The conversation about birth control access has intensified since abortion bans went into effect in states around the country. Reproductive health advocates say they’re hearing it in the communities where they serve.
“A lot of folks are fearful we’ll lose complete access to contraceptives and family planning tools,” said Indya Hairston, a research program manager at SisterLove, a sexual and reproductive justice advocacy organization based in Atlanta. “It’s a hard time for people, especially women and birthing persons, as our bodily autonomy feels under attack.”
Searches for birth control as well as queries like “will birth control be banned?” have risen sharply since the U.S. Supreme Court handed down the Dobbs opinion in June. It’s understandable, advocates say, but now’s the time to be watchful and proactive – not panicky.
Improving birth control access “feels more important now than ever,” said Dr. Raegan McDonald-Mosley, a physician and CEO of Power to Decide, a nonprofit dedicated to reducing unplanned pregnancies by improving access to and education about contraceptives.
“But it shouldn’t take a national reproductive health crisis in order for contraceptive access to be a priority. It should always be a priority.”
Reckon spoke with advocates and experts in reproductive health access to find out how they’re talking with their communities about birth control – and their advice for the rest of us.
What do people get wrong about contraceptives?
1. Birth control doesn’t work the same way for everybody. An option that was a great choice for your friend or your sister may not work for you, said Hairston, and that’s OK.
And the opposite is also true.
“If somebody’s friend had a bad experience (with one type of birth control), that’s going to make a big impression on them,” said McDonald-Mosley. “It’s important to respect people’s personal experiences. But it’s important to remind people that just because one person you know has a bad experience doesn’t mean you personally will.”
2. Most people tend to underestimate how effective birth control is and they overestimate the risks, said McDonald-Mosley.
Effectiveness depends on the method itself, but also on a person’s physical makeup as well as their lifestyle and other factors. McDonald-Mosley recommends checking sites like Bedsider.org, which lets you compare forms of birth control, according to factors such as effectiveness, cost, side effects, and how ‘mistake proof’ they are.
3. Your weight can impact birth control’s effectiveness, particularly when it comes to emergency contraception like Plan B.
Michelle Colón is the executive director of Sisters Helping Every Woman Rise and Organize (SHERo), a reproductive rights organization based in Jackson, Miss.
Colón said the weight issue is something she’s often talking about with folks in her community. Emergency contraception with levonorgestrel, like Plan B and others, may not work if you weigh more than 165 pounds. There are other emergency contraceptives but, unlike Plan B, they might require a prescription. And if you weigh more than 195 pounds, emergency contraception might not work for you.
For Colón, that’s become one more barrier to reproductive health.
“It’s part of the system that has been created and is being upheld to keep women and pregnant people oppressed,” she said, “and keeps us working harder just to get basic birth control.”
4. Emergency contraception like Plan B isn’t the same as medication abortion.
This is a common misconception, said Hairston. “Some people want to lump all of those into one category and they are very different.” When SisterLove studied Black and Latina women’s views and experiences with medication abortion, they found that in nearly every research group, people thought Plan B and other emergency contraceptives were the same thing as medication abortion.
They’re not. Medication abortion, such as through drugs like mifepristone and misoprostol, ends a pregnancy; emergency contraception works by preventing pregnancy.
Is “Everyone get an IUD” the conversation we should be having?
Intrauterine devices (IUDs) are small pieces of plastic inserted into the uterus by a medical provider that prevent pregnancy by keeping sperm from fertilizing eggs. They can last for years, and they’re considered among the most effective forms of birth control.
They’ve also been rising in popularity in recent years. But a push for women and people with uteruses to “just get an IUD” ignores real and valid concerns from communities that have historically experienced medical trauma.
“Contraception is great,” said Colón, “but we also have to admit contraception has been used as a weapon against poor people and people of color. We need to be honest and truthful about that history.”
McDonald-Mosley said she’s been pleasantly surprised at the popularity of IUDs and other long-acting reversible contraceptives in recent years. But, like any form of birth control, “they’re not for everyone,” she said, particularly if they’re pushed on patients who aren’t sure.
“There is a dark and pernicious history of reproductive coercion, especially around Black and Brown communities,” said McDonald-Mosley. “No one should be told, ‘It’s going to be so hard to get an abortion for an unintended pregnancy that you need to get (an IUD) or get sterilized.’
“We can’t accept this current moment as a new standard and accept coercive practices as a new standard.”
Patients deserve respect from providers no matter their backgrounds, said Colón.
“Don’t assume because someone is poor or a person of color that they have a house full of babies or need to be on a certain kind of birth control,” she said. “That’s very condescending and that’s the experience many communities of color and poor communities have had.”
Instead, advocates say, patients should expect providers to present a range of birth control methods to patients and let the patients make an informed decision.
“That white coat fear is still very much in effect, even in 2022,” said Hairston. “A lot of folks, myself included, rely on doctors as experts. But we are the experts of our own bodies. We have to empower women and birthing persons to take control of what they want because there are so many options.”
“Don’t let anybody talk you into something if it’s not what you want,” said Colón.
How should we have conversations with friends about birth control?
McDonald-Mosley encourages people to educate themselves and then become that knowledgeable friend who can offer trusted information.
“Use your own voice and do your research to find reliable, trustworthy information that is comprehensive,” said Hairston.
If you have the option, find a physician who listens to and supports your reproductive goals.
Some states have laws that allow doctors and nurses to refuse to prescribe medications that run contrary to their personal beliefs. This is true in Mississippi, where Colón lives. She said she personally knows of doctors who have refused to prescribe birth control to patients.
“Individuals need to go in (to a doctor’s office) prepared with a list of questions they want answered,” said Colón. “Be proactive when you’re speaking to a medical professional. You shouldn’t be embarrassed or feel inadequate speaking about these things. It’s your body.”
And if you feel like your provider isn’t listening, she said, “You can walk out.”
Looking for more birth control resources?
Here are five recommended by our experts: