Feminism, Backlash, and Sweetening The Pill

It’s been more than 20 years since Susan Faludi first published Backlash (with the provocative subtitle, The Undeclared War Against American Women), her thorough documentation of the ways women and feminism were under attack in the U.S. The War Against Women has been now been openly declared in American politics, and there is a backlash among women in online feminism.

I’m referring to discussions of hormonal birth control; specifically, how and with whom we can criticize the birth control pill. Before she joined the re:Cycling team, Holly Grigg-Spall wrote a guest post for us titled, Why Can’t We Criticize the Pill?  At the time, the title may have seemed a little overwrought, but now that her book criticizing the pill has reached the market and been reviewed in several online publications (including by some reviewers who refused to even read it), the question is more than apt. Lindsay Beyerstein’s review for Slate prompted some readers to start a petition asking the publisher to cease publication. Amanda Marcotte has written two posts on her blog slamming the book without reading it, and refused offers of a free copy so that she could respond accurately. Dr. Jen Gunter is also uninterested in reading it, labeling the book “that atrocious pill book” on Twitter and suspecting “a pro-life agenda”.

The criticisms of the book are many and inconsistent: (1) an assertion that Grigg-Spall claims the pill is bad because it is not ‘natural’,  (2) since the pill was bad for Grgg-Spall, no one should take it; (3) the pill is sexist and therefore dangerous; (4) the pill is anti-feminist; and furthermore, (5) Holly advances all of these claims in service of a anti-feminist, anti-woman, anti-choice, pro-life, Christian right-wing agenda. That last one is particularly galling, as every time she speaks or writes about these issues, Holly prefaces her talk or mentions in her writing that she is atheist, feminist, and pro-choice. (She often also mentions that she’s British, and was raised with a very different health care system than those of us in the U.S., and thus held different assumptions about access.)

All of these criticisms are either factually incorrect, or exaggerated or deliberate misinterpretations of Holly’s actual arguments. For instance, while she does question what ‘natural’ cycles would be like if women didn’t take the pill, she does not assert that pill = unnatural = bad. Nor does she advocate banning or restricting the pill. She does locate the pill in a complex matrix of capitalist and patriarchal social structures that do not benefit women, which is not exactly the same as saying “the pill is sexist”.

As a feminist, a scholar, and as a reader of books, I’m both fascinated and frustrated by the criticism Sweetening the Pill has received. I’m appalled that reviewers would write and publish reviews completely panning a book they haven’t read, and then refuse to read it. As a feminist, I’m frustrated by apparent efforts to shut down dissent. The pill has never been more politicized in American life, and as I’ve asserted elsewhere, we cannot be so focused on preserving access that we’re willing to ignore questions of safety. Furthermore, it is not anti-feminist to disagree with one another. Feminism has a long history of proliferating and becoming more powerful by listening to dissent from within. Anyone remember the “Lavender Menace“? The emergence of intersectionality? As a commenter on one of the hack pieces eloquently put it,

The feminist critique of reproductive technology (including the pill’s discontents) are well established going back before the existence of the pill itself as debates with Sanger and colleagues. I’m sure this is widely taught in the Women’s Studies programmes you mention, it was to us even in A-level sociology.

I just don’t understand why you are pretending this is a new thing or that anyone taking these positions is a non-feminist. Are genuinely unaware of the history of your own movement or is this a crude rhetorical move against people you don’t agree with? Feminists (Seaman and Wolfson) provided critical testimony in the 1970 Senate Hearings, this is not some sort of obscure or secret fact, Wolfson’s outburst as to the constitution of the hearings and why drug companies were better represented than women is surely famous?

It seems to be the case you want to retro-actively kick Barbara Seaman out of feminism. You know, the woman that Gloria Steinem said was the prophet of the women’s health movement… with respect I don’t think you have the power and you don’t have an argument.

Feminism has always supported counter-intuitive critiques given that problems are multi-valenced. While Sanger held that reproductive control was an essential pre-condition of liberation, “who controls the control”, why and how are far more provocative questions.

Agree or disagree with Sweetening the Pill, or any other book, but read it for yourself, and form an opinion based on what the book actually says — not what a reviewer says or a 140-character criticism on Twitter suspects it might say. And think very carefully, and perhaps read it again, before you decide that it’s not feminism just because it doesn’t match exactly your feminism.

