We Need a Thoughtful Discussion About Birth Control (A No Easy Answers Post)

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No Easy AnswersThere is a reason I generally don’t post about headlines: it takes me time to process things and make sure my first reactions all hold water. I hate the tendency to react without thinking, the way it leads us to view everything in black and white and fail to acknowledge the nuances in every situation, and the fact that if you stop and reflect for a while before posting, the topic has passed and no one cares anymore. But usually I choose to sacrifice timeliness in the service of thoughtfulness.

All this as a preface to the fact that my sister, the lawyer, pointed out that my post on Zika and contraception included a rather major flaw that, in my attempt to react in a timely fashion, I somehow overlooked. Namely, the whole flap about Zika really is about preventing pregnancy, not just about preventing disease spread, so the whole argument about barriers vs. hormonal birth control doesn’t hold up.

I feel particularly embarrassed because the topic of sexuality and its relation to family planning is so important to me, and I get so frustrated when people of faith end up turning off those they’re trying to convince by reacting without thinking things all the way through. It’s called shooting ourselves in the foot.

I think I shot myself in the foot, and I spent half the weekend cringing about it.

However, I do not delete the post, because I still believe most of what I had to say is important to have out there. Every single article that touches on the Church’s teaching on contraception emphasizes that “Catholics aren’t paying attention to this teaching, anyway,” as if that proves anything other than that people do what they want to do and always have—screwing around on their wives, cheating their customers, spreading rumors, and a host of other things the Church has always taught are wrong. Yet there’s not one of those other cases in which anyone would even consider suggesting that noncompliance = an institution “out of touch” and a teaching in need of change.

Birth control is one of those topics that people on both sides—myself included, apparently—just don’t seem to be capable of thinking rationally on. We can all project some semblance of reason, but there are conversations we ought to be having but which are considered to be non-starters.

For instance: if Church teaching on contraception is so universally ignored, why do its opponents get so bent out of shape about it? Why do they feel this compulsion to bring it up at every possible opportunity? What possible threat could it pose to them?

And another one: Is birth control actually good medicine? Isn’t it possible that it’s actually bad medicine, disrespectful to the dignity of woman, to go in and shut down a part of her body that is working just fine?

And related, but distinct, because sometimes the body isn’t working just fine: Is it truly good medical practice to use pharmaceuticals to mask symptoms of problems like PMS, endometriosis, PCO, thyroid deficiency, etc.? Shouldn’t we default to “Let’s figure out what’s wrong and fix it,” and only go to “mask the symptoms” when all other efforts have failed?

These are questions that truly puzzle me, and on which I truly would like to see thoughtful, non-polemic discussion take place. Perhaps there are things I don’t see that would make a difference to my view on them.

Can we have that discussion? Are there any people out there willing to read through a post on birth control and get to the end of it willing to engage?

For other posts in the No Easy Answers series, click here.

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14 thoughts on “We Need a Thoughtful Discussion About Birth Control (A No Easy Answers Post)

  1. “For instance: if Church teaching on contraception is so universally ignored, why do its opponents get so bent out of shape about it? Why do they feel this compulsion to bring it up at every possible opportunity? What possible threat could it pose to them?”

    I have contemplated this before. And what I came up with is that people want to be validated — in their emotions, in their choices, in everything. They want us all to say what they are doing is okay. Everyone hates to hear that what they are doing is a sin. I hate it, too. Even though I am not prone to sin in the area of contraception, I am prone to sin in other areas and I hate it when my sin is laid before me plain as day.

    I think that is what it is with the Catholic Church’s teaching on contraception — yes, it’s widely ignored — but when the Church lays it out there and exposes it for the sin it is, people get their backs up.

    • I’ve had my own set of thoughts on this, but I hesitate to put words in other people’s “mouths.” I’m really hoping people will chime in, but I’m not counting on it. It just seems like everything about sex is taken for granted and no topics surrounding its universality are ever, ever to be questioned.

      • One thing I think is different about contraception is that not only do many people and churches not see it as a sin, they see it as almost a virtue. You are able to control the size of your family so kids don’t starve, so mom’s health is preserved and, for some, so mom can economically contribute to the family rather than being pregnant all the time.

        Another thing is that you have celibate males promoting a teaching that most effects non-celibate (I was going to say married) women. Many people have the attitude of “you don’t play the game, you don’t make the rules”.

