Just Facts: Do I Need to Take a Break from the Pill?

Erica Sackin

You don’t need to take a break from the birth control pill, unless, of course, you want to. But you should always discuss these topics with your health provider to figure out what's best for you.

Rewire is partnering with Planned Parenthood New York City to publish a series on the facts about various forms of birth control.  Articles in the series will appear on the second Monday of each month.

I’ve heard it, and my guess is that you’ve heard it too. It’s the idea that you’re going to need to take a break from taking hormonal birth control. For a reason other than wanting to get pregnant right away.

The idea behind this usually comes from one of two sentiments. Either: “I have been on birth control for five years now. I think I should stop taking it for a little while, just to give myself a break from hormones.” Or: “I think I want to get pregnant when I’m 31. But I’ll need to stop taking birth control about a year ahead of time, to give the hormones a chance to leave my system.”

While there are reasons you might want to stop taking the birth control pill — such as you want to try out a different method of birth control; you’re fed up with the daily routine; you’re unhappy with your current pill; or you want to get pregnant – you do not need to take a break from taking the birth control pill.

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Back to basics.

We’ve outlined exactly what the Pill is in the past, but here’s a refresher:

The birth control pill is an oral hormonal contraceptive that’s taken daily. While there are many different brand name and generic versions of the Pill, they all work basically the same way. The pill is made up of estrogen, progesterone, or a mix of the two hormones. These hormones suppress ovulation, ensuring that a woman’s ovaries won’t release eggs. And they thicken a woman’s cervical mucus, thus blocking sperm from getting past the cervix.

Even though birth control pills all work the same way, that doesn’t mean they’re all the same. They have different mixes and levels of hormones. Because of this, they affect us differently – meaning that the side effects you get with one pill may disappear once you change brands. While many of you do well with whatever brand of pills is prescribed, for others finding the right birth control is a process – trying different brands until you find one that mixes well with your body’s chemistry.

Do you need a “break” from birth control?

No matter how long you’ve been taking the birth control pill, it’s just as effective as it was the day you started. You don’t need to increase your dosage, and the body won’t “get used” to it, making it less effective. The Pill contains hormones that naturally occur in the body, and they don’t accumulate in your body or build up over time. To make a long story short, there is absolutely no need to take a break from hormonal birth control.

However, let’s distinguish between need and want. Although the birth control pill you’ve been on since high school may still technically work fine when it comes to preventing pregnancy, that shouldn’t stop you from exploring other options, if you’re curious about them. Maybe you’re sick of taking a pill every day. Maybe you want to try out a more permanent method, like an IUD. Maybe you just want to try non-hormonal birth control for a little while. There’s no reason why you can’t explore birth control options to find one that fits your lifestyle better. But, if the Pill you’re taking is working for you, rest assured you can keep on taking it without any negative consequences.

But what if I am trying to get pregnant?

Another concern we’ll hear is from women who know they want to get pregnant at some point in the future (usually a year or two), and worry that they’ll need to give their bodies time to “get rid of all the hormones” that have “built up” in their bodies before they’ll be able to get pregnant.

While there are some hormonal methods (like the shot, Depo-Provera) that can delay your body’s ability to get pregnant by a few months, the daily birth control Pill is not one of them.

The birth control pill works as well as it does not because of the amount of hormones in your system, but because it’s a regular daily dosage of hormones. The constant regular intake of these hormones into your system replaces your body’s regularly scheduled hormone production. This prevents your body from producing the hormones that would kickstart ovulation. And without ovulation, there’s no way to get pregnant.

Any interruption in this daily regimen can trigger your body’s natural hormone production back into action, bringing on ovulation and, with it, the chance of pregnancy. Depending on the type, missing a pill by a few days or even hours can start this process.

Think about it: if you’re worried about getting pregnant when you accidently skip one pill, what’s the logic in assuming that once you’re trying to get pregnant, it will mean skipping a lot more than just one pill?

So, yes, some levels of hormones may stay in your body for a little while after you stop taking the birth control pill. But these won’t prevent ovulation, and they have no effect on a pregnancy if you do become pregnant.

Of course, as always, we’re not giving anyone medical advice. Making good decisions about sexual health and birth control is vastly different for each person. That means that no matter how much what we say rings true, you should always discuss these topics with your health care provider to figure out what works best for your health, body, and lifestyle.

