In Our Control

Copyright © 2010 by Laura Eldridge

A Seven Stories Press First Edition

This book is not intended to replace the services of a physician. Any application of the recommendations set forth in the following pages is at the reader’s discretion. The reader should consult with her own physician concerning the recommendations in this book
.

All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, including mechanical, electric, photocopying, recording, or otherwise, without the prior written permission of the publisher.

Seven Stories Press
140 Watts Street
New York, NY 10013
www.sevenstories.com

In Canada: Publishers Group Canada, 559 College Street, Suite 402, Toronto, ON M6G 1A9

In the UK: Turnaround Publisher Services Ltd., Unit 3, Olympia Trading Estate, Coburg Road, Wood Green, London N22 6TZ

In Australia: Palgrave Macmillan, 15–19 Claremont Street, South Yarra, VIC 3141

College professors may order examination copies of Seven Stories Press titles for a free six-month trial period. To order, visit
http://www.sevenstories.com/textbook
or send a fax on school letterhead to (212) 226-1411.

Library of Congress Cataloging-in-Publication Data

Eldridge, Laura.
In our control : the complete guide to contraceptive choices for women / Laura
Eldridge.—Seven stories press 1st ed.
     p. cm.
eISBN: 978-1-60980-241-7
1. Contraceptives—Popular works. I. Title.
[DNLM: 1. Contraception. 2. Contraceptive Agents, Female. 3. Contraceptive Devices,
Female. 4. Women’s Health. WP 630 E37i 2010]
RG137.E43 2010
613.9′43—dc22
                                              2009037886

v3.1

To Barbara Seaman (1935–2008)
A true heroine, a great activist, a fearless writer, a generous guide,
a wonderful teacher, and an even better friend
.

Contents

Cover

Title Page

Copyright

Dedication

Foreword by Jennifer Baumgardner

Introduction

  
1. Past Tense: Contraceptive History Before the Twenty-first Century

  
2. A Pill Primer: Hormonal Contraception for the Twenty-first Century

  
3. Hidden in Plain Sight: Nonhormonal Contraceptive Options

  
4. By Any Other Name: Alternative Distribution Methods and Hormonal Contraception

  
5. Of Tides and Phases: Menstruation and Birth Control

  
6. Spotless: Questions and Controversies with New Menstrual Suppression Drugs

  
7. Like Candy: The Politics of the Morning-After Pill and Bringing Hormonal Contraception Over the Counter

  
8. Running in Cycles: Fertility Awareness and Natural Birth Control

  
9. One Less? Facts and Fictions about HPV Vaccinations

10. What About the Boys? Or, Why Is There
Still
No Pill for Men?

11. Going Green: The Environmental Burden of Contraception

12. Around the World in Twenty-eight Days: International Issues in Reproductive and Contraceptive Health

Resource Guide

Acknowledgments

Notes

About the Author

About Seven Stories Press

Foreword
by Jennifer Baumgardner

When it comes to birth control, I fear I’m like an ostrich—I long ago stuck my head in the sand. You’d think I would have faced up to it by now. I’m a feminist who was raised on
Our Bodies, Ourselves
. I’m thirty-nine, I have two kids, and I don’t think I want more. I live with my second son’s father and have sex a few times a week. All that is good.

The problem is I have always been intimidated by my birth control options. Thus, I have often avoided using anything to prevent pregnancy. In the two decades in which I’ve had sex, I spent six years with two girlfriends. During the other fourteen years with men, I was often frustrated with erection-deflating condoms, scary IUDs, and the nausea-inducing birth control pill. Sometimes I look at the array of birth control devices available and think, “Hand me my rabbit pearl.” I’m not alone in wondering if masturbation beats sex, all things considered. All of my straight female friends fantasize about better birth control. My friend Christine used to fetishize “the shot” (Depo-Provera)—“Three times a year! You get it and forget it!”—but then she learned that the side effects were atrocious and, further bummer, Depo often didn’t work. Many have dreamed a nasty feminist dream about a male pill, but few of those women would trust a guy to take it. My sister uses condoms, but she claims it’s because she rarely has intercourse. “Why take a pill all month for that one time you’re going to have sex?” she asks. “I wish I were kidding.”

To be honest, I never found a contraceptive method that satisfied my contraceptive and sexual needs, and I never found a feminist guide that inspired me to make that search a priority. Until now.

Laura Eldridge is young, savvy, and smart. She worked intimately for most of the past decade with Barbara Seaman, the pioneering women’s health activist. Seaman (who married into her last name but knew it was perfect for a health journalist writing about birth control) was a thirty-something mother of three in 1968 when she discovered, via her column
at
Ladies’ Home Journal
, that women were suffering terrible, often fatal, side effects to the original high-dose Pill. Several pathbreaking books (including
The Doctor’s Case Against the Pill)
and campaigns against drug companies later, Barbara succeeded in getting birth control pills to carry warning labels and making the Federal Drug Administration accept input from patients as part of the drug’s regulation. She came into my life when she swept into the offices of
Ms
. magazine. Within months of meeting her, I was off the Pill.
In Our Control
makes me see that my ceasing to take the Pill isn’t where I should stop—it’s just the beginning of figuring out how to find birth control that works for me.