Yaz and Yasmin: An Unacceptable Level of Risk?

Photo by Flickr user Beautiful Lily // Creative Commons 2.0

Don’t feel bad if you missed last week’s headline news about the deaths of 23 young women from their birth control. It was a top story for CBC news and a few other Canadian sources, but it was barely a blip on the radar of most U.S. news outlets. Yaz and Yasmin, two similar new-generation birth control pills from Bayer, are suspected in the recent deaths of these young Canadian women.

These are among the best selling oral contraceptives in the world, but this is not the first time Yaz and Yasmin have been suspected of causing death or adverse effects. Earlier this year, Bayer agreed to pay up to $24 million to settle claims from plaintiffs with gall bladder injuries caused by the drugs, and the company set aside $1 billion to settle claims from approximately 4,800 women who have suffered blood clots due to Yaz or Yasmin. As of February, 2013, approximately 10,000 lawsuits against Bayer are still pending in the U.S., and an additional 1,200 unfiled claims are pending. The company anticipates additional lawsuits—and additional settlements—regarding blood clot injuries, such as pulmonary embolisms or deep-vein thrombosis.

The history of the birth control pill and its social impact is well documented. First approved by the U.S. Food and Drug Administration in 1960, it quickly became the world’s first “lifestyle drug,” and it has become the one of the most studied drugs in history. It is considered to be so safe that the American Congress of Obstetricians and Gynecologists (ACOG) recently recommended that oral contraceptives be sold without a prescription.

But all hormonal contraceptives–the pill, the patch, the shot and the vaginal ring–carry a risk of blood clots. For most users, this is a minor concern, affecting approximately six of every 10,000 pill users. For users of new-generation pills—that is, pills containing drospirenone, the fourth-generation synthetic progesterone found in Yaz, Yasmin, Ocella and several other brands—the risk jumps to ten of every 10,000 users, although Bayer maintains that their own clinical studies find the risk comparable to older pills. Note, however, that the risk in most of these studies is compared either to other hormonal contraceptives or to pregnancy, not to using effective non-hormonal contraception. As if women’s only choices were to be pregnant or be on the pill.

And it is this matter of women’s choices that brings me to my main point: Why we have we seen so little media attention to the safety profile of Yaz/Yasmin (and hormonal contraceptives more generally)? This isn’t about just a few unlucky Canadian women: Four women in Finland have died, more than 50 U.S. users of Yaz and Yasmin died in just a few years and France reports 20 deaths per year due to birth control pills between 2001 and 2011, with 14 attributed to the new-generation contraceptives. This is a major consumer safety concern, and a women’s health issue.

In an earlier time, this might have led to Congressional investigations, such as the Nelson Pill Hearings, which resulted in FDA-mandated Patient Package Inserts (PPIs)—the printed information about risks, ingredients and side effects included in pill packets, first required for oral contraceptives and then for all prescription drugs. It is hard to imagine today’s Congress calling for such an investigation. Among many other social changes since 1970, drug manufacturers in the U.S. hold more influence over both legislators and consumers, now spending nearly twice as much on promotion as they do on research and development.

A parallel can be found in the health crisis triggered by an outbreak of Toxic Shock Syndrome (TSS) linked to tampon use in 1980. TSS is a potentially fatal infection caused by bacterial toxin Staphylococcus Aureus. A new brand of superabsorbent tampon was linked with 813 cases of TSS, including 38 deaths, that year. By 1983, the number of menstrual-related cases reported to the CDC climbed past 2,200, and manufacturer Proctor & Gamble had “voluntarily” pulled the product from the market before the FDA forced them to do so. The intense media coverage, public concern and outcry from feminist activists pushed the FDA to reclassify tampons as a Class II medical device, an upgrade which meant tampons would require more specific regulation and possibly after-market surveillance. They were much slower to mandate absorbency standards, but eventually did so under court order. These actions resulted in a documented decrease in menstrual-related TSS, although it is important to note that it has not disappeared.

Today, more than 30 years later, young women are again dying from something purported to help them, something that affects mostly women. Thousands more are experiencing life-threatening, health-destroying side-effects, such as blindness, depression and pulmonary embolism. Canada’s professional association of OB-GYNs defended the drug, suggesting that perhaps the recent deaths could be attributed to non-contraceptive reasons for which it was prescribed, such as PCOS or diabetes, both of which are associated with higher risks of blood clots. But there is little evidence of public concern, outside of Yaz/Yasmin user message boards. Even feminist outlets aren’t always covering these issues as vigorously as we might hope.

