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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Sex Always Has Consequences

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Photo by Selbe <3, via Flickr

When I heard the story on the news this morning, I couldn’t decide whether to laugh or do a face palm. There’s a new study out saying that women taking the newer-generation mini birth control pills have 3x higher risk of blood clots compared to women who don’t take oral contraceptives. But, they hasten to add, that doesn’t mean you should stop taking them.

I’ve come to a realization lately that I think all women, and frankly all men too, need to come to terms with. For me, it was a long time in coming, considering how obvious it is.

There is no such thing as sex without consequences.

Proponents of natural family planning and proponents of artificial means of birth control both seem unable to grasp this simple truth. The NFP community likes to harp on the side effects of birth control and its potential to damage human relationships. Those who use birth control deride NFP as ineffective and contrary to human nature because it requires people to fight their instincts to come together at women’s most fertile time.

We would all like to think there’s some magic bullet that takes away the sacrifice and, dare I say it, suffering that is part and parcel of reproductive life. We want to be able to enjoy the coming together without the side effects/consequences. There are basically three courses you can take: you can impose artificial controls on nature (contraception); you can work with nature (NFP); or you can do whatever you want and let the chips fall where they may.

Photo by einalem, via Flickr

But every one of those paths has consequences.

If you use natural family planning, you have to deal with occasional (and for some people, frequent) ambiguity in the signs and the need to abstain when the woman is most interested in sex. There’s no question that requires sacrifice and, sometimes, suffering.

If you use chemical contraception, though–assuming it does what it’s supposed to do, and fools your body into thinking it’s pregnant already–you’re giving up that increased sex drive altogether. Which is why I find it puzzling when proponents of birth control criticize NFP for the abstaining when the sex drive is highest. I mean, it’s not like contraception solves that issue. And besides, there’s that whole thing about side effects, and environmental impact, and blood clots. Again: sacrifice, and sometimes, suffering.

Your third option is to let the chips fall where they may. You get the best of both worlds: sex whenever you feel like it, without side effects, without increased risk of blood clots. But there’s a natural consequence to that, too, and it involves bigger cars and bigger houses and a humongous grocery bill, to say nothing of college costs. And a lot of time pregnant and breastfeeding and exhausted. So again: sacrifice, and sometimes, suffering.

The reality is that sex does have consequences, no matter what you do. You can gnash your teeth all you like, but that’s the reality. Our job is to make the most responsible choice we can, based on as much information as we can. And the longer I’m involved with natural family planning, the more thoroughly convinced I become that NFP, while not without consequences, is the best option. It’s not the easiest, but it is the best–for women, for couples, for the world.

What It’s Like To Practice Natural Family Planning

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K and CAfter yesterday’s post about why I don’t like birth control, I think it only makes sense to talk about the alternative. Natural family planning is widely reviled as a game of reproductive roulette, an unreasonable burden on couples, or an unnecessary restriction on sexual expression. Those of us who use NFP try to dispel those myths, but we don’t really talk about what it’s like to live this life.

In no particular order, here are some of my thoughts about the fifteen years I’ve spent charting my fertility and using that information to plan our family.

1. I know myself. I know my body, what it does, what it’s doing at any given time in the cycle. I’m aware of sensations I once was not, and the cyclic changes are a continual source of awe and wonder. I’m coming up on forty this year, and I’m starting to see changes in the way my reproductive system responds as it approaches the waning years. I’m a whole lot more comfortable in my skin these days. NFP isn’t the whole reason for that, but it’s a big factor.

2. I’m a far healthier person because of my practice of NFP. I had erratic charts early-on, and that encouraged me to address dietary and lifestyle changes. Because I have to take my temperature every morning, I’m conscious of getting to bed and planning my life around good habits. I also learned that I drop two pounds when I go into Phase III (post-ovulation infertility). Huge implications for helping me manage my weight.

3. I’m aware of the hormonal shifts and how they impact me as a woman. There are two parts of the cycle when I am susceptible to being cranky, and knowing that makes me aware, as well, of the need to guard my reactions. This is particularly meaningful to me because I remember how out of control of my bitchiness I was when I was on progestin during the early part of the infertility battle.

