The generalization of birth control

Graphic by Florence Yee

Women seek better birth control and for men to have more contraceptive responsibility

Canadian women have access to over 10 different birth control options. However, some women have voiced displeasure over the fact that many methods are only designed for females, often putting the responsibility of preventing pregnancy solely on women. The methods can also come with many negative side effects.

“My doctor was pretty adamant about me being on the pill,” said 22-year-old Concordia student Sara DeMelo Zare. “After having asked about an IUD, he stressed that the pill was preferable for someone of my age—I felt like I was streamlined into a birth control stereotype.”

“My body definitely did not take well to the hormones I had introduced to it,” said DeMelo Zare. She said she experienced intense mood swings, cramps, severe leg pain, dizziness, excessive nausea and chest pain. “The physical pain far outdid shortened periods and their consistency,” she said.

Dana Martin, a 20-year-old mother of two from Toronto, said she believes birth control is assumed to work for all body types. “Birth control is generalized, 100 per cent,” said Martin. “What’s right for one woman may not be right for another.”

The most effective forms of birth control are copper IUDs, hormonal intrauterine contraceptives (IUC), hormonal implants, female sterilization and vasectomy, according to the Association of Reproductive Health Professionals. The Ortho Evra patch, the pill, the Depo-Provera shot, vaginal rings, diaphragms, both female and male condoms and the withdrawal method are deemed very effective methods. According to the same source, the cervical cap, plan B, spermicide, the sponge and fertility awareness are classified as moderately effective methods.

Martin, who used Tri Cyclen between the ages of 13 and 15, found the only benefits of the birth control were less painful periods and a much lighter flow.

“The side effects for me were extreme mood swings—I went through periods of depression for weeks on end—and weight gain,” said Martin. “By no means did the pill prevent pregnancy for me.” Martin said she became pregnant while on the pill.

“There are other methods of contraception and I’ve long considered just dropping the pill entirely,” said DeMelo Zare. “I thought of potentially looking into an IUD—but again, I’ve heard it has terrible potential impacts and often shifts and is even rejected by the body.”

For some women, hormonal IUC—the hormonal version of an IUD—have been beneficial in reducing menstrual bleeding and cramps, according to the Society of Obstetricians and Gynaecologists of Canada’s website SexandU. However, according to the same source, it may also cause perforation—if the IUD punctures the uterus—which happens to one in 1,000 women. Each year, often within the first month of use, between two to 10 women out of 100 have found that their IUDs moved from their original position and are pushed out of the uterus.

Women who experience heavy menstrual cycles are advised to use hormonal IUCs—which do not contain estrogen, but contain progestin only. Copper IUDs, which are non-hormonal, are not recommended for those with heavy flows, as they may create even heavier flows and painful cramps, according to Family Planning.

Twenty-two-year-old and former Concordia student Aisling Doolan described her experience of having a copper IUD insertion as the most invasive, painful and traumatic experience of her life.

“For the next five days after, I had an extremely heavy period and cramps,” said Doolan. “I’m not someone who ever experiences menstrual cramps so it really threw me off.”

“I continued to get my period for a whole month and felt so weak, drained and sore,” said Doolin. She said her iron levels were so low she had to take out the IUD after about three weeks.

“It seems like there’s no escape from the potential impacts birth control has on our bodies,” said DeMelo Zare, explaining that she feels it has become fairly discouraging.

“Doctors need to be more open, honest and thorough with their patients,” said Martin. “We have a health care crisis going on right now,” she added, referring to the fact that there are too many patients per doctor in Canada.

According to the World Bank—a global financial institution which offers free and open access to worldwide development data—between 2008 and 2014, Canada had 2.1 physicians per 1,000 patients, amounting to approximately 500 people per physician.

Concordia Health Services health promotion specialist Gabriella Szabo said the issue of lack of time and access to health professionals is likely true, but probably only one small part of a very complex issue.

Szabo questions whether general doctors and nurses are getting good training for contraceptive consultations in school. If not, this can contribute to doctors not providing thorough information on birth control. “Is contraception counseling reimbursed adequately so that doctors feel they can dedicate enough time to it?” Szabo questioned.

Schools are a source where students learn about contraception, said Szabo. However, the Quebec government only released a pilot project in 2015, beginning sex education in 15 schools in Québec set to last for 2 years, according to CBC. According to the same report, the pilot could be adopted by all schools in the province by 2017-2018, however there have not been any updates towards advancement of sex education in Québec high schools.

“Many of this current university cohort are coming from Quebec high schools that had no sex ed,” she said. “A comprehensive sex ed program would also include contraception education.”

While having a conversation with a long-term partner, Martin said she discovered he had little to no clue about any form of female birth control. “In my all-female [high school] sex ed classes, we were taught everything from how to put on a condom, to different forms of birth control, to childbirth,” said Martin. “But his male sex ed class mainly consisted of condoms and the different types of STDs/STIs one could contract from unprotected sex.”

“Why is it that, as women, we need to have a thorough understanding of how condoms work, but men don’t need to know the slightest about female birth control?” said Martin.

Less frequently do we hear women asking their male partners if they’ve pursued all areas of potential contraception, exercised proper condom use or are aware of what birth control their partner is on, said DeMelo Zare. “The expectation of women to simply have ‘taken care of it’ eliminates the proper use of and knowledge of contraception by men,” she said. “That, in itself, is truly disheartening.”

Condoms and other contraceptive methods, along with regular testing, are crucial to ensuring a healthy sex life, said DeMelo Zare. “Men should realize that they share an equal part when it comes to pregnancy and STD prevention,” said DeMelo Zare.

Graphic by Florence Yee

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