The Truth About The Pill

by Clare Blumer

Here’s something I wish someone had told me a very long time ago.

Remember that sex education class when you were about 14 and they told you about the birds and the bees and how to prevent them from multiplying? In fictional, TV-show classrooms, there was inevitably a poor, innocent cucumber and a condom involved.

I don’t remember the vegetable but I do remember paying attention to the various descriptions of the contraceptive pill and its magical, nearly perfect effectiveness at preventing pregnancy.

Concurrently, in history lessons about the women’s rights movement of the 20th century, the Pill was celebrated as the most important scientific advancement that could further the cause of gender equality. Childbearing and rearing were no longer an inevitability of sexual maturity. Consequently, women could choose their own destinies; enjoy sex and either delay or avoid motherhood altogether. They could take charge of their bodies!

Young me… sitting in class alongside other girls in green, sack-like dresses… thinking… one day… I’ll be on the fabled feminist freedom drug: The Pill with a capital ‘P’! A girl can dream…and sure enough, by the age of 17, I was on it.

There was a strange pride I experienced when I started on the Pill, as if, via prescription, I had joined the ranks of sexually liberated feminists, a Simone de Beauvoir or a George Sand, if you will. (For no good reason my feminist fantasies had manifested exclusively in the French.) It was like I had my own slogan on contraception: en charge et le contrôle.

It took me a while to learn that there’s something wrong about the Pill. Beyond the side effects and the health risks—there are just way too many women getting pregnant while using it. Friends, relatives, the lady next to you at the hair salon, your accountant, or if you want to hear the hoards cry, “I got pregnant on the pill,” just Google it. In the USA alone, Planned Parenthood puts the number of women getting pregnant on the pill as 6% per year (2014 statistics).

The ladies you usually hear from are the ones that went ahead with having a child they didn’t plan. And good on ‘em. More ladies of my generation probably should have babies earlier, damn the consequences of not having two platinum VISA cards to rub together.

But I also know the terrible stories. The resultant abortions, the confusion, the guilt, the break-ups, the broken hearts, the inescapable feeling of a sin committed. And layered within this parcel of tragedy is the piece of paper telling you that somehow you got it wrong, that you weren’t careful enough, that it’s your fault, and that you’ve become part of the 0.3% Pill failure idiot club.

But the joke is on you for another reason entirely. What you should have been told is that the 99.7% success rate of the Pill only applies to something known as “perfect use.” But you know what perfect use means? Taking it at the same time every day. Using a second form of contraception if you’re on another medication, or if you’ve thrown up because you had too much sangria at the Spanish Film Festival opening night.

If you, like most people, are not perfect and forget a day here and there, then the figure changes drastically and puts the failure rate of the pill at 9% in the first year with “typical use.” That’s right, with the way that most women take the pill, they’ve got nearly a 1 in 10 chance of getting pregnant in a year.

I was 26 years old by the time a doctor told me the real statistics on how many women get pregnant on the Pill. My doctor proactively asked me about my contraception when I was visiting for my asthma. (Anybody who remained with their childhood—usually male —doctor knows that not having to awkwardly bring up contraception yourself is cause for celebration.)

I told her I’d just started a new relationship and was thinking of going back on the Pill but was worried because of all the on-the-Pill pregnancies I knew about. She nodded knowingly as she pulled out a folder of contraception options. There were the two sets of stats: “perfect” and “typical.”

I’ve never been a perfectionist by any stretch of the imagination. I still don’t make my bed every day and I’m nearly 30. When I heard these stats, I recognized my personality flaws and chose another form of contraception.

My friend Jill says she didn’t use the pill “perfectly” when she got pregnant as a university student. “I was switching from one type of Pill to another as the first one made me moody,” she told Shera Mag. “I’m not sure what I did wrong but I might have left the changeover between one and another go too long.” She thinks she knew pretty early that something was up. Her breasts hurt and just a sip of alcohol made her feel nauseous. “I felt like I had made the mistake, that maybe I’d left it too long before starting the new one. I wasn’t paying attention.”

Jill was half way through her university course when she found out and says she never considered having the baby. “It was all wrong. I thought I had been doing the right thing and then the unthinkable happened. I was young and didn’t think twice about my decision to have an abortion.”

She says she doesn’t regret having the termination but now no longer trusts the pill. “I tell all my friends not to trust it. I didn’t use it properly, but most people don’t, and they don’t know when they’re going to get careless. So many people are on it for more than ten years.”

Another friend, Alison, had a very different attitude to the discipline of taking the pill. She had heard about the hazards of non-perfect use via other friend’s slip-ups, unexpected pregnancies, and abortions. She had been on the combined oral contraceptive known as “Brenda” for about eight months and took it religiously at 6 o’clock every evening. She wasn’t on any medication that might weaken the contraceptive properties of the Pill.

“My boobs got bigger and wine tasted like metal. I felt off, I felt strange,” Alison says. “I was at the pharmacy buying something else and picked up a three-test kit to rule out pregnancy so I could go to the doctor and work out what else was wrong.”

After the first positive reading, Alison used the whole packet of tests and found out she was pregnant. She tells me this story as she happily feeds her newborn. “I do have a baby and we’re so glad we do, but at the time it was a big, fat shock.”

Alison says her doctors didn’t really believe that she used it perfectly, but she knows she did, making her part of the supposed 0.3% that gets pregnant with perfect Pill use.

There are many other women for whom the Pill has worked well for years before they chose to have children. It worked for me for about five solid years of sporadic use over a ten-year period before I started to hear way too many unwanted pregnancy stories.

It still has some major advantages over other contraceptive methods: it’s cheap or heavily subsidized in a lot of countries, and it allows the female to take control of her contraception when her partner(s) may refuse to take responsibility.

According to sexual and reproductive health think tank, the Guttmacher Institute, based in the USA, the Pill is still the most popular form of contraceptive method in the States. They have a table showing how each contraception compares.

Hilariously, the “withdrawal method” is included as a contraceptive method. This is arguably not a contraception at all but one that many friends still cite as their main method of pregnancy prevention.

For the uninitiated, the withdrawal method relies on the precision timing of a male at their most vulnerable moment—before ejaculation. If we use the bullfighting analogy, it would be like the matador stepping out of the way as the bull charges toward the flag. Bullfighters die all the time and women get pregnant from the withdrawal method at a rate of 22% a year.

But if you’re worried about getting pregnant on the Pill and you’ve got to be on some form of contraception, what should it be? There are lots of contraceptive methods out there for every type of body, male or female, you just have to find what works for you.

Let’s ignore perfect use and look at the typical use stats. According to the Guttmacher, the best forms of contraception are:

  1. Implant (0.05%)
  2. The man getting a vasectomy (0.15%)
  3. An intrauterine device (IUD) (0.2/0.8%)
  4. Female sterilization (0.5%)
  5. Injectable birth control (6%)
  6. The Pill / The Vaginal Ring / The Patch (9%)

I chose the implant because it’s statistically proven to work the best for muppets like me. I have now had two very happy years with a plastic rod inserted into my arm by my very wise doctor, with her very informative folder of options. As you can see, it rates as the most successful in the research.

If I’m planning to get accidentally pregnant any time soon, I think I’ll go back on the Pill.

Title image source: sulekha.com

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