4. I have a lot more self-discipline because we use NFP. I’m talking about the mental discipline to make sure I do the observations consistently and don’t get lazy. Because “lazy” leads to unnecessary abstinence.

5. We are intentional about intimacy. Our window of abstinence is usually 12 or 13 days, but on either side of that window we prioritize intimacy. I would really love for someone to undertake a survey to see how often people using different forms of family planning have sex. I would guess–but it’s only a guess–that we make at least as much room for it in our lives as couples using birth control. It’s just spaced out differently. Or maybe, just maybe, because it has to be intentional, we actually make better use of time?

This post is not even remotely scientific, but it is illuminating. Let’s just say if this is the benchmark, we’re doing better than most.

6. Being intentional has another up side. Spontaneity sounds great, but busy-ness and spontaneity don’t really mix–and who’s not busy these days? Especially when you’ve got kids. Intentionality helps me to get myself in the right frame of mind.

7. There are all kinds of implications of being intentional. We have to work together to get the kids in bed on time, we have to talk through the weekly schedules so we don’t park our butts in front of the TV, we have to make sure we are interacting appropriately during the evening (because who wants to be intimate after you’ve been snipped at and criticized all night?). We have microcosmic conversations and macrocosmic conversations. What all this intentionality boils down to is: We really pay attention to each other, because our family planning choice requires it. Of course all married couples pay attention to each other, but NFP strongly encourages the conversation.

These are off-the-cuff thoughts, but enough for now. Others who use NFP: you want to share what your lives look like?

Birth Control Really Isn’t Health Care In The First Place

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It is no secret to anyone who reads this blog that I am a not a fan of birth control.  I think it’s unconscionable that women have been expected to suppress or perhaps even damage a healthy, normal part of who they are in the interest of unrestricted sex. Contraception has led to an expectation that women must be sexually available at all times. And it has facilitated relational dysfunctions like the hookup culture, which could not possibly exist without it.

I don’t normally comment on things political, but given this passion, I do want to make one observation in the wake of the supreme court decision earlier this week.

Birth control occupies an unusual, perhaps even unique, place in medicine. The purpose of medicine is to fix what is wrong with a human body, and birth control does not fix a woman’s health. In fact, it inhibits the normal, healthy function of her body. I am hard pressed to think of any other comparable situation in medicine (aside from vasectomy, which is part of the same topic).

Yes, the pill is slapped like a band-aid on any number of conditions, and I’m willing to concede that in some cases it can be useful to treat symptoms (although not the conditions underlying them). But birth control as a family planning method–which is what we’re talking about–is not treating a health problem. In fact, you could argue that it’s creating one by shutting down the way the body was designed to work.

For this reason, birth control’s presence in the health care law has always bothered me. I get why birth control must be administered by medical professionals: it’s a pharmaceutical, and where else in the regulatory hierarchy are you going to classify a pharmaceutical? But still–family planning is not health care.

What’s YOUR Problem?

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https://www.flickr.com/photos/duncan/8775923664/in/photolist-enuUmG-4mRE73-brxUed-8MbG79-dsF4yY-fMgE84-fcA4se-cNxbA7-fLAVLS-aZvrvM-4tgEgx-eRZwT2-bFkVcX-7duzmd-5ZJA5v-7jsSv9-bLx3Ap-jDY8pY-9X2afa-bmSQep-51es48-eM8PfC-4NUXrE-DRad6-fMyejL-gYCs4b--cfPqpq-fMyeUb-fMyeH3-fMgHTr-fMgHvP-fMyf1A-7aYhyD-q4NeA-6m3To-dSg79g-gQ9m3Y-eaZ4Fi-g8cQEM-fMyicW-7ThB2e-7PWTVz-fMgJde-fMgJ8R-fMyi3s-fMygQY-fMgGwv-fMyfG9-fMyeXE

Photo by Duncan C, via Flickr

Life is unpredictable, but over the past several years I’ve learned there’s one thing I can count on with absolute certainty: somewhere between one week and two days before university graduation, I will lose my voice. It happens virtually every semester, just before I join the platform party at honors convocation as the official singer of the alma mater.

