Why NFP and Why not ABC?
I want to approach this in terms of my personal experience first, and then, in the next section, I’ll talk about how that experience relates to broader trends and to the ethical issues surrounding birth control.
I’ve written in the past about my frustrations with natural family planning, my repeated failures to actually avoid pregnancy while using it, and the problems that I have with a lot of NFP culture. I’ve written less about my experiences with artificial birth control, so I want to cover that here.
I’ll start with my mother’s one-line sex-ed course: “The first thing you need to know is, birth control doesn’t work.” My mother’s record as far as pregnancy goes is pretty similar to my own: repeated pregnancies about two years apart for most of her fertile life. The difference is, she used contraception whereas I used NFP. So far as I know she mostly used barrier methods, though one of my sisters famously shared the womb with an IUD. At a certain point my mom’s body became too exhausted to carry most of her pregnancies to term, and after the birth of her eighth she told my father “miscarriage is not a form of birth control” and insisted that he get snipped.
So, I think it’s important to state up-front that while NFP hasn’t worked for me there is reason to think that hyper-fertility may be a contributing factor. Most women just won’t have eleven pregnancies while using contraception…but my mother did. Given my own track record, I suspect that I inherited her fertility.
Okay, okay, but there are pills for that. Most of the time when we’re talking about birth control we’re talking about hormonal contraception, not barriers. As my sister, a midwife, once quipped “When a couple tells me they’re using condoms, I expect to see them back in my office soon.” Everyone knows that barrier methods are really not super effective at preventing pregnancy, and mostly they’re used by teens who don’t have access to more effective methods, folks who are using them to prevent STD transmission, or couples who want a break between births but are open to having another baby in the relatively near future.
Most people want more effective birth control, so they go on the Pill. Or a hormone-loaded IUD. Or the Ring. Or the Shot. Or the Patch. Basically, a variety of birth control that suppresses a woman’s fertility using some combination of estrogen and progestin.
My own experience with this has not been good. A number of years ago, before I miscarried, I had severely irregular cycles. I was bleeding frequently, and a lot. After repeated trips to a gynecologist to try to figure out what was wrong, she reported that it wasn’t cancer. “Okay,” I said, glad for the intel, “that’s great. So what is it?” “Something hormonal, probably,” she said vaguely. “But if you’re not willing to go on the Pill, there’s nothing I can do for you.”
What I didn’t know at the time was that, as a Catholic, I actually could have gone on the Pill at that point – it would have been considered a lawful use of therepeutic medicine that happened, as a foreseen but not intended consequence, to suppress ovulation. I had been told differently by pro-lifers, so instead I tried and failed to practice NFP and I got pregnant and lost the baby.
But what I also didn’t know at the time, is that I am one of those women for whom hormonal contraception is an absolutely terrible, terrible idea.
After the birth of my most recent child I ended up having similar problems again. I had a severe post-partum hemorrhage that left me severely anemic, and then, about a month later, I started having the same kind of crazy, heavy, two-and-a-half to three-week cycles that I’d had before the miscarriage. There was no way that my body could handle the blood loss. My baby wasn’t gaining as fast as he was supposed to be, and my midwife was concerned that anemia might be contributing to a lack of breast-milk. I could conceive of no more reasonable, pro-life rationale for going on the Pill and I decided that I wasn’t going to make the same stupid mistake as I had last time.I went to the doctor and got a prescription. I did, however, mention a concern that I had: “My sister says that she had to go off the Pill because it caused severe mood disruptions. I’m kind of concerned because we have a similar history of Seasonal Affective Disorder and depression.” The doctor just barely managed not to roll her eyes, and replied, “Well, if you think that it’s going to upset your moods, thinking that can cause it to happen.” In other words “The Pill doesn’t really have negative mental health effects…it’s just psychosomatic.”
So I went on the Pill. And to my immense relief it did not cause any significant changes in the way that I felt. It made my vision go a little wonky, and I started to think that I might need glasses, but as far as my mental health was concerned I felt normal. It also gave me a break from blood-loss. My hemoglobin levels rose, and my breast-milk supply increased. As an unexpected bonus, my levels of gender dysphoria hit an almost record low. Plus, and I won’t pretend this wasn’t a plus, it meant that I didn’t have to worry about trying to chart postpartum cycles that were probably, but not necessarily, anovulatory.
Except, then it hit October. This is when SAD usually starts to become a problem for me. And this time it hit with a vengeance. Unfortunately, because I had already been on the Pill for a number of months with no ill effects I was no longer paying attention to the possibility that it might be affecting my mood. So when suddenly I started to feel record levels of depression I figured that it was because the stresses in my life had simply become too much. I’d hit a breaking point. I could no longer handle things, and the combination of this stress plus the grey October days was causing me to lose my mind.
For three months my mental health went from bad to horrific. By mid December I was thinking about suicide and self-harm literally all the time. I mean, it was at the point where I would have a really good day, where everything was going right and there was practically no stress and plenty to be happy about… on a day like that I would only casually think about driving into an oncoming Mack truck like two or three times. On a bad day, my brain would literally do nothing except present me with images of gruesome ways that I could kill/maim myself, and/or be killed/maimed by someone else. I would look at an object, like for example a lamp-post, or a cow, or a hydro meter, and my mind would instantly come up with a way that it could be used in a deadly scenario starring me.
But like I said, it never occurred to me that the artificial hormones might have something to do with it.
Until, fortunately, I forgot to take the pills with me when I went to my mom’s for Christmas. My mood improved almost immediately, but that was expected: I mean, it was Christmas. I was away from the usual stresses of life. Surrounded by my numerous relations. Everyone was happy. Of course I felt better. When I got home, I wasn’t supposed to start taking the pills again until I had completed a cycle and could start on day one with a new pack. So I wasn’t on the Pill. And while the stresses of ordinary life returned, my mood stayed normal. No suicidal ideation. No random impulses to kill myself. No nightmarish scenarios playing on repeat-loop in my brain. I felt… human.
It was so different from how I had felt the last three months, and so unexpected, that for like two weeks I was practically in shock, dazzled by the incredible, almost unbelievable wonder of feeling this way. Feeling, just for the record, the way that I would normally feel in the dead of winter – a state that, in any other year, I would have described as “depressed.”
Needless to say, I did not go back on the Pill.
Alright, but that’s one experience. An experience that can’t just be ignored, of course, but a marginal experience, right…?
Image courtesy of Pixabay
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