Is “Might Actually Work” Good Enough When It Comes to Contraception?


There's been a bit of online chatter recently about ditching hormonal birth control in favor of a return to natural methods of birth control. The problem is, 100% perfect use of these methods can be pretty tough...

This piece was written by Laura Lloyd and is cross-posted from the National Campaign’s blog, Pregnant Pause.


There’s been a bit of online chatter recently about ditching hormonal birth control in favor of a return to the more "organic" methods of birth control known as either Fertility Awareness Methods (FAM) or Natural Family Planning (NFP).

Sophie Morris writes a review of Jane Bennett & Alexandra Pope’s book, The Pill: Are You Sure It’s For You?, in which the authors question why women would use a less-than-perfect method when there are so many potential side effects. Based on her own experience with the pill, Ms. Morris agrees with Bennett and Pope that women should stop viewing it as "the default contraceptive," but she disagrees with them about the best alternative. While they encourage women to return to NFP, Morris feels as though "that remains risky business…if you can’t deal with an unplanned pregnancy."  She hasn’t figured out the best method for her, but knows there are options more effective than NFP.

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Over on double x, in an article titled, Your Grandmother’s Birth Control Might Actually Work, Nona Willis Aronowitz explains how she moved to FAMs after experiencing side effects while using the NuvaRing.  Before discovering FAM, she dismissed condoms due to her partner’s aversion.  She said no to the diaphragm on account of a history of urinary tract infections. And she brushed off the thought of the oh-so-effective IUD because she didn’t like the idea of "an invasive vaginal procedure." Ms. Willis Aronowitz settled on using the most effective FAM, known as the symptothermal method. This includes understanding when she’s most fertile (and avoiding intercourse without a barrier method during those times) by measuring her basal body temperature and monitoring the consistency of her cervical mucous on a daily basis, and then charting the data.

When used correctly, this version of FAM is between 95% and 98% effective. Not too shabby, right? The problem is, 100% perfect use can be pretty tough. I’m not saying the author isn’t capable of perfect use, but many just won’t be that good at it. With "typical use" of this method (which is just like it sounds: the way many women end up using this method when regular ol’ life gets in the way and they forget to take their temperature for a few days or a night of drinking changes their body temperature, etc.), the level of effectiveness drops to as low as 80%. That means that for every 100 women who use this method in a year, 20 of them will get pregnant. Those odds aren’t so hot for young adults not planning a pregnancy in the next year (and I’m not even entertaining the thought here of most teens using this method reliably).

It can be difficult for a woman to find the right contraception for her. There are pros and cons to each method and it’s understandable why the positive aspects of FAM/NFP are appealing to some. They’re inexpensive, don’t require a prescription, and don’t demand that the user adjust to any hormones.

At the same time, there are also so many things that can get in the way of using this method perfectly and even with proper use, there are a number of other methods that are still more effective – with much less effort and chance of human error. Don’t take my word for it. Read the articles themselves and the responses, many of which are excellent. A number of women explain why FAM is great in theory, but not in practicality. As double x reader lorikay4 notes (and you should read all of her comments), "there is a difference between ‘can work’ and ‘does work,’" and many women want something much more than "might" when they’re not planning to get pregnant.

News Contraception

Colorado Contraception Program Overcomes GOP Opposition

Jason Salzman

In a reversal from last year, Colorado lawmakers on Thursday approved a state budget that includes funds for a program credited with reducing the teen birth rate by 40 percent and the teen abortion rate by 35 percent.

Funding has survived for a successful contraception program in Colorado after a group of Republican lawmakers joined Democrats in supporting the initiative.

A recorded vote on the amendment Thursday confirmed that four Republicans joined Democrats in killing the anti-LARC amendment, the Denver Post reported.

Both pro- and anti-choice advocates knew that Republicans in Colorado’s senate would offer an amendment this week to eliminate funds from a budget bill for a state program credited with reducing the teen birth rate by 40 percent and the teen abortion rate by 35 percent.

The question remained: Would Republicans, who have a one-seat majority in the state senate, hold ranks, as they did last year, and leave the program unfunded?

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The answer came Wednesday in the form of a senate voice vote against the amendment, offered by state Sens. Laura Woods (R-Westminster) and Tim Neville (R-Littleton), that would have eliminated $2.5 million for Colorado’s Family Planning Initiative. The program provides long-acting reversible contraception (LARC), such as intrauterine devices (IUDs), to low-income people.

About 30,000 long-lasting contraceptive implants were distributed during a five-year pilot program under the state’s Family Planning Initiative. Participating clinics in 37 of Colorado’s 64 counties serve 95 percent of the state’s population.

During a brief debate on the senate floor Wednesday, Neville expressed his concern about the “use of widespread and temporary sterilization products on women and girls in Colorado.” Such “temporary sterilization,” he said, does “nothing to prevent the spread of STDs.”

“There is nothing to suggest that the psychological and medical risks and costs associated with the increased sexual activity will be managed or addressed by these funds or this legislation,” Neville said.