This year was no exception. For three days I took cough syrup, slathered myself with Vicks, and drank tea in an attempt to get the slow-moving virus to clear my body before graduation. It happened just in time. Praise the Lord, I had a voice on Saturday morning.

But the thing that stands out to me about this weekend is that the commencement speeches were the best I’ve ever heard. Jim McKelvey, who co-founded Square, had everyone laughing at intervals, but the message was serious. He wanted to point out to the graduates that no longer can they count on praise or immediate feedback like grades to keep them motivated. From here on out, they have to motivate themselves.

It could have been a real downer of a message, except for the humor and the takeaway: Find a problem. Find a problem that bugs you down so deep, you’re on fire about it. A problem so troublesome, it gets you out of bed in the morning. Find that problem, he said, and then go fix it. And if you succeed, find another one to solve.

After McKelvey came Jim Held, the owner of Stone Hill Winery in Herman, Missouri, who was being awarded an honorary doctorate. He came to the microphone and said, “I could talk about the wine industry in Missouri, but I won’t. Instead, I’m going to tell you about the last 2 1/2 years of my life.” It was a simple but powerful story of a stroke he was told he wouldn’t recover from–and did. He changed his bad habits, and he changed his future. The takeaway: the choices you make have consequences. So make good ones.

I come out of this weekend feeling pretty blessed, for many reasons I can’t go into in public. But this blessing I can share: I feel tremendously blessed to be staring down age 40 with a clear sense of what my life-motivating problems are–the ones that motivate me to get out of bed in the morning. There are two. One of them I outlined on Friday. The other is the need for a healthier view of sexuality, one that recognizes and embraces the message Jim Held underscored: personal responsibility and self control, the fact that choices and consequences go together and you must take the responsibility to exercise self-control to achieve the outcome you value.

I feel even more blessed that these two passions of mine dovetail so seamlessly: that living out a sexuality that respects the way we are put together (as opposed to slapping a pharmaceutical on something that isn’t broken in a misguided attempt to “free” sexual expression from its natural consequences) also respects the earth.

My question for you today is this: what motivates you to get out of bed in the morning? What global problem do you want to solve? You don’t have to answer that publicly, but think about it. And if you’re willing to share, so much the better.

7 Quick Takes

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Alex brought this home from school this week. They had to write a song based on the blues.

Alex Sings The Blues

___2___

Julianna’s language can be killingly funny. She tries so hard to tell us something, and we listen, we have her repeat, but we are so lost. So we take a stab at it. “Bacon?”

Doh doh doh doh doh!” she says, rapid fire, with deeply tolerant impatience and an exact imitation of Mommy’s inflection when saying “no” repeatedly.

Unfortunately, it doesn’t translate well to the blogosphere.

Picnic, playground, Pinnacles 002

Random unrelated cute picture

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We went to a (wwwwwwayyyyyy overpriced) Mothers Day buffet on Sunday. Nicholas brought back his first plate. “This,” he said solemnly, holding up a white square, “is squished cheese.”

___4___

Michael has another ear infection. So for the first time in our parenting career we are having the tubes discussion.

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Michael has also developed a not-so-cute habit of banging his head on things when he’s not happy. It seems a rather self-destructive way to embark on the tantrum stage. Unfortunately, Alex and Nicholas think it’s funny. I’m having to tell them not to laugh at him. I can already see my least favorite stage of parenting; it’s no longer around the bend, it’s just down the stretch a little way. Blech.

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Because I’m pathetic, the news story about Angelina Jolie’s preventive double mastectomy this week was the last nudge I needed to make a couple of doctor appointments I’ve been procrastinating. One of them is minor, the other not so much: I will be getting tested for BHD next week. It’s a genetic condition that runs in families and impacts 50% of people in any family that has it. Except mine, where every single person who has been tested has been positive. It doesn’t have major everyday implications, but certain conditions will be treated differently if you have it, and there are long-term health risks to be watched. So off I go at last.