But you don’t need to take a break from the birth control pill. Unless, of course, you want to.

Analysis Law and Policy

Indiana Court of Appeals Tosses Patel Feticide Conviction, Still Defers to Junk Science

Jessica Mason Pieklo

The Indiana Court of Appeals ruled patients cannot be prosecuted for self-inducing an abortion under the feticide statute, but left open the possibility other criminal charges could apply.

The Indiana Court of Appeals on Friday vacated the feticide conviction of Purvi Patel, an Indiana woman who faced 20 years in prison for what state attorneys argued was a self-induced abortion. The good news is the court decided Patel and others in the state could not be charged and convicted for feticide after experiencing failed pregnancies. The bad news is that the court still deferred to junk science at trial that claimed Patel’s fetus was on the cusp of viability and had taken a breath outside the womb, and largely upheld Patel’s conviction of felony neglect of a dependent. This leaves the door open for similar prosecutions in the state in the future.

As Rewire previously reported, “In July 2013 … Purvi Patel sought treatment at a hospital emergency room for heavy vaginal bleeding, telling doctors she’d had a miscarriage. That set off a chain of events, which eventually led to a jury convicting Patel of one count of feticide and one count of felony neglect of a dependent in February 2015.”

To charge Patel with feticide under Indiana’s law, the state at trial was required to prove she “knowingly or intentionally” terminated her pregnancy “with an intention other than to produce a live birth or to remove a dead fetus.”

According to the Indiana Court of Appeals, attorneys for the State of Indiana failed to show the legislature had originally passed the feticide statute with the intention of criminally charging patients like Patel for terminating their own pregnancies. Patel’s case, the court said, marked an “abrupt departure” from the normal course of prosecutions under the statute.

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“This is the first case that we are aware of in which the State has used the feticide statute to prosecute a pregnant woman (or anyone else) for performing an illegal abortion, as that term is commonly understood,” the decision reads. “[T]he wording of the statute as a whole indicate[s] that the legislature intended for any criminal liability to be imposed on medical personnel, not on women who perform their own abortions,” the court continued.

“[W]e conclude that the legislature never intended the feticide statute to apply to pregnant women in the first place,” it said.

This is an important holding, because Patel was not actually the first woman Indiana prosecutors tried to jail for a failed pregnancy outcome. In 2011, state prosecutors brought an attempted feticide charge against Bei Bei Shuai, a pregnant Chinese woman suffering from depression who tried to commit suicide. She survived, but the fetus did not.

Shuai was held in prison for a year until a plea agreement was reached in her case.

The Indiana Court of Appeals did not throw out Patel’s conviction entirely, though. Instead, it vacated Patel’s second charge of Class A felony conviction of neglect of a dependent, ruling Patel should have been charged and convicted of a lower Class D felony. The court remanded the case back to the trial court with instructions to enter judgment against Patel for conviction of a Class D felony neglect of a dependent, and to re-sentence Patel accordingly to that drop in classification.

A Class D felony conviction in Indiana carries with it a sentence of six months to three years.

To support Patel’s second charge of felony neglect at trial, prosecutors needed to show that Patel took abortifacients; that she delivered a viable fetus; that said viable fetus was, in fact, born alive; and that Patel abandoned the fetus. According to the Indiana Court of Appeals, the state got close, but not all the way, to meeting this burden.

According to the Indiana Court of Appeals, the state had presented enough evidence to establish “that the baby took at least one breath and that its heart was beating after delivery and continued to beat until all of its blood had drained out of its body.”

Therefore, the Court of Appeals concluded, it was reasonable for the jury to infer that Patel knowingly neglected the fetus after delivery by failing to provide medical care after its birth. The remaining question, according to the court, was what degree of a felony Patel should have been charged with and convicted of.

That is where the State of Indiana fell short on its neglect of a dependent conviction, the court said. Attorneys had failed to sufficiently show that any medical care Patel could have provided would have resulted in the fetus surviving after birth. Without that evidence, the Indiana Court of Appeals concluded, state attorneys could not support a Class A conviction. The evidence they presented, though, could support a Class D felony conviction, the court said.