Yet the birth control pill in general has never been more politicized in the U.S.: In the last year or so, we’ve seen headlines and public debates about insurance coverage of the pill, access to emergency contraception and so-called personhood bills which have been introduced in legislatures in at least eight states. Feminist activists and health care advocates have been working tirelessly to protect access to the pill along with other forms of birth control, as well as the right to end an unintended pregnancy—and feminist journalists have been writing about these activities.

In the urgency of responding defensively to these political attacks—and we must respond—feminists cannot ignore corporate threats. Just as preserving contraceptive and abortion access is critical to women’s health and well-being, so is protecting contraceptive safety.

Cross-posted from Ms. magazine blog.

Yaz and Yasmin Back in the Spotlight

Guest Post by Holly Grigg-Spall, Sweetening the Pill

Last year the FDA made the decision to keep the birth control pills Yaz, Yasmin, and Beyaz on the market despite controversy over corporate corruption of the review process.These drugs are back in the spotlight.

The French health minister has called for doctors to stop writing prescriptions, 2,000 lawsuits against Bayer launched in Canada last month, and Marie Claire Australia dedicated five pages to an in-depth feature about the side effects, instigating an investigation by the country’s top current affairs show Today Tonight.

Bayer has gone about settling the 13,000 lawsuits in the US out of court, likely with the hope of keeping the details of confidential files regarding marketing techniques and research out of the public eye. Unperturbed by mounting reports from women of the myriad health issues caused by their products, the company launched Yaz Flex in Australia at the end of 2012. The first oral contraceptive on the Australian market presented as being for the purpose of preventing periods, Yaz Flex comes in a digital dispenser that records how many pills have been taken and alerts the user when she’s missed a dose. There are enough tablets to allow for just three breaks a year. In the US in April the FDA, equally unperturbed, ruled that pharmaceutical company Activis can start selling generic versions of Yaz, providing a low-cost version of what has been the most expensive oral contraceptive of recent years.

The feature in Marie Claire Australia generated 300+ comments on the magazine and television show’s Facebook pages. Many of the commenters were women who had developed blood clots when taking these brands. Some had made the connection at the time and others made the link only as a result of the coverage after months or years of not knowing why they had endured the injuries. Some of the women were presently experiencing the symptoms of a blood clot mentioned in the show and made the decision to stop taking the pill as they typed.

The piece was written by a long-time member of the Yaz and Yasmin Survivors forum and balances interviews with women who suffered the serious physical side effects with those who have been victim to the serious psychological side effects. I’m among those who experienced a long list of negative physical and psychological effects when taking Yasmin for more than two years and it was this forum that prompted me to stop taking it.

Monash University in Australia is one of the few facilities to have undertaken research into the correlation between birth control pills and depression. Professor Jayashri Kulkarni found that women on the pill were twice as likely to experience depression, anxiety, and mental numbness (known as anhedonia). The Yale Daily News reports that in the wake of her research receiving a little media attention Dr Kulkarni received more than 300 emails from women “clearly describing when they went off the pill that they felt subjectively more happy. The anhedonia, for example, disappeared, the irritability disappeared, the sense of poor self esteem disappeared”.

She is now focusing her attention on researching what she believes to be the particular psychological impact of the Yaz brands, those pills containing the synthetic progesterone drospirenone and low-dose synthetic estrogen.

Although there is no direct-to-consumer advertising in Australia these brands of pill gained popularity there just as they did in Europe and Canada. It is interesting to note that Marie Claire US ran an article in 2011 titled ‘The New Super Pill’ that named Yaz and Yasmin as the latest, greatest “no-acne, no-bloat and pms-be-gone” pills that also allow you to “shorten your period”. The pages of magazines such as Marie Claire in the US are usually scattered with adverts for Yaz and Yasmin, the NuvaRing, Nexplanon impant, and Mirena IUD. The print and television commercials often play on the same insecurities reflected and bolstered by the majority of the women’s magazine articles.

Articles with headlines like that of the Marie Claire Australia piece, “Bitter Pills: The Birth Control With Deadly Side Effects”, are usually accused of scare-mongering women off the pill unnecessarily despite the fact that reactions suggest they might well be saving lives. Generally women who decide they don’t want to take one brand are presented with another — and how many women know Yaz Flex, Yaz, Yasmin and Beyaz are 99% similar in composition and won’t just be shifted among the four? Judging from the comments responding to the piece, women who decide they are done with birth control pills are likely to be offered a Mirena IUD, implant, or Depo shot, all of which hold their own set of deadly and life-shattering side effects.

Women commented on the Facebook pages that they had made an appointment with their doctor only to be told not to worry and keep on taking their pills. Yet more remarked on their anxiety over stopping taking them as the article described the difficulties women experienced after they came off. Among women sharing doubts over whether the implant or shot should be their next choice, one woman asked:

“What other safer alternatives are there to birth control pills then?”

These articles don’t tend to go into the non-hormonal alternatives for contraception and cycle health that could support women in their choice not to take these drugs, and leave those scared of side effects to struggle along feeling trapped between pharmaceuticals and unwanted pregnancy, or on pharmaceuticals and not looking like the models in the magazines. That support needs to be out there and easy to find, or we will continue to see messages like this, sent out into the silence:

“I have been on Yaz for 3 months and just recently got switched to Yaz Flex yesterday so that it’s easier for me to remember takin it on time etc. by my doctor. I told her about what’s been happening in the last month or so, and she just gave me a cream for rashes etc. BUT I am seriously concerned as to if what I am experiencing is normal or not. I may be over reacting, I was put on this pill to regulate and lighten my period and also for my acne, it has helped a lot, but in the last month or so I have been experiencing an extremely itchy face, I have been finding it hard at times to breath and I’m very shortened in breath, it’s starting to scare me a lot. My heartbeat is irregular and I feel extremely light headed. I have been also experiencing horrifying migraines and headaches. I’m only 15 I may just need more understanding to what is happening if it is normal, somehow I feel it’s not please help :,(“

Could use of the pill be linked to insulin resistance?

Adapted from a photo by anna marie-grace // CC 2.0

The pill is one of the most intensely studied drugs in history, and believed to be among the safest – safer than aspirin, as an editorial in the American Journal of Public Health noted twenty years ago. Yet young women seem to be quitting in droves, for a variety of reasons: to restore feelings of psychological and emotional health, regain lost libido, relieve cardiovascular symptoms and disorders, or ease anxiety about these or other health issues.

When women report these side effects of birth control pills, physicians often recommend they try another brand, but many of these side effects are common to hormonal birth control, especially oral contraceptives. A new study published this month in Human Reproduction suggests there may be yet another common side effect: Researchers in Finland found that oral contraceptives may worsen insulin sensitivity and are associated with increased levels of circulating inflammatory markers.

The study was very small and ran only for a short time, so drawing conclusions is premature, but since the beginning of the year, I’ve been following several online discussions of young women quitting the pill. Although I have yet to see development of Type 2 diabetes or insulin resistance cited as a reason to quit the pill, I have seen such a variety of health issues and medical problems described that this study caught my eye immediately. Current estimates indicate that 12.6 million, or 10.8 percent, of all U.S. women ages 20 years or older have diabetes (diagnosed and undiagnosed). Could it be related to their birth control? Perhaps in those already genetically predisposed.

Research from the Guttmacher Institute indicates nearly 60% of pill users take it for non-contraceptive reasons, such as for cramps or other menstrual pain, menstrual regulation, acne, endometriosis, as well as for prevention of unintended pregnancy. Fourteen per cent of US pill users (more than 1.5 million women) take birth control pills solely for non-contraceptive reasons. If the Finland study proves to hold true for larger groups over extended periods, there’s another reason to be more cautious prescribing the pill.

 

Hormone Imbalance: Breaking the Silence

Guest Post by Leslie Carol Botha Women’s Health Freedom Coalition Coordinator, Natural Solutions Foundation

I still remember the first Society for Menstrual Cycle Research Conference I attended in Tucson, AZ in June, 1999. The statement that made the most impact was the collective concern that in ten years there might no longer be a menstrual cycle. It turns out the truer words were never spoken.

In the past 40 years, the pharmaceutical industry has spewed out and packaged and repackaged so many synthetic hormone contraceptives – pills, injections, and implants that virtually eliminate the menstrual cycle.  It also amazes me that in the 30 years I have been involved with the women’s health movement condoms and spermicide are still the safest and most effective contraceptive on the market.

