All I had to tell my provider to get a Mirena IUD last September was that I wanted one. Getting an IUD is not a pioneering move: Despite a bad rap that has endured since a defective version injured hundreds of thousands of women in the ’70s, the method is enticing more and more women with its 99% effectiveness and three-to-12-year lifespan. I also live-tweeted my insertion — a more unusual choice, but one I viewed as an extension of the social media habits I already had, not some radical act. I hoped that describing my experience in real-time, my feet in stirrups as my provider slipped the plastic T into my uterus, would prove helpful to some women — and, bonus, the distraction was better than ibuprofen for relieving the pain. What was surprising, at least to me, was the response: Twitter's overwhelming interest in a fairly uneventful medical procedure on the one hand, and on the other, the incredulity of many who couldn’t fathom how I could get so “personal” so publicly. Especially since the only reason I seemed to want an IUD was so I could have unprotected sex with my partner.
It’s been 60 years since the FDA set in motion the rise of oral contraception, by approving a hormone that prevented pregnancy in 1956. You couldn’t say that’s why you wanted it, though. Hormone pills were prescribed for “menstrual irregularity,” not birth control, and labeled with “warnings” that they would prevent pregnancy. These warnings served more as advertisements, and miraculously, the number of women suffering from “menstrual irregularity” exploded overnight, with doctors complicit in the lie they were forced to tell. Finally, in 1965, the Supreme Court ruled that married women could use the pill as contraception (citing the “right to privacy in marital relations” rather than a woman’s right to birth control); it took until 1972 for the court to rule this use legal for single women, too. And now 44 years later, it’s still a statement to broadcast, in no uncertain terms, what you do to avoid unplanned pregnancy, as I did. We still advance the idea that some women deserve access to birth control more than others — and we risk perpetuating this false hierarchy when we focus on BC's noncontraceptive benefits in the attempt to defend it in the public eye. When I Google “why women get birth control,” the first result is a WebMD article with the headline “Birth Control Pills: Benefits Beyond Preventing Pregnancy.” Sandra Fluke, the law student whom Rush Limbaugh famously labeled a “slut” after she spoke before a 2012 congressional panel on contraception coverage, centered her testimony on acquaintances who needed BC for polycystic ovary syndrome and possible endometriosis. In a popular (and powerful) BuzzFeed story from 2014, “We Asked 22 Women Why They Take Birth Control And These Are Their Answers,” seven of the women, or a third of those featured, named cramps, acne, PCOS, pain, endometriosis, or unruly hormones without mentioning pregnancy — all (perfectly legitimate and important) health care needs other than pregnancy prevention.
I say “other than” because pregnancy prevention is health care. The Guttmacher Institute reports that 42% of women on BC use it exclusively for contraception, and I am one of them. (An additional 14% rely on it for reasons that have nothing to do with contraception.) I’ll be even clearer: I have an IUD to avoid having an abortion, which is what I plan to have if I get pregnant. That’s it, and that should be enough. I tried the pill and didn’t like how I felt (I’m saving my tears for favorite book characters who die), and I don’t like using condoms with my (monogamous, tested) partner; having someone come inside you is, in my opinion, sensual and intimate and awesome. I’m not shy about this. For generations, though, women have been compelled to talk around their needs when they’ve been able to address them at all. Decades before the advent of the pill, manufacturers hawked birth control products under the vague umbrella of “feminine hygiene” and even insinuated that products with no birth control merits could prevent pregnancy. (Don’t put Lysol in your vagina, folks. Coca-Cola, either.) On a more serious note, women around the world still seek to escape reproductive coercion with birth control methods they can conceal from their partners. And when we make the case for women’s right to access to birth control with the argument that hormone regulation isn’t “just for” family planning but also for clearer skin, lighter periods, regulated moods, or lower cancer risk, as I’ve done in the past, we risk skirting the core truth that there is no hierarchy of birth control need. If a woman wants it, she should have it.
There is no hierarchy of birth control need. If a woman wants it, she should have it.
The first birth control clinic in the U.S. opened 100 years ago this year in Brownsville, Brooklyn, offering patients pamphlets and counseling for nine days before it was shut down. Last week, Congress voted for the eighth time to defund Planned Parenthood, the nation's largest family planning provider. Birth control technology has evolved, but we’ve been having the same conversation about access for too long. If we are on BC because we like to fuck with abandon, let’s own it: Our mothers and grandmothers couldn’t. If we’d rather not tell anyone why we’re on it, that’s cool, too. When every reason to take BC is just as valid as any other, we dispense with the need to explain ourselves at all.
The Bed Post is a series that explores what holds us back from sex and love with whom we want, when we want, where we want, and how we want — because we all deserve sex and love lives that are not only free of evils, but full of what is good. Follow me on Twitter at @hlmacmillen or email me at hayley.macmillen@refinery29 — I’d love to hear from you. Find all of The Bed Post right here.