In other words, the Indiana Court of Appeals told prosecutors in the state, make sure your medical experts offer more specific testimony next time you bring a charge like the one at issue in Patel’s case.

The decision is a mixed win for reproductive rights and justice advocates. The ruling from the court that the feticide statute cannot be used to prosecute patients for terminating their own pregnancy is an important victory, especially in a state that has sought not just to curb access to abortion, but to eradicate family planning and reproductive health services almost entirely. Friday’s decision made it clear to prosecutors that they cannot rely on the state’s feticide statute to punish patients who turn to desperate measures to end their pregnancies. This is a critical pushback against the full-scale erosion of reproductive rights and autonomy in the state.

But the fact remains that at both trial and appeal, the court and jury largely accepted the conclusions of the state’s medical experts that Patel delivered a live baby that, at least for a moment, was capable of survival outside the womb. And that is troubling. The state’s experts offered these conclusions, despite existing contradictions on key points of evidence such as the gestational age of the fetus—and thus if it was viable—and whether or not the fetus displayed evidence of life when it was born.

Patel’s attorneys tried, unsuccessfully, to rebut those conclusions. For example, the state’s medical expert used the “lung float test,” also known as the hydrostatic test, to conclude Patel’s fetus had taken a breath outside the womb. The test, developed in the 17th century, posits that if a fetus’ lungs are removed and placed in a container of liquid and the lungs float, it means the fetus drew at least one breath of air before dying. If the lungs sink, the theory holds, the fetus did not take a breath.

Not surprisingly, medical forensics has advanced since the 17th century, and medical researchers widely question the hydrostatic test’s reliability. Yet this is the only medical evidence the state presented of live birth.

Ultimately, the fact that the jury decided to accept the conclusions of the state’s experts over Patel’s is itself not shocking. Weighing the evidence and coming to a conclusion of guilt or innocence based on that evidence is what juries do. But it does suggest that when women of color are dragged before a court for a failed pregnancy, they will rarely, if ever, get the benefit of the doubt.

The jurors could have just as easily believed the evidence put forward by Patel’s attorneys that gestational age, and thus viability, was in doubt, but they didn’t. The jurors could have just as easily concluded the state’s medical testimony that the fetus took “at least one breath” was not sufficient to support convicting Patel of a felony and sending her to prison for 20 years. But they didn’t.

Why was the State of Indiana so intent on criminally prosecuting Patel, despite the many glaring weaknesses in the case against her? Why were the jurors so willing to take the State of Indiana’s word over Patel’s when presented with those weaknesses? And why did it take them less than five hours to convict her?

Patel was ordered in March to serve 20 years in prison for her conviction. Friday’s decision upends that; Patel now faces a sentence of six months to three years. She’s been in jail serving her 20 year sentence since February 2015 while her appeal moved forward. If there’s real justice in this case, Patel will be released immediately.

Commentary Violence

This is Not The Story I Wanted—But It’s My Story of Rape

Dani Kelley

Writer Dani Kelley thought she had shed the patriarchal and self-denying lessons of her conservative religious childhood. But those teachings blocked her from initially admitting that an encounter with a man she met online was not a "date" that proved her sexual liberation, but an extended sexual assault.

Content note: This article contains graphic descriptions of sexual violence.

The night I first truly realized something was wrong was supposed to be a good night.

A visiting friend and I were in pajamas, eating breakfast food at 10 p.m., wrapped in blankets while swapping stories of recent struggles and laughs.

There I was, animatedly telling her about my recently acquired (and discarded) “fuck buddy,” when suddenly the story caught in my throat.

When I finally managed to choke out the words, they weren’t what I expected to say. “He—he held me down—until, until I couldn’t—breathe.”

Hearing myself say it out loud was a gut-punch. I was sobbing, gasping for breath, arms wrapped as if to hold myself together, spiraling into a terrifying realization.

This isn’t the story I wanted.

Unlearning My Training

I grew up in the Plymouth Brethren movement, a small fundamentalist Christian denomination that justifies strict gender roles through a literal approach to the Bible. So, according to 1 Corinthians 11:7, men are considered “the image and glory of God,” while women are merely “the glory of man.” As a result, women are expected to wear head coverings during any church service, among other restrictions that can be best summed up by the apostle Paul in 1 Timothy 2:11-12: Women are never allowed to have authority over men.