However, a new trend is emerging as condoms and birth control pills are being pushed on the back burner because of ‘human error’. Women and men are not always diligent or careful about condom use, and many girls and women forget to take their pills.  What is now being prescribed to adolescent girls — whether or not they are sexually active — are implants and injections. Health considerations are not taken into consideration, nor are hormone levels. Somehow the pharmaceutical industry still views this as a one-size-fits-all prescription for all women, no matter their age of their state of health.

Menstrual cycle advocates are most aware that birth ‘control’ is about control…controlling the woman’s body with potentially harmful synthetic hormones. What has been overlooked are education and natural methods of fertility awareness.

While our focus recently has been on the politics of birth control, another ugly monster has reared its head and that is the silent epidemic of hormone imbalance. Not only is this the result of taking synthetic hormones for birth control but our environment, our foods, and water supplies are filled with estrogen mimickers upsetting the delicate orchestration of hormones in our bodies.

Another concern is the excess estrogen stored in women’s bodies and passed on genetically to their offspring.  It is possible that their children are hormonally imbalanced at birth.

Either way, the damage has been done. I believe we are at the tip of the iceberg in this silent epidemic and that hundreds of thousands of women are being misdiagnosed and over-prescribed. In most cases, thyroid imbalance is not considered as a cause of depression, and the prescribed fix is generally Prozac or a higher dose of synthetic hormones.

In 2009, I posted an article to my blog, from eHow editor, Shelly Macrea titled: What is Hormone Imbalance?, a very informative article and probably one of the first pieces for a general audience on the myriad of conditions that hormone imbalance can cause.

At the time I had three responses (with an average of 30,000 unique visitors a month.) In June of this year, another post on the article (which by this time was buried in my archives) appeared from a woman suffering anxiety due to hormone imbalance. And then another post appeared and I decided to bring the article out of the archives and re-post it. What ensued was a steady stream of women commenting on almost a daily basis on their extreme anxiety and depression and the myriad of misdiagnosis and drugs they were prescribed. I am posting the link here so that others can read what I believe should be of concern to all of us: Hormone Imbalance Anxiety, A Precursor to Other Health Issues.

In March of this year, I posted Laura Wershler’s article Coming off Depo Provera Can Be a Woman’s Worst Nightmare. Once again, truer words were never spoken. More and more women are now posting about their experiences on this drug – and the ensuing hormone imbalance and health issues.

Women are suffering.

This is an insidious ‘War on Women’. On the one hand we have had to fight for our reproductive rights and the availability of birth control – on the other hand it is the same birth control that is slowly killing us.

It’s National Women’s Health Week — Celebrate and Reminisce with the FDA

I admit, I didn’t know that this is National Women’s Health Week until I received a reminder in my inbox from a U.S. FDA mailing list, letting me know about the Food & Drug Administration’s role in promoting Women’s Health. They’ve published a brochure (available in both HTML and PDF versions) commemorating 100 Years of Protecting and Promoting Women’s Health.

Image Source: Public Domain

Society for Menstrual Cycle Research members and other women’s health advocates and activists will want to look through the list of the accomplishments the FDA claims responsibility for and lists as unequivocal improvements in women’s health.

For instance, we’ve had many discussions at re:Cycling about the FDA approval of the pill in 1960 as one holding mixed benefits for women, and not always the best choice for women’s health. The brochure also asserts that in 1970, “FDA initiated the first package insert written for consumers to explain to women the benefits and potential risks of oral contraceptives.” That happened in 1970, but Barbara Seaman, Alice Wolfson, and the other founding mothers of the National Women’s Health Network had more to do with its initiation than the FDA.

And here’s another inspiring quote from the FDA brochure:

1980: Making Tampon Use Safer

Problem: In 1980, there were 814 confirmed cases of menstrual related Toxic Shock Syndrome (TSS) and 38 deaths from the disease.
Response: FDA began requiring all tampon packages to include package inserts educating women about the risk of TSS and how to prevent it. In 1997, there were only five confirmed menstrually-related TSS cases and no deaths. The tampon package inserts with TSS information continue to be used today.