LARC usage does not result in increased sexual activity, studies show.

Some state GOP lawmakers have said they stood against funding for LARCs because they considered that kind of contraception to be abortion.

“I have no moral problem with contraceptives. The problem is when you kill the child,” state Sen. Kevin Lundberg (R-Berthoud) told the Associated Press in November 2014.

Medical professionals have repeatedly shown that Lundberg’s assertion about LARCs is medically inaccurate.

Woods, the other sponsor of the amendment, tried to cut LARC funding despite warnings that her anti-choice positions could damage her re-election efforts in a swing district vital to GOP hopes of retaining control of the state senate.

Pro-choice advocates praised the vote to retain LARC money in the budget bill, saying it will offer Coloradans control of their fertility.

“Self-determination and the ability to be a parent when we are ready should not be a privilege,” said Cristina Aguilar, director of the Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), in an email to Rewire. “All women should be able to make decisions about their bodies and their futures.”

Colorado’s house last week rejected a similar amendment, so now the state budget bill will go to Gov. John Hickenlooper (D), who is expected to sign it.

House Republicans voiced similar opposition to the LARC funds.

Some opposed the program based on the incorrect argument that IUDs cause abortions.

“I would be fine with family planning,” said Rep. Gordon Klingenschmitt, as quoted in the Colorado Springs Gazette. “I would be fine with some kinds of birth control, but when the taxpayers are funding post-conception abortion pills, that crosses the line.”

Other Republicans, such as Rep. Patrick Neville (R-Castle Rock), argued that “birth control is already covered by the Affordable Care Act,” and thus Colorado’s initiative is not needed—even though the program’s training and funds for some types of birth control are not covered by the national health-care law.

Pro-choice advocates said the LARC program should serve as a model for other states.

“Here in Colorado, we know what’s proven to work on women’s health care—access to low-cost, long acting reversible contraception and keeping medical decisions between women and their doctors,” said Karen Middleton, director of NARAL Pro-Choice America, in an email to Rewire. “Funding the LARC program is one of the smartest things we can do for both individual women and public policy as a whole. We hope other states will follow Colorado’s lead.”

After Colorado Republicans rejected $5 million for the LARC program last year, the Colorado Department of Public Health and Environment undertook its own fundraising effort, raising enough money to keep the program going at a reduced level.

The original six-year LARC pilot program was undertaken in Colorado with support from the Susan Thompson Buffett Foundation.

News Politics

Trump: Planned Parenthood Does ‘Very Good Work,’ But Should Be Defunded Anyway

Ally Boguhn

Donald Trump has repeatedly promised to defund Planned Parenthood even as he admits that the organization provides services, such as cancer screenings, that wouldn’t be easily covered by other clinics in its absence.

Donald Trump has repeatedly promised to defund Planned Parenthood even as he admits that the organization does “very good work,” such as cancer screenings, that wouldn’t be easily covered by other providers in its absence.

“I have many, many friends who are women who understand Planned Parenthood better than you or I will ever understand it,” Trump told host Chuck Todd during a February 21 interview on NBC’s Meet the Press. “And they [at the organization] do some very good work. Cervical cancer, lots of women’s issue[s], women’s health issues are taken care of.”

The Republican presidential candidate went on to declare that he nevertheless does not support continued federal funding for the organization. “Planned Parenthood does a really good job at a lot of different areas. But not on abortion—so I’m not going to fund it if it’s doing the abortion.”

Trump struck an almost identical tone in a Thursday interview with Christian Broadcasting Network’s The Brody File, similarly noting that he would defund Planned Parenthood, although they “do cervical cancer work. They do a lot of good things for women.”

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“As long as they’re involved with abortion, as far as I’m concerned, forget it … I wouldn’t fund them regardless. But they do do other good work. You look at cervical cancer. I’ve had women tell me they do some excellent work, so I think you also have to put that into account but I would defund Planned Parenthood because of their view and the fact of their work on abortion,” Trump said.

Host David Brody claimed that there were other organizations who could provide the scope of services that would be eliminated, should Planned Parenthood lose funding—despite experts who say community clinics would not be able to fully fill that gap in coverage and evidence from Texas that this strategy has failed. In response, Trump pointed out the scale of work the reproductive health organization provides.

“That’s right, but they do a big job. There are a lot of women who are taken care of by Planned Parenthood,” Trump said.

The cognitive dissonance displayed by Trump when it comes to Planned Parenthood is nothing new. The Republican candidate has consistently demonstrated a disconnect between what he deems to be the important services provided by Planned Parenthood and his assertions that the organization should be defunded. The Hyde Amendment bans most federal funding for abortions. Nonetheless, Trump has spent months pointing to what he has called the “good aspects” of Planned Parenthood’s work

The discrepancy between these two talking points has led many conservatives, including rival presidential candidate Ted Cruz, to question whether Trump is truly anti-choice.

Cruz recently launched an ad attacking Trump’s shifting stance on abortion rights, using the candidate’s past “pro-choice” position to suggest that Trump cannot be trusted to appoint a new Supreme Court justice.