Why this physician stopped prescribing birth control

Her 17-year-old legs dangled over the edge of the exam table. She had come for a prescription of oral contraceptives. Her boyfriend, she said, had been patient. He wasn’t ready to be a father, and so they were waiting. But lately he had started to put the pressure on and asked her to come in. She wasn’t eager for this change in their relationship, but it seemed like the next step, what more could she ask for?

Like most doctors, I graduated medical school with a mountain of debt and an impractical understanding of the human condition, one that assumes the necessity of purchasing lots of chemicals and ingesting them to maintain health. I laughed at my friends, who were set on natural family planning; I wished them luck and figured most would have a baby within the year.

As it turned out I was right, many of them did get pregnant. But the case was also true for my friends who had opted for the pill, a few missed doses or a change in prescription and they too were pushing baby strollers at the park.

The stats agree: natural family planning and birth control pills are nearly equally effective. When used correctly they can both, for the most part, avoid an unwanted pregnancy. They both require a small amount of daily attention and are subject to human error. Natural family planning has the benefit of being completely free of cost and without any medical side effects. On the other hand, pills require a near lifetime of stuffing money into the pockets of a pharmaceutical company plus the risk of blood clots, cancers and a slew of hormonal and mood disturbances.

Natural family planning only takes a few hours to explain, but it was given all of one sentence in my medical training. Even back in my high school health class I learned how to put on a condom and took a handful of them home (much to my mother’s dismay) but never once saw a fertility chart.

As a doctor, I spent many a breathless hour trying to convince my teen moms to commit to birth control. Maybe it was just to spite me, but they showed up with their car seat carriers and nylon nails year after year with their second and third and fourth pregnancies. The message wasn’t sinking in. I look back with regret now convinced I was giving them the wrong message.

Women in our nation are longing for wholeness. Yet birth control slices a decisive division through the female soul.

My teen moms, like all women, are sexual by nature. Intimately interwoven in their sexuality is fertility. For centuries cultures have developed natural methods to allow for the expression of sexuality while respecting its relationship with fertility. Marriage evolved in some form across the globe, in part, because it allowed for sexual activity in a context that ensured childcare for those babies who were the natural consequence of this form of intimacy.

The sexual revolution, though it touted the mantra of women’s liberation, sold us a lie in the form of a tiny pill. It promised women the experience of sex completely unburdened from its natural consequences. The falsehood of this claim has been demonstrated over and again by the epic dilemma of the many unplanned pregnancies which occur even while using birth control. What the revolution did establish was the belief that the responsibility for an unplanned pregnancy can be fully placed on a woman. A baby is no longer the result of sex but is due to her failure to use birth control correctly, nature be damned.

As it turns out the burden of fertility and the limits it required on a woman’s sexual expression protected her from exploitation. The contraceptive age has allowed women to experience a new kind of sexual freedom, but this freedom has come at a price. Sex liberated from any links to fertility, quickly normalized the female body as a sex object. Without the constraints of a pregnancy, men were given free access to women’s bodies as never before, and the industries of pornography and sex trafficking have exploded.

And despite all the new freedoms that women have been granted, there is no evidence to demonstrate that they are any more content with their sex lives or happier in general than in the past. Those who forgo sex until it can be had in a setting of intimacy and security that satisfies them are treated as if suffering from pathological sexual repression. While our teens are feeling pressure to have sex and experiencing sexual violence at ever diminishing ages.

The gains in sexual freedoms that contraceptives have allowed will never outweigh the damage done to womanhood, now divided and objectified.

Though she didn’t ask for it, my patient deserved more than what I gave her. She left that day with the script in her hand. With my scribbled signature I dissolved the boundary that nature had given her to own and protect her own body.