Thank You, Birth Control Pills, for an Impressive 25-Year Run

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Commentary Contraception

Thank You, Birth Control Pills, for an Impressive 25-Year Run

Martha Kempner

Today, the National Campaign to Prevent Teen and Unplanned Pregnancy is asking us to take a moment and thank birth control for “all that it makes possible for individuals and society.” I took more than 5,000 birth control pills in my life, and I can think of a number of reasons why I’m thankful to each and every one of them.

One Saturday night last month, I took my very last birth control pill after the better part of 25 years. Though not everyone agrees there’s an age limit, my OB-GYN has been telling me for a while that I’m getting too old for the pill. I finally relented and scheduled an appointment to get an IUD. So I knew that the tiny pink pill I was swallowing was going to be my last.

I’ve been thinking about that last pill this week because of the National Campaign to Prevent Teen and Unplanned Pregnancy’s social media event Tuesday asking participants to take a moment and acknowledge birth control for “all that it makes possible for individuals and society.” The campaign is designed to acknowledge the benefits of all contraceptive methods using the hashtag #ThxBirthControl. For me, though, contraception has been all about the birth control pill. By my very rough calculations, I took about 5,300 total birth control pills in my life and I can think of a number of reasons why I’m thankful to each and every one of them:

♥ I stopped having debilitating menstrual cramps. I have a distinct memory of walking around my college at 6 a.m. listening to a mix tape on my Walkman. No one was usually up at that hour on campus, but I had such bad cramps that I’d left a class early the day before—the wooden lecture hall seats were just too uncomfortable—and didn’t sleep well that night. The only thing that seemed to help was being in motion.

When I went home a few weeks later, I asked my mom to take me to a gynecologist. For some reason, I wound up with a new doctor I’d never seen before, an old, gruff man who performed a relatively painful pelvic exam and then met me back in his office. It was attached to the waiting room and he didn’t close the door. He said, “I’m going to put you on the pill. There’s no reason that the pill should reduce cramps, but women have been taught for generations that it’s okay to complain about pain during menstruation. Hopefully after a few months of being on the pill, you’ll realize there is no pain and you can go off of it.” Yes, I remember this verbatim.

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I was 19 and had not yet studied anything about human reproduction or contraception. If I’d known then what I know now, I might have been able to tell him he was a misogynistic ass who had no idea what he was talking about. Instead, I just felt violated and started to cry. But I also started to take the pill, and my periods became significantly lighter and less painful—and not because the cramps had just been in my head. #ThxBirthControl

♥ I had a lot of options to control side effects. I was on the pill for most of 25 years, but I wasn’t always on the same one. One night after my first few months on the pill, I called home crying to my mother about how awful everything was. I was pretty hysterical. She asked me if maybe, just maybe, this sadness could be a side effect of the pill. “No,” I wailed, “you don’t get it, I hate my life.”

But a few weeks later when I went for my follow-up appointment at University Health Services, I told the nurse practitioner about my mood swings. “I think I hate my life, but maybe it’s the pill,” I said.

“Well,” she said, “the pill is easier to change.” She put me on a version called triphasil, which meant that the amount of hormone went up each week as I got closer to my period. The pills in the pack were different based on the week—and I definitely noticed that I cried more during peach-colored pill weeks.

In graduate school, I switched to a different pill because I was getting breast pain. And after my pregnancies I was on the progestin-only pill, sometimes called the mini-pill, so that I could keep breastfeeding but not get pregnant. There aren’t just a wide range of options for contraceptives in general; for women who choose the pill, there are many choices that can help us take control of our own reproduction and how we feel. #ThxBirthControl

♥ I didn’t have my period on my wedding day. This one may sound trivial but what I think I’ll miss most about the pill is the ability to manipulate when I had my period. Most months, you take three weeks of active pills and a week of sugar pills, during which you get your period. Although I mostly followed these rules, I found it to still be effective to skip that sugar pill week some months and start the next pill pack right away so I didn’t get my period at all. Or, I rearranged which week of the month I took the sugar pills. With a calendar and a little foresight, I found it possible to make sure that vacations and special events stayed period-free. #ThxBirthControl

♥ I didn’t get pregnant accidentally. For the first few years of being on the pill, it was not my sole form of birth control. I grew up during the beginning of the AIDS epidemic and was taught from seventh grade on about the importance of condoms. The advice at the time—which I still give today—was to use condoms until you were in a monogamous relationship and had both been tested for HIV and other sexually transmitted infections (STIs).

But I’ve now been in a monogamous relationship for 20 years, and the pill is what kept us from ever experiencing an unintended pregnancy. Sure, unintended pregnancies can happen on the pill, but I was careful to take it every day and use backup when needed, and it worked for me. #ThxBirthControl

♥ I got pregnant when I wanted to. The pill is also what allowed us to plan our family and have children when we decided we were ready. We were not people who would kind-of-sort-of try and just see what happened. Every time friends told us that they were “not trying to get pregnant, but they just weren’t using contraception for now,” my husband would call foul. A true computer scientist, he would say, “This is a binary proposition. Either you are using birth control or you are trying to get pregnant.” At the beginning of 2005, we chose the second option and I stopped taking the pill. By November, I was pregnant.

I went back on the pill while she was a baby and stayed on it until I was ready for number two.

Some people might make their decisions about the second child based on a vision of the ideal age gap—they may want them close together so that they can be best friends, or a few years apart so there aren’t two kids in diapers at once. My decision was based on real estate. We lived in a 650-square-foot New York City apartment until our first daughter was 2 and a half. A small one-bedroom place that had been hard to navigate with just the two of us now housed a toddling child and a hell of a lot more stuff (most of which had to be kept above waist level as part of child-proofing). I was not having a second child until we had more space. So I stayed on the pill until we were settled in our suburban house with more rooms and lots of closets. I went safely off the pill after the last box was unpacked, and got pregnant just a few months later. #ThxBirthControl

I have now had my IUD for a month. Most nights, I still feel like I’m forgetting something when I don’t take my pill before bed, but before long, I’m sure that will be a relief. I don’t have much to say about Mirena yet—it’s too soon to know how much I’m going to like it—but I don’t want to have any more children and IUDs have a failure rate of less than 1 percent. So I’m pretty sure that if this campaign is run again next year, I’ll have even more reasons to thank birth control.