If you’ve spent any number of years in conservative Christianity like I did, you’re likely familiar with the fundamentalist tendency to demonize that which is morally neutral or positive (like premarital sex or civil rights) while sugar-coating negative experiences. The sugar-coating can be twofold: Biblical principles are often used to shame or gaslight abuse victims (like those being shunned or controlled or beaten by their husbands) while platitudes are often employed to help members cope with “the sufferings of this present time,” assuring them that these tragedies are “not worthy to be compared with the glory that is to be revealed to us.”

In many ways, it’s easy to unlearn the demonization of humanity as you gain actual real-world experience refuting such flimsy claims. But the shame? That can be more difficult to shake.

The heart of those teachings isn’t only present in this admittedly small sect of Christianity. Rather, right-wing Western Christianity as a whole has a consent problem. It explicitly teaches its adherents they don’t belong to themselves at all. They belong to God (and if they’re not men, they belong to their fathers or husbands as well). This instilled lack of agency effectively erases bodily autonomy while preventing the development of healthy emotional and physical boundaries.

On top of that, the biblical literalism frequently required by conservative Christianity in the United States promotes a terrifying interpretation of Scripture, such as Jeremiah 17:9. The King James Version gives the verse a stern voice, telling us that “the heart is deceitful above all things and desperately wicked.” If we believe this, we must accept that we’re untrustworthy witnesses to our own lives. Yet somehow, we’re expected to rely on the authority of those the Bible deems worthy. People like all Christians, older people, and men.

Though I’ve abandoned Christianity and embraced feminist secular humanism, the culture in which I grew up and my short time at conservative Bob Jones University still affect how I view myself and act in social situations. The lessons of my formative years created a perfect storm of terrible indoctrination: gender roles that promoted repressed individuality for women while encouraging toxic masculinity, explicit teaching that led to constant second-guessing my ability to accurately understand my own life, and a biblical impetus to “rejoice in my suffering.”

Decades of training taught me I’m not allowed to set boundaries.

But Some Habits Die Hard

Here’s the thing. At almost 30, I’d never dated anyone other than my ex-husband. So I thought it was about time to change that.

When I found this man’s online profile, I was pleasantly surprised. It was full of the kind of geekery I’m into, even down to the specific affinity for eclectic music. I wrote to him, making sure my message and tone were casual. He responded instantly, full of charisma and charm. Within hours, we’d made plans to meet.

He was just as friendly and attentive in person. After wandering around town, window-shopping, and getting to know one another, he suggested we go to his favorite bar. As he drank (while I sipped water), he kept paying me compliments, slowly breaking the touch barrier. And honestly, I was enthralled—no one had paid attention to me like this in years.

When he suggested moving out to the car where we could be a little more intimate, I agreed. The rush of feeling desired was intoxicating. He seemed so focused on consent—asking permission before doing anything. Plus, he was quite straightforward about what he wanted, which I found exciting.

So…I brought him home.

This new and exciting “arrangement” lasted one week, during which we had very satisfying, attachment-free sex several times and after which we parted ways as friends.

That’s the story I told people. That’s the story I thought I believed. I’d been freed from the rigid expectations and restraints of my youth’s purity culture.

Now. You’re about to hear me say many things I know to be wrong. Many feminists or victim advocates almost certainly know the rationalizations and reactions I’m about to describe are both normal responses to abuse and a result of ingrained lies about sex in our culture. Not to mention evidence of the influence that right-wing conservatism can have on shaping self-actualization.

As I was telling people the story above, I left out important details. Were my omissions deliberate? An instinctive self-preservation mechanism? A carryover from draconian ideals about promiscuity?

When I broke down crying with my friend, I finally realized I’d kept quiet because I couldn’t bear to hear myself say what happened.

I’m a feminist, damn it. I left all the puritanical understandings of gender roles behind when I exited Christianity! I even write about social justice and victim advocacy. I ought to recognize rape culture!

Right?

If only being a socially aware feminist was enough to erase decades of socialization as a woman within rape culture—or provide inoculation against sexual violence.

That first night, once we got to my car, he stopped checking in with me. I dismissed the red flag as soon as I noticed it, telling myself he’d stop if I showed discomfort. Then he smacked my ass—hard. I pulled away, staring at him in shocked revulsion. “Sorry,” he replied, smirking.

