This week I met someone new that I chatted with for a while.
When she asked me what I did, I explained to her what I do, which generally involves me saying “I teach something called fertility awareness, which means I teach women how to chart their cycles and determine exactly when they are fertile so they can use it as a natural birth control method or to help them get pregnant.”
That’s pretty much as simple as it gets!
But two things were striking about this conversation. One was that she said she uses an app to chart her cycles, pulling out her phone and showing me one of the various period tracking apps (P.S. If you want to use this method as natural birth control don’t use a period tracking app, please).
The other thing that was striking was that she said “It’s really weird that we are talking about this.”
Of course I get it, in fact, I would have said the same thing at one point in my life. The mention of periods and birth control is pretty much taboo except for with your very closest girlfriends, and even then we don’t really spend a whole lot of time on the topics (unless you are like me, in which case: Why’d we stop talking about birth control, periods, and sex ed after only 5 hours?).
You may be thinking: So, Hannah, what’s your freaking point?
Well, for as long as we have the inability to talk about birth control and periods we don’t really have a complete understanding of what we are doing, how it works, how well it works, what other people are doing, or even how people got pregnant.
The last one is particularly interesting.
Most women have incomplete knowledge of their options and poor knowledge of the actual efficacy of different birth control methods.
Obviously, when you hear about a friend or acquaintance having an unexpected pregnancy, you don’t want to ask them the specifics of what birth control they were on and how well they were using it, especially the last part.
Can you imagine how accusatory that would sound?
“You’re pregnant?! Wow, awesome/scary(/whatever). How did that happen? Oh you were on the pill? Well did you actually take your pill every day at the same time, or what?”
Not very inviting or supportive, yeah?
But without that info we end up making assumptions that aren’t true (you know what they say about assumptions ;)). Especially when it comes to two different birth control methods: withdrawal and fertility awareness.
Withdrawal happens to be somewhat popular and probably always will be, but there are a few ways that we communicate about it that makes it a problem.
First, we tend to think of it as “not a birth control method.” I have had countless people tell me they don’t use birth control at all, only to find out they use withdrawal.
I also hear that withdrawal worked perfectly, until they got pregnant. Upon further questioning it’s frequently that withdrawal didn’t happen, not that it happened but they got pregnant anyway.
With fertility awareness, it’s often that someone “used it” but didn’t learn it well or that they did learn it well but purposely took a risk on a fertile day and had unprotected intercourse anyway since they didn’t actually care that much about an unplanned pregnancy.
I’m not saying that people who use birth control methods correctly don’t get pregnant, because that certainly isn’t true, but the incidence is actually very low. You can see in this chart by the Guttmacher Institute the difference in unplanned pregnancies from those not using birth control, using it but not using it well, and using it perfectly.
We can also have a false sense of security when using a less effective form of birth control or using it incorrectly. Again, withdrawal is a common method being paired with other methods and I often see people saying they are not using condoms well or all of the time yet they haven’t gotten pregnant. Most of the time this is because they are using withdrawal all of the time.
Or using herbal birth control and saying that is why they haven’t gotten pregnant, even though they are also using withdrawal all of the time.
The real problem
If you try to have a real conversation about birth control with your doctor that generally doesn’t go well.
Most people have no idea how to read a scientific study, unless you happened to study something in the science realm in college (rare), and even then the ability to read them is often lacking.
A lot of info online and in books is outdated or unreliable (bias is a real thing).
And if you listen to your friends, chances are you don’t actually know what was going on, nor if they have good information themselves.
You can see the huge gap in knowledge in the findings of a survey by the American College of Nurse Midwives. Of all of the “birth control methods” the one that had the most women says they knew a lot about it was abstinence. That high percentage of women who knew a lot about it? 70%. It only goes down from there.
Because of all of that, it’s really important to do massive research, questioning, talking, and demanding (from your stubborn-ass doctor, who else?) to get the info you need.
Obviously you are here soaking up some of this information. Where else do you go for women’s health and birth control information? Have you found any other great sources? Let me know in the comments.