. Under this view, the clinic staff would not feel they “failed” a client if she came back for an abortion. (Statistically, most women who have abortions have had at least one before.)
One of the things that I always enjoy at work is when a patient – either on the phone or on the day of her abortion – asks lots of questions about birth control. I love being able to share as much information as possible, and letting her come up with what she feels is the best method for her at the time. I feel fortunate to work for an abortion provider that really puts that decision in women’s hands. Though I think it’s imperative that all women – who want it – have access to both birth control and birth control information, I also think it’s totally OK for patients not to receive birth control after their abortions if they don’t want it. I’ve heard comments (that I believe are judgmental) like this to women on the day of their abortions, “Are you sure you want to continue using condoms as your birth control? I mean, that’s what you said you were using this time and look what happened.” I find this cringe worthy, parental, and well, totally not feminist.
I’ve come across quite a bit of judgment/bias on certain types of birth control methods, too. Barrier methods, withdrawal, and “natural family planning” types of BC seem to be frowned upon. It’s true that statistically they’re less effective, but certainly that depends on the individual using them, their knowledge about the method(s), and their knowledge about themselves and their bodies. Just as it’s important for women to have access to as much information they want when considering an IUD versus Implanon, women who are interested in natural family planning/withdrawal/barrier methods deserve to have accurate information on those methods as well. And they deserve to be supported. I’ve been working in RH for many years and I choose not to use a hormonal birth control method. In fact, for over 10 years, I haven’t used any type of “conventional” birth control at all. Not even condoms. (Gasp!) My partner and I use the withdrawal method. Our children were planned and I have not had any unplanned pregnancies. Many people (myself included) combine several methods together (I tend to use withdrawal with some natural family planning and Plan B for back-up when needed). I believe I know when I ovulate. My periods are regular and I experience mittleshmerz. My partner is very – err – disciplined I feel very confident and happy with my BC choice.
Unfortunately, despite my success in preventing unplanned pregnancies and planning some planned ones, I still am given a hard time by my PCP and other physicians who kind of “mock” me that I do not use any birth control. Then they lecture me about it. (Which is super annoying and I always want to say, “It’s OK. If I get pregnant, I can just get an abortion at work!”) The fact is, I DO use birth control. Just not hormonal or device-driven birth control. And I believe I know what the hell I’m doing and – really – no unplanned pregnancies in 10 years is pretty damn good, in my book! I also cannot be the only person out there with a similar experience.
I think our jobs are to trust that women know what’s best for them at the time. Given them the information about the birth control they’re interested in. Answer their questions. Ask them questions. Help provide an environment of critical thinking. Let them decide what method they want. Help them get it. (On a macro level, advocate that all women can access affordable contraception!) And support them in their decision. We trust them to make the decision to have an abortion (which, don't-ever-forget might actually be her form of birth control, too!), we should trust them to make decisions about their overall reproductive health.