        I also think the church has done a terrible job of actually teaching the teachings. I took some classes years ago for catechist certification. They were all scheduled to last all day, all let out a couple of hours early because “something came up” for the instructor–an ex-priest who had spent years working for the archdiocese in a number of capacities. One of the classes was on the sacraments, and since he “had to shorten class” he left off matrimony and holy orders. My son went to a Catholic high school and the sacraments were part of the curriculum one year. Did they ever get to matrimony? Nope. If I hadn’t read it on line, I’d have no idea that the “no birth control” teaching was any more than that. The whole bit about openness to life, sex being unitive and procreative, and the problems with separating the two–not really mentioned in pre-cana. Maybe mentioned in an NFP class but why in the world would I take one of those?

      • All of what you say is true, Ruth, although I don’t buy that it’s all legitimate–specifically about the celibate thing. I’ve always thought that sex is such a strong motivator that the people most likely to be able to view the topic objectively are those who have no vested interest in the matter.

        The catechesis issue is one that I agree with wholeheartedly. It is the focus of what I do now. And as for “virtue,” that’s where I have to sigh, because again, it boils down to an all-or-nothing view of the topic: there’s either birth control or a dozen kids; NFP just doesn’t even register on the radar. Because it requires abstinence, and because people think it doesn’t work, are my suspicions.

      • I couldn’t figure out how to reply under your response. so I’ll do it here. I used NFP from my mid-30s through menopause. Except for one instance it worked fine 🙂 Actually, in that one instance, I had been diagnosed with PCOS, I was in my early 40’s and my cycles were whacky and hard to track (I didn’t say it would have been impossible had I bought charts, a thermometer and/or paid real close attention to everything you were supposed to pay attention to–but I was used to textbook perfect cycles that did what they were supposed to do when they were supposed to do it and I didn’t chart) and I figured that I was probably over all that anyway….

        I’ve never done any scientific studies, but my guess is that for most women most of the time properly following NFP rules could get to be second nature after not too many months and that for most fertile women, most NFP systems would end up calling for 7-10 days abstinence per cycle, which IMO is pretty tolerable. However, I have read on various on-line forums of people who had months of potentially fertile days post-partum (and these were real NFP nerds who knew all the rules) or weeks at other times. Like my whacky cycles were indicative of PCOS, and perhaps perimenopause, their long cycles may have been indicative of something else going on, but at that point in my life, PCOS wasn’t really a problem–I wasn’t trying to get pregnant and the cysts, while annoying at times, never got serious enough to have to be dealt with. I might have made different choices in how carefully I used NFP if getting pregnant would have been a serious problem, but there are just so many instances in which NFP can require prolonged abstinence to be sure of avoiding pregnancy and it calls for so much judgment from people who aren’t experts–by that I mean that the pill has a perfect use failure rate below 1%, and an average use failure rate somewhat higher–but the average use failure is caused by failure to take the pill as prescribed. NFP has high perfect use rates, and quite a bit lower average use rates. How much of that difference is because women read the signs wrong and how much of it is because they choose to take chances? Of those who choose to take chances, how many of them are taking what I guess I’d call dumb chances–a woman with pretty regular cycles choosing to use the first wet day, or only waiting two days past peak (or less) and how many of them are women who have had long patches of unclear signs and crossed their fingers and …

  2. As far as the question about whether bc is good medicine, I’m not a doctor, etc. but yes, I think it can be. If my college-aged daughter complained of extremely painful periods, I wouldn’t want her put on the pill, without finding out why she was having the pain. If the answer was endo, my inclination, if I was asked my opinion, would be to laser out what they can get, and then put her on what are thought of as bcps to delay its return. As far as I know, she isn’t sexually active, so I consider the argument about whether or how often they cause early miscarriages is irrelevant in her case. She isn’t in a position to have a baby, and I want her fertility maintained until such time as she is in a position to do so; therefore I want to treat the endo, but since the doctors practically guarantee it will come back, and the only way to delay it is hormonal…

    If asked to give advice to a young married woman with the same diagnosis, I’d suggest the laser surgery, and, if at all feasible in her life, to try for pregnancy sooner rather than later. If I was “done” having kids and having trouble with endo, particularly if money for surgery was an issue, covering the problem up with the pill doesn’t sound like such a bad idea. Different people have different goals in treating different conditions. For a woman who doesn’t want any more kids getting birth control and symptom control in one pill doesn’t sound like such a bad idea. I have one friend who told me she considered going back on the pill after she had her tubes tied because she felt better on the pill than off.