Sure, the FDA is proud of those safety rules now, but in 1982 the agency asked the industry to come up with their own voluntary standards because they did NOT want to regulate tampon safety. After years of pressure and organizing from Boston Women’s Health Collective members Esther Rome and Judy Norsigian, activist Jill Wolhander, researcher Nancy Reame, and others to standardize tampon absorbency ratings, the FDA finally enacted regulations in 1989, by court order. Nine years after 38 women died from a tampon-related illness.

Just last year, the FDA could have made another decision that would almost certainly save women’s lives, by removing birth control pills containing the synthetic progesterone drospirenone from the market, but instead the advisory panel voted by a four-person margin that the drugs’ benefit outweighed the risks.

You know what else isn’t on the list? Emergency contraception, a.k.a. the Morning After Pill and Plan B. The agency hemmed and hawed and delayed unconscionably for years, until finally approving it for limited over-the-counter availability in 2006 — a year after Susan Wood walked out of the FDA Office of Women’s Health for good over what she believed to be “willful disregard of scientific evidence showing Plan B to be safe.”

Celebrating organizational achievements that advance and protect women’s health is a fine thing. I’m glad Frances Kelsey withheld approval of Thalidomide in 1960, and for the most part, I’m glad the FDA is on the job. But while we’re celebrating women’s health and reminding everyone to be active, eat healthy, and get preventive health care (if they are so fortunate to have access to health care), let’s also celebrate the activists and advocates that keep agencies like the FDA in line.

“Lives will be saved” – the FDA decision not to ban Bayer’s birth control pill

Guest Post by Holly Grigg-Spall

 

Photo by Monik Markus // CC 2.0

How many of us read the inserts included in a packet of pills? How many decide not to take the pills on the basis of the information enclosed?  The rapidly reeled-off list of side effects stated at the end of a televised advert for a new drug has more comedic value than serious consequence to most. If we do have doubts, many of us will rely on the reassurance of a doctor, and then take the pill anyway.

I recently wrote a piece for Ms. Magazine Blog outlining the FDA reappraisal of top-selling oral contraceptives Yaz and Yasmin. It was discovered that drugs such as these containing drospirenone held a significantly higher risk of causing blood clots. Research by the FDA and other bodies suggested this conclusion was definite, while research funded by the pharmaceutical company behind these billion-dollar products, Bayer, suggested the opposite conclusion to be true: that there was no increased risk evident. A team of experts, some of which had financial ties to the company, voted against having the pills taken off the market when presented with the question of whether the risks of taking these pills outweighed the benefits.

Bayer is facing 11,300 lawsuits from women who have been seriously injured and family members of women who have died after taking one of the company’s bestselling hormonal contraceptives. They have settled the first 500 addressed with a total of $110 million in payouts. When discussing this process with a lawyer representing many of the women I was told that Bayer would do anything to avoid a trial wherein the full spectrum of their marketing strategies would be revealed.

The FDA came to the decision to add into the insert included with these drugs a statement of the discovery of “conflicting” research that suggested the pills had a higher risk of causing blood clots  (up to three times higher) – acknowledging the discrepancy of the research funded by Bayer and giving it equal standing as that performed by other bodies including the FDA itself.

Prior to this decision being announced a number of women’s health groups got together to write a letter to the FDA asking that they look again at the question put to the board of experts. They argued that the correct comparison for the board to consider would be between drospirenone-containing contraceptives and other oral contraceptives, and not between Bayer’s drugs and unwanted pregnancy. In the final sentence, they remarked that they believed that “lives will be saved” if the pills were no longer on the market. They met with the FDA and one representative asked that the FDA strongly reassess its acceptance of Bayer-funded research. Another asked that the drugs no longer be prescribed and that the FDA “get back to the arc of history and progress that protects women while supporting their contraceptive needs.”

The new labeling will state the “conflicting” findings and advise that women speak to their doctor if concerned. The official statement on this decision, relayed through the media coverage, reminded women that when compared to pregnancy the risk of development of a blood clot was insignificant. They also asked that women currently taking the drugs not stop doing so. Despite the FDA studies suggesting the blood clot risk is particularly high for women under 30, the statement compounded the understanding that the issue is only relevant to those over 35,  those overweight, those that smoke, and those with relevant medical history.

Is this additional text in an insert enough? Cynthia Pearson of the National Women’s Health Network has given an unqualified no as her response to the decision.  If no is the answer, then what needs to happen next? At this time I’ve seen no coverage outside of news reports that has shown the response of the wider feminist, or just female, community.

