Wednesday, March 24, 2010

Laura Eldridge: 50 Years Later -- The Dark Side of Birth Control

(via Seven Stories Press)

50 Years Later: The Dark Side of Birth Control
by Laura Eldridge

As we get ready, in 2010, to celebrate the 50th anniversary of hormonal contraception in the United States, women have every right to stand up and cheer for a birth control option that has revolutionized how effective a contraceptive can be. "The Pill" and its descendants have indeed provided women with a unique tool that has changed the terms in which women control their social and professional choices.

Amidst all the applause, though, let us not oversimplify the history of a drug that has often coupled danger with opportunity, and indeed reinforced some serious inequities even as it promised to enhance women's rights. Today, 50 years later, ovulation suppression through hormonal drugs still harbors many adverse effects, which range from mood swings and diminished libido to fatalities from blood clots. The innovation itself emerged at the cost of experimentation on poor women, and came, in part, out of a desire to control the fertility of poor populations.

... Women have certainly seen their lives and opportunities transformed in the past fifty years. While the pill is one powerful player in this remarkable story, this revolution has occurred largely through the persistent efforts of women (in multiple contexts and conditions) on their own behalves. The pill did not create second wave feminism. And likewise, it did not create all the changes that that remarkable movement oversaw. Those things happened because courageous women were willing to sacrifice and fight over time for them. In recent years, the reproductive justice movement, powerfully led in many cases by feminists of color, has made the point that single-mindedly striving for the right to birth control and abortion ignores the complex power systems that too often dictate the terms in which women make decisions about their health in general and their reproductive and sexual health in particular.

And that brings us to the current moment. As the pill starts its second half-century, women find themselves dealing with many of the same old problems. Access to health care is deeply unequal: many go uninsured and many more lack basic education about their bodies and sexual health. While the shocking sterilization abuses of poor women and women of color that persisted into the nineteen eighties have been curtailed, the experience of Norplant in the nineteen nineties showed that new and potentially dangerous products are still marketed disproportionately to these women.

Doctors still pressure women to use pharmaceutical birth control and dismiss concerns about side effects and dangers revealing that while women have entered the medical profession, they have not been immune to perpetuating sexism and perhaps even more distressingly, drug company agendas.

Women have come to accept with little question that contraception should be their responsibility. Even in an age when HIV/AIDS has brought new relevance to condom use, women still struggle with partners who insist that it is better for them to bear the costs of contraception in their veins than cause sexual inconvenience. And of course all these years later there is still no "pill for men" or modern contraceptive equivalent for male bodies.

In fact there has been very little contraceptive innovation at all. Drug companies, burned by law suits with the pill, Dalkon Shield IUD and more recent devices such as Norplant have largely decided that the pill (and other hormonal contraceptives) are "good enough." Repackaging of the same old drugs--in the form of implants, injections, rings, patches and chewables--are sold as innovation and pills promising to eliminate periods show the way in which contraceptives are being subtly re-branded as lifestyle drugs.

Rarely in any contraceptive debate is the issue of respecting a woman's natural reproductive cycle raised. If men were asked to take a hormonal therapy that would cut off the healthy production of their sex cells, would they take it? Would they take it if it would reduce their sexual appetite and adversely affected their moods? Would they take it if it increased their risks of developing high blood pressure, metabolic problems, certain cancers and having a stroke? Maybe. Yet, women everyday take on these risks to suppress ovulation without ever considering whether they are loosing something essential when they do so.

The pill has indeed helped women to write heroic chapters in their histories. It has provided a contraceptive efficacy that was only a dream before, and other health benefits such as some protection against ovarian cancer and relief for women with severe menstrual distress. But it is not a silver bullet.

And even today it poses serious health questions and comes with a host of side effects. As we stand on this important anniversary, perhaps we need to do the thing that seems to be the hardest: to appreciate this remarkable innovation while also being honest about its limitations. To give credit to this exceptional tool while also frankly acknowledging the sometimes difficult histories that have allowed to it take its current position of prominence in the contraceptive landscape. We need, once again, to broaden the conversation, educating women to make responsible decisions about birth control that would respect other birth control choices. And even as we enjoy and use this amazing product, we need to keep pushing and fighting for something better.

Laura Eldridge is the author of In Our Control: The Complete Guide to Contraceptive Choices For Women, the first step in broadening the conversation about birth control to include, evaluate and promote all available alternatives to the Pill. She is also the editor, with the late Barbara Seaman, of the anthology The Body Politic: Dispatches from the Women's Health Revolution. Both books will be published in June by Seven Stories Press. The above article originally appeared in full at AlterNet.

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