    • Katrina

      I’d love for everyone to step into the shoes of someone who’s been there, but unfortunately we can’t, which is the problem with the argument to begin with. There’s no way for you to try being the girl who has to be absent from school two (or more) days a month due to problems that currently have no other medical “fix” (yes, that was me). Or to try being the one who has huge hormonal imbalances and has been seeking doctors and natural methods for fixing one’s own body with food and still being miserable 25 days out of the month (or more) for her entire life, but because she’s not actually dying of anything and refused to take a prescription to fix it, continues to be miserable because she literally has no other options. After years of trying natural fixes, she finally starts taking hormone supplements and gets on birth control to have more days feeling normal per month. Hormone imbalances aren’t like going about your day with a cramp or a headache. For some people, it means going about your day as if you’re not yourself, like your head is in a fog, you can’t do anything right and nobody (least of all your own self) wants to be around you.

      How fair is it for people who don’t have these problems to judge these women? Instead of lifting them up and telling them it’s not their fault their bodies are not perfect and we do our best to understand that they are doing what they can to be themselves, we demean them for things they have no control over. Hormone imbalances are one thing I discuss with my closest friends because they can be so debilitating to our lives and are just not taken seriously by the medical community. We do our best to lift each other up and recognize none of us has the same experience as the other. http://qz.com/611774/period-pain-can-be-as-bad-as-a-heart-attack-so-why-arent-we-researching-how-to-treat-it/

      And what about the women who don’t want kids – ever? If the “cure” for her problems is to get pregnant to supposedly sort everything out – BTW it doesn’t work for everyone. It didn’t for me. In fact, it got much worse.

      • Katrina

        I guess what I’m trying to say is… there is an easy answer: don’t judge other people or take away their right to make their own decisions. You don’t know what it’s like to live in their body everyday. You shouldn’t be making that decision for them.

      • Right, exactly, there’s no easy answer. Your story illustrates really clearly why there is a medical exception to the teaching, and really it sounds like you approached this as I would: that hormonal birth control is a last resort, not a first line of defense. But I think the cultural discussion on the topic goes the opposite direction–to dismiss anything that ISN’T hormonal birth control, for any reason, be it health or family planning. And I think there are compelling reasons to rethink that set of assumptions. Which is not to justify judgment or going off half-cocked, but to say that people ought to be able to talk about it without both sides interpreting everything said as an attack. Which means we have to change HOW we talk about it, too, because sometimes the interpretation is justified. Often, actually, I think. And it goes both directions. People who use NFP feel like they have to keep it secret because they get judged and belittled for it.

        Truthfully, I don’t think women, as a rule, are being given good information. The doctors are formed in the same atmosphere and most of them really don’t know anything about NFP. All the birth control lists/surveys lump in rhythm with modern NFP and so the numbers are skewed.

  3. Susan

    Re: Medical – the point of the hormones can be to even out the body’s own response and give it time to heal: the signature characteristic of PCOS has been shown in some cases to go away after an amount of time on hormonal birth control as part of an overall treatment plan (treating complicating factors as well).

    • I know that is the rationale behind certain people I know being put on birth control for PCO, but I’m puzzled as to how the body is going to fix itself of a condition like PCO. I also have PCO, but it’s been controlled for years now (and allowed me to both conceive and avoid without further intervention) by being on metformin. I know that doesn’t work for everyone. My current (NFP-only) doctor has explained that PCO is actually a blanket term covering a number of different manifestations.

      On Mon, Feb 22, 2016 at 9:53 PM, Kathleen M. Basi wrote:

      >

      • Susan

        I resisted initially, going the Metformin route as well. Metformin didn’t work well for me: complicated other medical issues, and my cycles got even more irregular.

        After an ER visit for suspected hemorrhage and subsequent follow up visits and procedures with specialists, I’m now stable on a pill, and the “cottage cheese” PCO appearance has disappeared.

        It may not be “too late” for me to go off the pill and conceive (and carry to term) a child; the specialist said it was possible and would be supported — sooner rather than later. However, that first requires me to meet and marry a like-minded gentleman.

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