Let me sum up:
Recent Rachel Maddow Man Cave
Let me splain:
I was gleeful to see this edition of the Man Cave. And I was über-impressed by Beth Schopis’ bravery. I think there are crazy numbers of people (both men and women, unfortunately) who don’t have their heads wrapped around the science of hormonal birth control. Information is empowering, and I am thankful to Rachel and Beth for getting more of it out there.
I have some complicated emotions about contraception, and this hit home for me in a wacky, tearful way. (My Friday evening progressed with season 1 of “Walking Dead,” and even more tears).
Disclaimer/Paranoid-Attempt-to-Establish-Liberal-Street-Cred: I’m not a religious zealot. I went to college in Berkeley. I work in community mental health. I moved to Iowa a few years ago and giddily participated in a caucus for the first time by standing with Kucinich, and then Obama. I am not Elizabeth Hasselbeck. Interestingly, Hasselbeck is the only other person I've heard of discussing the pill’s uterine impact on TV. She is, of course, also a person who might have answered Beth’s question with “I oppose birth control because it kills people!” Or "What you're calling birth control, I call abortion!"
So…I don’t think zygotes are people, and I find it terrifying when people try to legislate on their behalf. But I had a very groovy philosophy teacher in high school who got me thinking about when people become people, and the immense grey area in this question. I don't have an objective answer to when human life begins. But I think that when two gametes have beaten the odds and fused together into a unique genetic code, that's pretty dang cool. And in my personal decision making, I don’t like the idea of doing something that would actively interfere with the viability of an egg after fertilization. When I first started taking the pill nearly a decade ago, I’d recently seen a scary evangelical rant about the pill and implantation. I explained my—admittedly quirky—stance on this topic to my doctor and asked for more information on how the pill works. Her initial response was “if you get pregnant while taking the pill, it won’t harm your baby.” And I said “Ok, but what I’m asking is whether the pill can interfere with the implantation of a fertilized egg. Can it do that?” She said “No.”
A few years later, I read an official FDA breakdown of the three pill mechanisms presented by Rachel this week. That is, the pill:
1. Reduces the odds of an egg being present in the uterus to nearly zero.
2. Thickens cervical mucus, impeding swimmers (I was debating the odds Rachel might actually say “mucus”)!
And 3. (despite what that doc had told me) Thins the uterine lining such that it would impede implantation should an egg sneak through and get fertilized, which does happen from time to time.
So…I made an appointment at women’s health and met with a nice resident. I explained my desire to avoid interfering with the implantation of a fertilized egg, and said that I was primarily interested in talking about back-up options (sponge/cap) to have on hand for times where break-though ovulation was slightly more likely (like if I was late taking a pill during the first week of a pack) to minimize the chance of a sneaky egg getting fertilized while I'm making my uterus less-than-optimally-hospitable by taking the pill. The resident was pretty stumped by my stance. She eventually called in an older, male doctor, who pretty dismissively said that I should just make my husband wear condoms because he was lucky to be getting lucky (I had explained neither of us was a fan of condoms). I tried explaining my position as calmly as I could, but by the end I definitely had a lump in my throat and some quaver in my voice. And after about 40 minutes of chatting with both of them, the resident suggested that I seemed really paranoid about getting pregnant and said that they could give me some Plan B (which is a great option for someone whose sole goal is avoiding pregnancy, but kind of the opposite of what I was asking for since it is another method that can, potentially, interfere with implantation).
After more consideration, a guilt heavy email exchange with the folks at creightonmodel.com (who certainly weren't down with me combining their methods with scandalous barrier methods), and some reading (I was lucky enough to have access to medical journal databases as a grad student—here’s hoping open access publishing becomes more widespread!) I decided to stick with the pill. Though the “actively interfering” piece still weirds me out, the odds of an egg getting fertilized and failing to implant still seem at their lowest while I’m on the pill, since the odds of an egg inadvertently getting fertilized are higher with condoms and fertility monitoring than the pill, and fertilized eggs often naturally fail to implant. Confused/bored/annoyed yet? Thanks for sticking with me.
My experiences while trying to make decisions about contraception left me feeling pretty frustrated and vulnerable. Emotions run so hot on reproductive issues, and that often impedes the distribution of accurate, helpful information. I am a lady who wants to minimize the odds that an inadvertently fertilized egg will get turned away from Ye Olde Uter Inn (ack). I realize that’s a pretty weird stance, but that’s where I’m at. And I was left feeling misinformed and alienated when interacting with both the "natural family planning" folks and with medical professionals. I wish it had been easier to find accurate information to help me make decisions consistent with my personal preferences—that is a right and a necessity for any woman making decisions about her health. And, again, I appreciate both Rachel and Beth navigating difficult conversations to make accurate information more widely available.