When I heard that the FDA was asking for a comparison between pregnancy risks and the risks of Yaz and Yasmin, and that the women’s health groups were calling for, in their letter to the FDA, a comparison between these oral contraceptives and other brands not containing drospirenone, I immediately wanted to know why the comparison was not between using these pills and not using them — as in using other forms of non-hormonal contraception with similar effectiveness. This would produce the biggest gap, and put the statistics in starker relief.

There is too much dependent on the FDA not acknowledging the efficacy of non-hormonal contraceptives or admitting that research funded by the pharmaceutical company producing the drug is not reliable. These were for some years the most popular oral contraceptives. It is important that it is believed that there truly is an “arc of history and progress that protects women.”

Even the women’s health group representatives appear to understand this as a blip in an other uninterrupted history of outstanding service. To my mind, such behavior by the FDA should raise some serious suspicions of their motivating force. They advise that women should discuss this with their doctors – doctors who probably know less than I do, due to time constraints, inclination, as well as doctors that could well be directly or indirectly benefitting from backing Bayer.

If it’s taken this long to get a tentative admission of the blood clot risk, what do we not know about the other side effects of these pills? What were the benefits, outside of preventing pregnancy, of Yaz and Yasmin that the FDA saw as so important to women?

The reaction of the women’s health groups suggests an attempt to work within the system, rather than against it.  Does the FDA see itself as protecting the freedom of the millions of women who decided to take Bayer’s oral contraceptives, the millions that made it a bestseller? When a corporation can and will do anything to sell its product in ways that even the most cynical consumer would find shocking can we uphold the notion of informed consent?

We live in a very different time to 1970 when the result of the Nelson Pill Hearings was the inclusion of an insert in birth control pill packets. Then, the other noise of advertising – both overt and hidden – was not loud enough to drown out the message. We are now far happier with corporations telling us what to do than we are with being dictated to by the government. Consumer-driven choice keeps women on the pill – with doctors swapping them between the many brands as side effects appear. Laura Wershler and I put together a guide to a birth control rebellion. We live with a culture that stresses there is no alternative – to the pill or the system that supports it.

To quote a recent New Yorker piece by Margaret Talbot, by the way of Karl Marx, perhaps we must admit that – “Women make their own circumstances but not under circumstances of their own making” – and work from there.

What’s missing from Mother Jones’ birth control calculator?

Source: Public Domain

In response to Rick Santorum’s recent assertion that birth control only costs “a few dollars” and therefore there shouldn’t be such a big fuss about denying insurance coverage, Mother Jones published a birth control calculator this week that estimates your lifetime costs for birth control, based on your current age. The calculator asks you to enter your age and then select your preferred method. Options include the pill, IUDs, Implanon, injections, the patch, the vaginal ring, and surgical sterilization. (It doesn’t specify sterilization for women or for men, but given the context of the current debates, I’m assuming the calculator estimates only the cost of female sterilization.) It also fails to take into account that, in reality, most women use more than one method throughout their reproductive years.

Now, I know that aside from the cost of reference books, charting supplies, and perhaps a course or two to get started, using Fertility Awareness Methods is free, but condoms and spermicide aren’t. And as NPR reported on Tuesday, it can be difficult or inconvenient to get those methods covered by health insurance. Diaphragms and cervical caps aren’t cheap either, and they both require physician visits to be properly fitted. Diaphragms last a long time, but they do need to be replaced every few years. It’s been a while since I needed one, but I’m pretty sure that my health insurance covered the cost of my diaphragm, although I had to pay out-of-pocket for the accompanying spermicide gel. In my student days, I got both at my school’s Student Health Center, covered by the student health insurance fees that we were required to pay whether we used the student health center or remained on parental insurance.

I’ve written before about my bewilderment at the diaphragm’s disappearance, but I’m increasingly frustrated that the current political debates about the pill are contributing to the apparent erasure of all non-hormonal methods of birth control. The pill has become synonymous with birth control in some quarters, without consideration of the profound implications of that swap for women’s health.

I am not opposed to the pill, by the way. I want it to be available, I think it should be covered by health insurance, and I want it to be safe. But I also want women to have complete, accurate, accessible information about all of their birth control options. And let’s get all of them covered by health insurance.