___7___

I had procrastinated on this decision in part because I didn’t want insurance to have any excuse to deny coverage at any point for anything, with that “pre-existing condition” thing. When I was at my primary care doctor’s office yesterday, we talked about it. “Well,” she said, “the universal health care law took care of that. That’s the best thing about the new health care law–that and free contraceptives.”

I thought: There’s a lot I like about the national health care law, but free contraceptives are on the “what I DON’T like” list. Am I supposed to witness right about now, as to all the practical, non-religious reasons why I think contraceptives are bad for women?

I didn’t. I didn’t have the energy. Or the time. I failed. I know. One of these days I simply must buck up the courage and have the conversation. It’s so weird, the difference between my primary care doctor and my NFP-only OB/gyn. I like my p.c.–I like her a lot, actually. She said “gosh darn” yesterday and I wanted to hug her. But it’s such a different world between her office and his. Hers is fancy, his is…home. Hers, I am always on my guard, because I know my world view is so different and I have to be careful about what I say and what I hear. At his office, I feel completely, totally safe. At home, as I said. It’s just interesting. I know this has got to be a peculiarly “traditional Catholic” kind of difficulty. How do you guys deal with this?

7 quick takes sm1 7 Quick Takes Friday (vol. 217)

Environment, Family, and Planning

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Birth control pill

Birth control pill (Photo credit: Wikipedia)

Not that long ago I wrote a blog post called Too Big For Me. I know the world’s problems are too big and too complex to be reduced to black and white. But there is a topic that most people consider closed, no longer worth debating, that warrants another look.

http://www.scientificamerican.com/article.cfm?id=birth-control-in-water-supply

I’ve shared before what happened to male fish when exposed to trace amounts of the estrogens used in birth control. The question is whether birth control residue is being filtered out of our water supply or not. The Scientific American article above stands a bit at odds with a statement made in another article, which seems to indicate that this is a non-issue. Put those two side by side and I can only draw the conclusion that here is another case of the experts not really knowing for sure. So the question is: is the risk important enough to warrant action?

If there was no option, it might be an easy answer. But here’s my thing: why is it that virtually everyone thinks getting hormones and chemicals out of our food supply is a good idea, but at the same time see nothing untoward about pumping their bodies full of hormones to shut off a perfectly healthy bodily system?

I think the resistance comes from the belief that there’s no other option; without the hormonal manipulation women willingly subject their bodies to, they would be barefoot and pregnant all the time. That would be an even greater environmental strain, all those extra people, right? Because how else can we space/limit family size? We really don’t have any other choice.

Wrong.

People are appallingly uneducated about their bodies and how they work. The fact is, you can space children and limit family size simply by watching the cycle of fertility as it circles, and matching your behavior accordingly. I am, of course, talking about natural family planning.

Now, in general, the assumption is that NFP = rhythm and thus using it is, ahem, ineffective. Rhythm was, indeed, pretty ineffective, but modern NFP has almost nothing in common with rhythm. Modern sympto-thermal NFP has been studied at 99% effective (that’s the same as hormonal birth control, by the way). If you don’t want to wade through the scientific jargon, the summation can be found here, but I wanted to provide the non-“biased” source.

We have been using NFP from the very beginning, through infertility and the subsequent successful planning of three more children. Although I began down this path “because the Church says so,” it has been most of a decade since I have come to realize that in this case, there’s an incredibly practical reason beneath what the Church says. It makes me furious to see the objectification of women in modern society, and to realize that women are participating in it themselves by allowing their value to be defined based on their sexual availability.

In short, I’m all about people planning families, I just don’t see how it’s good for or respectful of human beings in general and women in particular to deliberately shut off a healthy, functioning system in order to do it. I don’t have all the answers; I just want women to wake up and realize that birth control is not the only, or even the best, answer in most cases–it’s only the path of least resistance. And I think it’s irresponsible to ignore the health and environmental risks simply because abstinence is inconvenient.