He suggested that we go back to my house, saying we’d have more privacy than at his place. I was uneasy, unconvinced. But he began passionately kissing, groping, petting, and pleading. Against my better judgment, I relented.

Yet, in the seclusion of my home, there was no more asking. There was only telling.

Before I knew it, I’d been thrown on my back as he pulled off my clothes. I froze. The only coherent thought I could manage was a weak stammer, asking if he had a condom. He seemed agitated. “Are you on birth control?” That’s not the point! I thought, mechanically answering “yes.”

With a triumphant grin and no further discussion, he forced himself into me. Pleasure fought with growing panic as something within me screamed for things to slow down, to just stop. The sensation was familiar: identical to how I felt when raped as a child.

I frantically pushed him off and rolled away, hyperventilating. I muttered repeatedly, “I need a minute. Just give me a minute. I need a minute.”

“We’re not finished yet!” he snapped angrily. As he reached for me again, I screeched hysterically, “I’M NOT OK! I NEED A MINUTE!”

Suddenly, he was kind and caring. Instead of being alarmed, I was strangely grateful. So once I calmed down, I fucked him. More than once.

It was—I told myself—consensual. After all, he comforted me during a flashback. Didn’t I owe him that much?

Yet, if I didn’t do what he wanted, he’d forcefully smack my ass. If I didn’t seem happy enough, he’d insistently tell me to smile as he hit me again, harder. He seemed to relish the strained smile I would force on command.

I kept telling myself I was okay. Happy, even. Look at how liberated I was!

All week, I was either at his beck and call or fighting suicidal urges. Never having liked alcohol before, I started drinking heavily. I did all I could to minimize or ignore the abuse. Even with his last visit—as I fought to breathe while he forcefully held my head down during oral sex, effectively choking me—I initially told myself desperately that surely he wouldn’t do any of this on purpose.

The Stories We Tell and The Stories That Just Are

Reflecting on that week, I’m engulfed in shame. I’m a proud feminist. I know what coercion looks like. I know what rape looks like. I know it’s rarely a scary man wearing a ski mask in a back alley. I’ve heard all the victim-blaming rape apologia you have: that women make up rape when they regret consenting to sex, or going on a date means sex is in the cards, or bringing someone home means you’re game for anything.

Reality is, all of us have been socialized within a patriarchal system that clouds our experiences and ability to classify them. We’re told to tend and befriend the men who threaten us. De-escalation at any cost is the go-to response of almost any woman I’ve ever talked to about unwanted male attention. Whatever will satiate the beast and keep us safe.

On top of that, my conservative background whispered accusations of being a Jezebel, failing to safeguard my purity, and getting exactly what I deserve for forsaking the faith.

It’s all lies, of course. Our culture lies when it says that there are blurred lines when it comes to consent. It violates our personhood when it requires us to change the narrative of the violence enacted against us for their own comfort. Right-wing Christianity lies when it says we don’t belong to ourselves and must submit to the authority of a religion or a gender.

Nobody’s assaulted because they weren’t nice enough or because they “failed” to de-escalate. There’s nothing we can do to provoke such violence. Rape is never deserved. The responsibility for sexual assault lies entirely with those who attack us.

So why was the story I told during and after that ordeal so radically and fundamentally different from what actually happened? And why the hell did I think any of what happened was OK?

Rape myths are so ingrained in our cultural understanding of relationships that it was easier for me to believe nothing bad had happened than to accept the truth. I thought if I could only tell the story I wanted it to be, then maybe that’s what really happened. I thought if I was willing—if I kept having him over, if I did what he ordered, if I told my friends how wonderful it was—it would mean everything was fine. It would mean I wasn’t suffering from post-traumatic stress or anxiety about defying the conservative tenets of my former political and religious system.

Sometimes, we tell ourselves the stories we want to hear until we’re able to bear the stories of what actually happened.

We all have a right to say who has what kind of access to our bodies. A man’s masculinity gives him no authority over anyone’s sexual agency. A lack of a “no” doesn’t mean a “yes.” Coercion isn’t consent. Sexual acts performed without consent are assault. We have a right to tell our stories—our real stories.

So, while this isn’t the story I wanted, it’s the story that is.

I was raped.