Fertility Awareness Part 2 – Birth Control and its Effect on Reproduction

 

Since I wrote this article 4 years ago, some of the information I had quoted directly from sources has changed. I believe this is because of biases in media shifting the way information about birth control is presented, which I find actually pretty scary. I decided to keep some of the old information there, so you can see the shifts for yourself. Brand new information is italicized.

I totally believe that women have the right to know about their bodies and be correctly informed. That’s why I wrote this article in the first place, and that’s why I’m including it here. Spoiler alert: I believe that life begins at conception. If you’re still interested, grab a cup of coffee and read on. 

Missed Part 1? Read about our story and contraception vs birth control here. 

It’s all Semantics? Contraception vs. Birth Control

People consider “the pill” and other forms of hormonal birth control a form of contraception, which is, based off of definition, untrue. It is important to know that while people use the terms interchangeably, there is a significant difference between contraception and birth control.

Contraception literally means “against conception.” It prevents pregnancy by keeping the sperm and egg from ever meeting, whether it’s by creating a barrier between the two, killing the little swimmers, or through permanent sterilization. Condoms are a form of contraception. Pulling out, though not effective for all men, would be considered a form of contraception. Breastfeeding is nature’s own contraception – for a mother who breastfeeds on-demand exclusively, ovulation is put off so she can focus on her newborn with concern of getting pregnant again too soon. 

Fertility awareness is also a form of contraception. It is a method that requires the awareness of one’s fertility to prevent pregnancy. Once you know and understand how your reproductive system works, the rest is pretty simple: don’t have unprotected sex on days when you could get pregnant. Some women choose to use additional forms of contraception, like a condom, on fertile days. Fertility awareness works for preventing pregnancy, but it is currently better known as a method for planning pregnancy.

Birth control’s definition is just what you would guess: controlling the number of children born. This includes contraception, but it also includes preventing a fertilized egg from implanting and developing into a baby. According to this definition, surgical abortion is also a form of birth control.

Hormonal birth control is any form of birth control that releases hormones into the body to prevent the birth of a child. These include oral birth control pills, intrauterine devices (IUDs), injections, implants, vaginal rings, and patches. Each method varies in composition of hormones and the way the hormones are released, but they basically work in the same way.

A Brief History of Birth Control

In ancient history, contraception was rare and irrational. The human race needed to be sustained, and children were viewed as a blessing. In 3,000 BC, the first condoms were developed, constructed with materials like fish bladders, animal intestines, and linen (makes you appreciate the latex a bit more, doesn’t it?).  It was nearly 5,000 years later, in 1500, when it was discovered that you could soak condoms in chemicals to kill the sperm – the first spermicide. It wouldn’t be until the late 1900s that hormonal birth control would come on the scene.

Margaret Sanger: Hero or Villain?

The concept of hormonal birth control was the brainchild of Planned Parenthood founder Margaret Sanger. Sanger, born one of eleven children in 1879, was alive during a time when even distributing information about birth control was illegal. She was notorious for her radical opinions on controlling fertility and got a lot of flack from the government because of it. This did not deter her in the least. She opened the first American birth control clinic in 1916, and women flocked to it, which greatly enhanced the drama. Years later, she approached scientist Gregory Pincus about creating a human birth control pill which made its formal debut in 1960, courtesy of American chemist Frank Colton.

Women were excited to try this new pill that would offer them more control in their lives and circumstances. Despite the government’s resistance to this birth control craze, the Supreme Court legalized birth control for married couples in 1965, the year of Sanger’s death.

While Sanger is often revered for her contribution to women’s rights, few sources mention her more…well…less than savory ideals. 

The November 1921 edition of The Birth Control Review, a publication “dedicated to voluntary motherhood” and edited by Sanger, includes the tagline: “Birth Control To create a race of thoroughbreds” (Birth Control Review, November 1921). A few pages later is an article about a eugenics conference. While this edition of TBCR includes an article on Child Welfare from contributor Mrs. How Martyn, which rightly speaks to the rights of a child to be loved and cared for, there is an article on “Immigration and Birth Control” a few pages later that would make any modern feminist shutter.