The trouble with most advice out there for women and girls about preventing pregnancy and STIs is that the “experts” never give the full picture, and they don’t take into consideration the unique situation every unique woman is in. Contraception is not a one-size-fits-all scenario. It is about options. There are many, and they all have their triumphs and caveats, and each woman needs to figure out what works best for her in her current sexual life. The message of
In Our Control
is an important one: there
is
an option out there for you, and your best option might change throughout your life. This book sets out to keep women in control of their sexual health by equipping them with all the information they need and trusting them to make their own decisions.

Yet,
In Our Control
does more than just offer a survey of contraceptive choices. It brings us into the fascinating history behind this hot topic. Laura Eldridge traces the historical and political roots and ramifications of birth control development, noting how times of social power for women are often met by hostility to birth control, and how middle class and rich women were always able to buy secrecy around their reproductive mishaps. Besides providing a cogent overview of everything from fertility awareness to female condoms, she analyzes why birth control is such a sticky wicket. Is the Pill liberating for women—or dangerous? Are condoms the least effective form of birth control—or the best, given that they also prevent the spread of STIs? Eldridge stays away from either/or prescriptions, concluding, “If you aren’t happy with your birth control, there is no reason not to try another method.” And with this book, you can figure out how to best do that, armed with health information and political context.

I realized after reading
In Our Control
that there was a lot I didn’t know. We have more alternatives than I was aware of, for instance, and birth control options that may be annoying in some ways are powerful in others. Most of all, I learned that contraception does not have to be a damper on your sex life. With Eldridge’s astute work in hand, I might just get my head out of the sand and face the facts of life.

Introduction

Three years ago, at twenty-seven, I ended my long-term relationship with the Pill. I had used it off and on for about nine years. Things hadn’t been good for a long time, and I had desperately been looking for a way to leave, but felt trapped. It turned out the answer I’d been looking for was there all along.

I first went on the Pill when I was eighteen. I had been in a relationship for almost a year and was thinking about having sex. Of course I planned to use condoms as well, but I was heading off to college in New York City in the fall and didn’t want to jeopardize my future in any way. A good child of the 1990s, I had sat through tons of sexual education classes. They all conveyed the same message: birth control pills were the way to go. I also knew what my friends were saying, what the girls who had become sexually active before me whispered over French fries in the cafeteria of my small Utah Catholic high school. The only way to be really safe, pregnancy-wise, was to take matters into your own hands.

Being eighteen, I didn’t march up to the family doctor and ask for the Pill, although thanks to good marketing on the part of pill makers, I probably could have. I could have feigned bad periods or claimed that I wanted to erase the blemishes that had danced farther and farther down my forehead toward my eyebrows as puberty progressed. But I didn’t. Instead, I did what savvy young people in the Salt Lake Valley did when they were in my situation: I went to the small Planned Parenthood located about two blocks from my high school.

Kids went there because it was cheap, and more importantly, because of its precious “don’t ask, don’t tell” policy. I knew girls too afraid to ask for pelvic exams who went there out of concern for basic health, and of course I knew those who went for pregnancy tests and abortions. I was pretty nervous on that desert-hot July day when I parked my beat-up red car next to the clinic and walked furtively into the small lobby, praying that none of my friends’ parents would see me. I read over a brochure that listed the different
contraceptive methods next to their respective efficacy rates as I sat and waited for my consultation, but in truth I had decided what I wanted long before I darkened the clinic doors. A kind, soft-spoken staff doctor gave me my first pelvic exam and wrote me a prescription for a popular tricyclic pill.

The first few weeks I was on the Pill, not much happened. My breasts swelled up and became painful, and I found that though I hadn’t really had PMS before, I was suddenly inconsolable for two or three days before a bleed. Otherwise, I was pretty happy.

I went off to school in the fall and dropped the Pill. I rarely saw my boyfriend and remembering to take it was too much of a pain. I would go back on periodically over the next six or seven years, always struggling to take it regularly but never considering that otherwise unexplained changes in my health—for example, migraine headaches I had never experienced before—were due to Pill use. And I can honestly say I didn’t think much more about it.

In 1999, the way I thought about contraception changed. I had the tremendous honor of meeting and working with the great author and activist Barbara Seaman. Barbara died recently after a short battle with lung cancer and nearly fifty years of battling with drug companies, doctors, and scientists over dangerous drugs, including hormonal contraception and hormone replacement therapy.

I met Barbara as part of an internship for a women’s studies class. I fancied myself a serious feminist and jumped at the chance to work with an author who, a friend explained to me, had been an active member of the second-wave women’s movement. Imagine my surprise when on my first day of work she told me that her first book,
The Doctors’ Case Against the Pill
, critiqued a drug that I had come to see as synonymous with the gains feminism had made. I was about to learn that while the Pill has indeed revolutionized and improved women’s lives, the story is much longer and more complicated.