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How Birth Control Actually Works

For as long as female birth control has existed, it has been controversial. Efforts to make birth control available to women in the United States have long been met with resistance—including a federal ban. In 1916, Margaret Sanger opened the first birth control clinic and was arrested for “maintaining a public nuisance”. This happened many times until 1938 when a judge lifted the ban. In 1950, Sanger funded the research to create the birth control pill and, in 1960, the pill was approved by the FDA.

Though a short synopsis of the history of birth control, it highlights just how difficult it was for women to obtain contraception. Fast forward to present day and getting birth control is a lot easier—the Affordable Care Act (ACA) now requires plans in the Healthcare Marketplace to cover FDA-approved contraceptive methods and President Obama has taken steps to disallow the defunding of Planned Parenthood.

Despite women having easier access to birth control, there are still a plethora of misconceptions about what birth control actually does. Even more so, there are many women who use birth control and have no real insight into the negative effects it has on their bodies. Birth control has become a tool used to manipulate women’s bodies and, though women should have the freedom to choose whether to use it or not, this choice is best made when armed with all of the facts.

How Birth Control Prevents Pregnancy

Perhaps you remember a couple years ago when Hobby Lobby refused to cover plan B birth control or IUDs, on the grounds that they caused abortions? The crazy thing is that they won in supreme court. Regardless of the religious beliefs that allowed them this, the belief that birth control can even cause an abortion is false.

In order to dispel this myth, let’s take a look at how pregnancies happen and how birth control actually works.

During ovulation, you release an egg from your ovary. The egg must then be met by sperm and form a single cell (called fertilization). Then, that fertilized egg has to travel through your fallopian tubes and attach to your uterus. This process is called implantation. Only once the fertilized egg has implanted do you become pregnant.

There are a lot of people who believe that a fetus is a baby. We won’t argue that here, not because we believe it but because it’s irrelevant to the facts—your egg is not even a fetus unless it combines with sperm and implants properly into your uterus.

Birth control does not destroy that fertilized egg, it simply prevents ovulation, fertilization, or both from occurring. No fertilized egg, no pregnancy.

There are many kinds of birth control and they all work in similar ways. These are the most popular birth control methods and how they prevent pregnancy:

  • The PillThe birth control pill, in all its varied forms, prevents pregnancy by stopping sperm from meeting an egg. The hormones stop ovulation and thicken cervical mucus, making it harder for sperm to swim to the egg.
  • IUD — There are two types of IUDs: hormonal and nonhormonal. Hormonal IUDs prevent fertilization by damaging or killing sperm and making the cervical mucus thick and sticky, preventing sperm from swimming to the uterus. While we’re primarily exploring how hormones in birth control work, it’s important to understand how a nonhormonal IUD works, too. Copper, or nonhormonal IUDs, cause the uterus and fallopian tubes to produce a fluid made up of white blood cells, copper ions, enzymes, and prostaglandins. This fluid kills sperm.
  • Depo-Provera Shot and Nexplanon Similar to other methods of contraception, the Depo-Provera shot and Nexplanon both use the progestin hormone to stop ovulation, thicken the cervical mucus, and thin the lining of the uterus (which makes it difficult for a fertilized egg to implant).
  • Plan BOften called “the morning after pill”, Plan B birth control is used as back up contraception. It temporarily stops ovulation, prevents fertilization, and prevents a fertilized egg from attaching to the uterus. However, if you’re already pregnant, Plan B won’t terminate your pregnancy.

Ultimately, most birth control methods manipulate the reproductive cycle and/or stop sperm in its tracks.

The Side Effects of Birth Control

It’s clear then that birth control can’t be considered abortive in any way—it just prevents a pregnancy from occurring. Sounds great, right? It is and it isn’t.

For those of us looking to stay child-free or who don’t want any more children, contraception is ideal. It prevents us from having to chart ovulation so that we don’t become pregnant and is more reliable than “the pull-out method”. Condoms are an option but, for people in committed, monogamous relationships, they aren’t always ideal.

From mild side effects like bloating and spotting, to more consequential side effects like weight gain, mood swings, decreased libido, and depression, the convenience and ease of mind that comes with birth control isn’t without consequence.

The side effects vary between contraceptive methods but they all have them. The manipulation of our menstrual cycle leads to many alarming occurrences in our bodies, with one of the most studied being depression.

In a recent article by Broadly, the link to depression and mood swings due to birth control is explored in great depth.

[A Danish study conducted by JAMA Psychiatry] found a particularly strong correlation between teenage birth control users and depression: there was an 80 percent increased risk for teens taking birth control to start taking antidepressants after going on the pill. This statistic is particularly troubling, especially as many teen girls are prescribed the pill before they're even sexually active—sometimes to treat acne or severe menstrual symptoms, and sometimes just as a general, preventative measure. "It was seen as an essential thing to do," says Grigg-Spall, [author of Sweetening the Pill] "It was more of a rite of passage."

The article goes on to talk about the fact that, while there had been research done on the side effects of birth control, it wasn’t until 1970 that a hearing was held to “investigate the link between pill usage and decrease in libido, depression, and blood clots.” Flack was given when no women were asked to speak at the hearing, further proof to the point that we were being treated as test subjects without our knowledge or consent.

Thankfully, this hearing led to a decreased amount of hormones in the original birth control pill and a requirement that contraceptives include information on all potential side effects. Now, transparency in birth control is more of a given.

But it’s not just teenage girls who are subject to developing depression or having mood swings due to hormonal birth control. From menarche to menopause, hormones in birth control are a key player in disrupting our natural cycles and burdening us with some or all of the side effects. And even with the potential side effects listed in commercials or on birth control packaging, the potential damage is more of a footnote than it should be.

Grigg-Spall has done a lot of work to highlight the dangers of taking birth control without knowing all of the potential damage it can do, both on a physical level and to our society. We’re using birth control to treat everything from acne to endometriosis and its use as a way to stop the menstrual cycle entirely is gaining in popularity. While this may seem like a good solution to dealing with reproductive or hormonal issues, the potential long-term effects of hormonal birth control aren’t taken into consideration.

Menstrual Manipulation—Are You Informed?

The point of all of this is not to say that you shouldn’t use birth control. It’s about gathering all the facts and making an informed decision based off of them. Women have fought so hard for the right to choose and be in charge of their own reproductive health and yet when it comes to birth control, many of us are quick to choose before having a full set of facts. We’re gambling with our reproductive health, instead of making intentional choices about how we do and don’t want our menstrual cycles manipulated.  

Before going on or switching birth controls, gather the facts—the potential side effects, how the birth control prevents pregnancy, what hormones are used in it, and how it may impact your physical, emotional, and mental health. Don’t just look at the websites of your birth control method. Read about other people’s experiences, talk to your friends, and have an honest conversation with your doctor. Whatever you choose, be confident that you’re making the best decision for your body.

Photo Credit: Keystone-France/Gamma-Rapho via Getty Images


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