In Defense of the Pill and in Favor of Improving It


A lot of women have been complaining about the pill recently as the little birth control drug celebrates its 50th anniversary. It has unpleasant side effects; it puts the financial and personal burden of contraception squarely on women’s shoulders; it kills libido. There’s a whole crowd out there who think the new types of pills which change your menstrual cycle or get rid of it all together are unnatural because they suppress our goddess-given rhythms.

This brand causes migraines. This one creates crazy mood swings. One can switch to the patch or the nuva-ring, but then there are more side-effects. For young woman, birth-control bitching and switching feels like a mandatory rite-of-passage, a hormonal equivalent to dissing skinny jeans and then buying them, or discussing how the Sex and the City movie sucked, but you’re going to see the second one anyway.

The fact remains that all the critiques leveled this week are valid: the pill is far from perfect, both medically and socially, and we really do need a male birth control pill. We also have to put pressure on the medical establishment to keep innovating for those women whose options still feel limited. As Geraldine Sealey wrote in her Salon article “Why I Hate the Pilll:

The truth is that the development of innovative birth control methods has virtually come to a standstill. According to a 2008 report by Harper and several colleagues, public and private funds for contraceptive research have dried up in recent years. Most pharmaceutical companies have withdrawn from investing in contraceptive R&D, perhaps due to fears of costly personal injury litigation.

For Sealey and many of her friends, there ought to be better and more options for contraception. She cites a Guttmacher study which shows almost half of all women unhappy with their current methods, and points out that this discontent can lead to unintended pregnancies.

Still, I feel like our little buddy in its colorful plastic, day-by-day case is in need of a defense. Because for many women, the pill remains utterly and completely liberating. Just as it did when it first came out, the pill effectively keeps its satisfied users from the whole “biology is destiny” thing. For the women who refill those prescriptions month after month, a few weird side effects will be endured so that we can enjoy what the pill gives us: freedom.

First of all, there’s freedom from even worse side effects–the ones that mother nature bestowed on us. Sealey describes feeling like a freak because hormonal contraception doesn’t work for her. But there are a group of women who feel like freaks without the pill, who need the pill for a variety of physical reasons. I like to joke about this group, in which I’m included, saying that we’re solid proof that there’s no intelligent design. We’re also the modern-day equivalent of those women in Victorian novels who were probably labelled hypochondriacs or hysterics because they were constantly laid up with a “sick-headache” or often left the room “feeling faint.” Yep, that’s us women with totally irregular or debilitating periods, the ones who watch those commercials for tampons and hip birth control brands and nod vigorously at every symptom mentioned and then some that aren’t. There are women out there with allergies to painkillers or to latex, women with back pain and headaches and cramps that are so bad we wouldn’t be able to work or play sports or socialize for many days out of the month if we didn’t have the pill. But we have it, and we can function a lot better with it–we don’t have to take to our beds or shun mixed company. This is a decided feminist victory. I know that saying “I take the pill for reasons other than birth control” can feel like a cop-out, but its capacity to allow many of us to live normal lives shouldn’t be underestimated.

And it’s true, even more importantly, that the pill is effective and excellent birth control when used correctly. We hear horror stories of women who skip pills and end up pregnant. But the pill is capable of being really great insurance. Just ask the neurotic women out there, the ones who really, really don’t want to deal with a pregnancy scare. For them, the pill is a great boon, and almost totally foolproof when combined with another method, or even on its own, After a decent period of taking the regularly and training oneself not to forget to take it, a lot of worry evaporates. There’s no need to fret about a mishap the way there is with barrier methods of birth control, and no need to even think about birth control when one is about to have sex. With a brand that doesn’t affect sex drive, it’s pretty wonderful and revolutionary to be freed from that particular paranoia.

Of course, there is one major thing society could do to really ensure that the pill remains revolutionary: provide better health insurance. One of the key factors in being able to take advantage of the pill is access to a caring, patient Ob-Gyn who will help a woman find a method and brand that works best for her–sometimes trying three, four or five types of hormonal birth control. A good doctor will also help women get the best discount on her prescription and field questions about how many skipped pills mandates back-up and other emergency situations. A good doctor can’t be found without a good insurance plan. Furthermore, one of the main reasons women skip pills or aren’t able to back up their birth control is because they can’t afford to.

A recent Ibis reproductive health study in Massachusetts, even after health care reform, found a correlation between young adults’ insurance coverage and personal choices about contraception use:

Insurance coverage of contraception was a significant factor in shaping women’s decisions about contraceptive use and method selection; our results reveal that there are a number of systems gaps that impact the ability of young adults to access affordable and continuous contraceptive and other SRH services. Young adults who find themselves uninsured for transitional periods; young adults who are enrolled in health plans with religious restrictions on counseling, referrals, or service delivery; young adults who travel and seek routine care outside of their defined insurance coverage area; and young adults who are enrolled in non-prescription YAPs are among those populations that may find themselves “underinsured” with respect to contraceptive services. Young adults also felt that providers offered only limited information about the full range of contraceptive methods.

In order for the pill, which is liberating for some women, to be revolutionary for all, this kind of information and access needs to dramatically increase–and that requires political and social will.

Geraldine Sealey’s piece and this piece together prove that women’s bodies and needs are widely divergent–hence everyone feeling like “a freak”– and the options as they currently stand don’t cover us all. The current vogue of anti-pill backlash shows that women are ready for another leap of innovation and activism the way we were before the original contraceptive pill appeared. We need to keep the revolution going until all women can be satisfied with their birth control.

Like this story? Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Follow Sarah Seltzer on twitter: @sarahmseltzer

  • harry834

    Viagra, Rogaine, male hair products to avoid grey, other products for “a touch of grey”, similar products for facial hair, male deoderant, treatments for low sex drive in old male age, etc…

  • elyzabeth

    I would say that any medical treatment exists soley to prevent biology from being destiny.  Biology encompasses all the fun stuff like cancer, heart disease, diabetes, gangrene, infertility, small pox etc.  Biology is kind of a douchebag.