How to Talk to Your Friends About Birth Control: Lessons From the Pro-Vaccination Crowd

How best to persuade people who are wary of vaccinating their children because of ill-informed anti-vaccination propaganda? That’s the question Women Thinking Inc. took on when it decided to poll parents, mostly mothers, about why they hesitate to vaccinate. Now the organization has a handbook out, based on that research, explaining how to talk to people who have heard vaccinations are dangerous and as a result are considering not getting their kids vaccinated. It’s a great read and highly recommended. It also has lessons that pro-choice, pro-science people can learn from when talking to friends and family members about an issue that many people are similarly uninformed about, the birth control pill.

The birth control pill and vaccinations have a lot in common. Both are types of preventive medicine that are, by medical standards, extremely safe. (Indeed, the pill is safe enough to be sold over-the-counter, and is in many countries. Many vaccines are also available without going to a doctor.) Despite this, both kinds of medications have been subject to alarmist messages, not just from the right-wing media, but from non-partisan, liberal, and feminist sources that otherwise wouldn’t be associated with a negative attitude toward modernity and modern medicine. There’s recently been a surge of debate about the pill in the media, with the anti-pill side being notable mainly for its indifference to questions of scientific rigor.

As Amelia Thomson-Deveaux explained at the American Prospect in response to a spate of misleading stories that tried to scare young women into thinking the pill will cause blindness, bad information about the pill is known to cause women who might otherwise find it to be beneficial medication to go off it:

In fact, sensational reporting on such findings can have an actively negative impact on women’s ability to choose the best contraceptive method. For years, women’s magazines reported that birth control pills caused weight gain. Even after numerous studies debunked this claim, concern about putting on a few pounds is one of the main reasons why women stop using the pill, or refuse to take it in the first place. In 1995, after the British Committee on the Safety of Medicines erroneously suggested that certain types of birth control pills dramatically increased women’s risk of blood clots, rates of unintended pregnancy soared.

As Thomson-Deveaux notes, the pill doesn’t work for everyone, but these misinformation campaigns are clearly talking women who otherwise would have found the pill to be safe and effective out of using it.

So what can we learn from the Women Thinking guide on vaccination when talking to people about the pill, particularly friends who are worried—but probably have no reason to be—about side effects they heard about from alarmist reports? The first and most important thing to remember is to know your audience. Is your friend convinced the pill is an evil poison and won’t have anything to do with it? She’s not persuadable, so agree to disagree and move on. Only talk about this with women who have heard scary stories and aren’t sure what they believe. Here are some other findings that may be useful:

Don’t assume she is stupid for questioning the safety of the pill. She’s probably really smart and engaged—how else would she have come across these scare stories? It’s not her fault that the journalists writing them are not diligent about the facts.

Emphasize the safety of the pill, but be honest about the risks. Be clear that the pill does not work for everyone, and talk specifically about how smokers are at too high a risk of stroke to use it. But emphasize that the side effects are small and clearly documented enough that, in many countries, they sell it over-the-counter, and there haven’t been any major problems because of it.

Use metaphors to emphasize how normal the pill is. Some people have concerns that it’s “unnatural” to take the pill because it suppresses ovulation. Point out that we suppress “natural” processes all the time, such as when we take painkillers to suppress pain or when we go inside or wear coats to shield our bodies from the cold.

Emphasize how popular the pill is. The pill is the most popular form of contraception in the United States, despite barriers to access such as price and having to get a prescription. Over ten million women are on it, and nearly 28 percent of women using contraception use it. Many people fear the pill is “untested,” but it’s been popular like this for 50 years now, which suggests if there was some kind of mass health problem stemming from it, it would have cropped up by now.

Don’t spend time trashing the people who float misinformation. Try to avoid “defending” the pill against detractors as much as possible, and instead frame your argument in positive terms. Instead of saying it’s “not dangerous,” try saying instead “it’s been shown to be relatively safe.” People don’t like it when you sound defensive and think you’re hiding something, even if you’re not.

Don’t be afraid of anecdotes. It’s frustrating, because we’re talking about statistical probabilities here, but the fact of the matter is that anti-pill arguments work in no small part because they focus on the anecdotal over the statistical realities. So fight fire with fire. Talk about any positive experiences you or others have had on the pill. Be honest about what you like best about it, including things like sexual spontaneity, regular periods, and confidence in the method as pregnancy prevention. Personally, I like the feeling of power over my body it gives me to be able to say no to ovulation if I want. I think that’s a valuable framing and should be used if that’s how you feel.

Listen to her concerns and don’t push too hard. Ever had the Diva Cup enthusiasts swarm you, trying to convince you that rainbows will fly out of your vagina if you start using it and insinuating that you might be morally corrupt if you don’t drop your tampons right this second? Know how that makes you never want to use the Diva Cup and snarl at it when you see it in stores? Yeah, don’t be that person. (I admit I struggle personally not to be that person, so do as I say, etc.)

This is one place where pro-pill people have a major advantage over pro-vaccination people in these one-on-one conversations. The goal for pro-vaccination people is to get a parent to agree to vaccinate. For pro-pill people, the goal is much smaller: to convince a friend not to close herself off to a possibility that she might really love the pill. It doesn’t matter what she ultimately chooses as a contraception method, as long as it works for her. Your only goal is to help make sure her choice is based on evidence, not scare-mongering. Pushiness shouldn’t be too much of a temptation.

And anyway, if she’s still on the fence, you can always point out that in an extensive study out of St. Louis, researchers found that intrauterine devices (IUDs) were wildly popular with women who were given comprehensive counseling about their options. If not getting pregnant for a while is a goal of hers, then reminding her that that’s an option, without being pushy, is always a great thing to do.

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  • Contraceptive CHOICE Project

    Thank you for featuring our research!

  • Hannah Ransom

    Hi Amanda,

    While I appreciate that some women will want to take the pill and that will be best for them, I do think it is good to note that most women do have some kind of unpleasant side-effect due to the pill. I know women who have been on it for a mere 2 months and their sex drive hasn’t recovered 3 years later. Now, I know this is an anecdote, but it’s important to note that for some women just going on it to try it out has lasting effects.

    I also would not say that these last 50 years have been great for women’s health, so I’m not so sure that I would jump to say that on a population basis the pill has been proven to be safe.

    I totally understand not wanting to shut anyone off from their possibilities, but there is also the fact that most women are shut-off (by their doctors, no less) from information and education on any non-hormonal options, and that is a shame.

    Also, I would say that a lot of women who choose against hormonal contraception, especially if they have never taken it at all and not just because they personally had a bad experience, do so because they don’t like drugs of any type.

    In summation, I totally support choice and information, but the sad fact is that with doctors, at least, most women get not enough information about possible side-effects of hormones and not enough positive information about non-hormonal methods (except copper IUDs, which seem to be a little better excepted now than just 5 or so years ago).