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Let's Talk About Natural Birth Control

Here’s a fun little back story on my adventures in birth control: When I was about fourteen, I was asked by my doctor if my periods were uncomfortable. When I said yes, she prescribed me the birth control pill. By high school, at least half of my friends were also on the pill; it was a pretty normal thing. As a sophomore in college, I got a blood clot (a DVT, to be exact… 30% of people who have these die of them, btw), and – after a hospital stay, two weeks of strict bed rest, six months of blood thinners and a litany of blood tests to determine whether I had a clotting abnormality that would require me to take medication for the rest of my life, it was determined that my blood was normal. The clot had been caused by the birth control pill, a recognized and not-exactly-unusual side effect, but one that hadn’t been communicated to me at all when I was first handed a prescription.

Because of the clot, taking the pill again was no longer a birth control option for me (not that I had any desire, by then, to do so), so I used a diaphragm for a while. It wasn’t convenient and was sometimes uncomfortable, so, several years later, when Aaron and I shacked up together in Brooklyn, and, soon after, became engaged, I didn’t use the diaphragm all the time; I paid attention to my cycle and used protection for several days on either side of cycle day 14… when, according to commonly dispelled – even among doctors -- reproductive wisdom, I would be fertile. Needless to say, my pregnancy with Kaspar was a bit of a (happy) surprise.

A not-so-happy surprise, however, was that my pregnancy was categorized as high risk, thanks to that blood clot back in college. I would have to inject myself with blood thinners (and thus sustain painfully bruised upper thighs) twice a day until Kaspar arrived. During my first appointment with the maternal fetal specialist (high risk OB), however, the doctor did an ultrasound, looked at my chart, and then looked back at me. “Based on the first day of your last period,” he said, “I’m not seeing what I’d expect to on the screen here. This pregnancy may not be viable; let’s do another ultrasound in a week, and then we’ll know. And if this one didn’t stick, don’t worry – another one will.” A week later, however, he looked again at the screen, then back at me with a smile, and said the baby was definitely in progress, and had grown sufficiently from the last appointment to suggest that nothing was amiss. “You must have ovulated late,” he said. Which explained why I got pregnant in the first place. But pretty much conflicted with everything any doctor had told me up to that point about ovulation. As far as I’d been told, it was a simple matter of mathematics; ovulation always occurred halfway through a woman’s cycle. Apparently, this was not true, and I had a pregnancy to prove it.

Fast forward nine months, and I was a mom. I was ecstatic to be one, but wanted to know I wouldn’t be pregnant again, by accident, any time soon. I could have used the diaphragm every time we had intercourse, I guess, but it really didn’t feel great. And I was never sure if I had it in correctly. My doctor suggested a copper IUD, citing its safety, its ten-year longevity, and so forth. The idea of not having to think about my birth control was very appealing. Six weeks after delivering Kaspar, my OB inserted the IUD into my cervix. The timing was actually great, since, after labor contractions, the cramps that followed the IUD insertion were a piece of cake. But the discomfort that followed in the subsequent weeks and months wasn’t quite what I’d been sold on. I returned to my doctor, sure that my uterus must be punctured or that my body was rejecting the device. He took a look, said everything was fine, and that what I was experiencing was normal. My body would adjust to the IUD and the symptoms would subside.

They did, to some extent. I still have the IUD now, almost three years later, and it’s… fine. But it’s not great. I mean, I haven’t had any surprise pregnancies with it, so there’s that. But my periods hurt, a lot. Sex sometimes (not always) hurts a little. And I have weird aches and occasional spotting that freak me out; yet, when I go in for annual pap smears and ask about all of this stuff, I’m told it’s normal. Par for the course with a copper IUD.

What I wasn’t told directly (and haven’t been, as of yet) is that doctors aren’t exactly sure why the IUD works. I’ve heard different explanations from different providers. Some say that it won’t allow a fertilized egg to stick itself to the wall of the uterus, because it manually scrapes the lining. Others say it’s the copper itself that prevents pregnancy. The copper – whatever its function -- kind of weirds me out, too; I literally have a foreign object, made of a heavy metal, in my body. Despite thinking this whole thing a bit suspect, I’ve been conceding to it based on the birth control options that are out there; the IUD seemed, until recently, to be the most appealing option among a small collection of bad options. So I’ve been sucking up the side effects and considering the subject, for all intents and purposes, closed.

Then, last week, I got together with an acupuncturist friend to have lunch, and trade services. (I’m a licensed massage therapist.) As we compared notes on what we wanted addressed, respectively, by the other’s care, I mentioned a slight, intermittent pain I was feeling in my lower right pelvic area. I said I didn’t know what it was, but that, since getting an IUD, I sometimes feel mysterious sensations in that area. We started talking about the shortcomings of birth control, and she asked if I’d read Taking Charge of Your Fertility. Another friend had, in fact, recommended it to me a couple of years ago, but I’d assumed any ‘natural’, self-regulated birth control method was synonymous with the “rhythm” method. Obviously, that hadn’t worked for me (and we all know I’m not the first), so I didn’t read the book. My acupuncturist friend, however, said she’d been using the Fertility Awareness Method (FAM), as outlined in the book, as birth control for six years, without ever becoming pregnant. Now she plans to become pregnant, and she’s going to use it for that, too.

I was intrigued. I’ve been planning to get my IUD removed in the near-future anyway, since Aaron and I are planning on baby #2 (one way or another) in the coming year. I thought, once IUD-free, I’d kind of leave it up to chance and let myself be semi-surprised again. It turns out that, using FAM, I can probably make a pregnancy more targeted, in terms of timing, than that. And likewise, I can hold off until we’re really ready to dive in, but without having to compromise my health, comfort, or safety on account of birth control.

I’ve read a couple of chapters of the book, and I’m now totally fascinated, not only with the viability of this method, but because of what it means for women who use it, and all of the women who don’t, or can’t, because their healthcare providers aren’t bringing it up. Using physiological indicators of fertility, namely waking body temperature and cervical fluid consistency – both easily determined, taking only a few minutes a day – and a simple charting method (not counting), women can know when they are able to get pregnant. We can know if we’re ovulating late. We can know when we are pregnant. And we can avoid getting pregnant without inundating our bodies with hormones, metals, and so forth. That’s what the book claims of this method, anyway.

The fact that women are only fertile for a few days each month, while men are fertile ALL the time, and yet women have shouldered the responsibility (and hazards) of birth control for all of these years is also fascinating – slash frustrating! But rather than be frustrated, I appreciate having another option, namely taking the bull by the horns and taking care of our needs/wants/desires/health and, where reproduction -- i.e. parenthood -- is involved, the very course of our lives. I can’t believe that a method of birth control allowing for this kind of autonomy isn’t more widely known. There are all kinds of political and financial reasons for this, of course, but I should mention that FAM isn’t completely foreign to people (as much as it was foreign to me). I’ve been surprised by how many moms I know actually used the method to become pregnant. One, who I had lunch with a few days ago, did so successfully, and mentioned that a friend of hers gave her a copy of the book for that purpose. “I can’t believe I wasn’t given this book in high school!” I said. She nodded emphatically, “Right?!”

Aaron laughed at that sentiment when I repeated it to him later, saying high school-aged kids would, for sure, end up pregnant with something like this. He might be right (I could barely remember to take the pill every day at 16… charting my cervical fluid would, admittedly, probably have been a bit out of reach), but… I still think I should have been given this book then! It’s a matter of education about our bodies, not just birth control. My reproductive system, and its role in making babies, has been either oversimplified (because sex does not necessarily always equal babies) or shrouded in mystery (because ovulation does not always happen on day 14), for my entire life. Which is crazy. Because, meanwhile, I got a blood clot, had a baby, and am now about to have a copper IUD removed in order to have another baby! And I’m only learning now that my body gives clear physical indicators when I’m able to become pregnant. (Or not become pregnant.) Cuh-razy.

One of the reasons offered in the book’s early chapters for doctors not disseminating information about FAM, despite widespread awareness among them of its efficacy, is because they believe it’s too complicated for many women to grasp. Another is that doctors tend to schedule only a finite amount of time with each patient, thus rendering a thorough explanation of the method impossible. It’s much faster, and more profitable, to prescribe a pill, or an IUD for that matter. (Mine cost $500 out of pocket, and I had health insurance.) Toni Weschler, MPH, the book’s author, contends that – after years of educating women about FAM – she’s found pretty much everyone can learn how to do what’s required in order to correctly follow the method. This suggests that doctors would probably discover the same thing, if they had the time. The doctor who first prescribed me the birth control pill didn’t even have time, evidently, to discuss possible side effects – although she did mention that I’d probably get fewer zits, and enjoy shorter periods, as a result of taking it. This is what it is. But that FAM was never even mentioned when, as an adult, I asked about birth control options that are non-hormonal, reliable, comfortable and safe, is unacceptable.

Anyway, I’m going to give it a shot. Natural birth control seems like a logical extension of my commitment to natural parenting; and the Fertility Awareness Method seems far more reliable than the rhythm method. If it doesn’t work, I’ll be happily surprised by a second pregnancy (which will require me to take blood thinners throughout, like the first one, but I'm pretty much at peace with this). If it does work, I’ll plan that pregnancy and achieve it right when I expect to. Either way, it’s win-win. After baby number 2, however, I’m gonna talk to Aaron about taking one for the team and having a vasectomy… but that’s another post for another day.

What do you use for birth control? Are you happy with it? Do you suffer any side effects? Do you have any experience with natural birth control/family planning? Have you heard of – or used – the Fertility Awareness Method? Pros? Cons? Results??? Share your experience in the comments below!