“Immigration…” poses this question early on: “Thus with the immigration question we must know what we are ultimately after or our attempts at solving the problem are absurd. Do we want to raise the average physical and mental status of the people of the United States?” The article then goes onto say: “It comes back to the question of ‘what do we want?’ There seems little doubt but that continuing along present lines will mean a gradual lowering of the physical and mental average of the country. This is principally because of two things: blindness toward the Birth Control movement, which results in an increase of the drunken, shiftless, and feeble minded classes, and blindness toward the immigration question which has eventually the same result. The two subjects – immigration and Birth Control- are so closely related that our attitude toward either one must in a measure be dependent upon our attitude upon the other.” Ironically, the question on cover of the November 1921 edition is: “Is Birth Control Moral?” A worthy question, indeed. 

Generally, Sanger is not perceived as a racist and most argue that her interest in Eugenics was merely cultural for the time and is not a cause for concern. In any case, the public had latched onto hormonal birth control and the world we know today came into effect.

The Female Reproductive System

In order to know how birth control prevents pregnancy, we must remind ourselves how the female reproductive system naturally works.

Harvey Klinman, PhD from the Yale University School of Medicine, compares a woman’s reproductive system to a garden for his revolutionary Endometrium Function Test (a diagnostic test to determine if the health of an infertile woman’s endometrium is influencing her inability to get pregnant). In order to have a fruitful harvest, he argues, you must have a healthy seed – the egg – and hearty soil – the endometrium, or uterine lining.

Before the seed can be “planted,” it matures within its little home called the follicle. Estrogen, developed slowly in the ovaries during the eggs’ development, keeps everything in check (think of it as a really enthusiastic event planner). Estrogen tells the endometrium, “Grow! You might have to cushion a baby soon.” The endometrium obediently thickens in preparation for such an event. Estrogen also dictates to cervical mucus (that nasty stuff you sometimes find in your panties) that it needs to get thick and wet so that it can help facilitate the journey of the sperm to the egg. Everything anticipates the potential child, even your sex drive. According to the American Pregnancy Association, your libido naturally heightens during that time to tell your body that “you’re ripe for baby making.”

Finally, when the egg is ready, it bursts out of its follicle and journeys down the fallopian tube where it awaits fertilization. Progesterone, estrogen’s co-manager, takes over and informs endometrium that ovulation has occurred. “Don’t worry about growing – just focus on maturation. You have to be nutritious enough to support a growing child.”

Contrary to common belief, the average woman is only fertile for 5-7 days of each month. Because sperm can live in a woman’s body up to about five days, sexual intercourse within the five days before ovulation, increases the chance of pregnancy.

The egg will only wait around 24 hours after ovulation to be fertilized by a sperm. If no little guys come, the egg will disintegrate into the uterine lining. Upon hearing that there was no fertilization, estrogen and progesterone leave. Endometrium, discouraged that it no longer has a purpose, breaks down – literally – resulting in your beloved period. If the egg is fertilized, it will implant in the endometrium, which will lovingly nourish it, and in nine months, as long as there are no complications, a baby will be born.

But when the hormonal contraception is introduced, everything changes.

Birth Control and the Female Body

According to the American College of Obstetricians and Gynecologists, “birth control pills contain hormones that prevent ovulation. These hormones also cause other changes in the body that help prevent pregnancy. The mucus in the cervix thickens, which makes it hard for sperm to enter the uterus. The lining of the uterus thins, making it less likely that a fertilized egg can attach to it.” 

*This has changed in the past five years. Now, if you look it up, they completely remove the part about the fertilized egg all together: 

The Physician’s Desk Reference, which is meant for doctors, not patients, still mentions it though:

Pause. Did you catch that? Fertilized egg. If an egg is fertilized, that means the first two contraceptive steps failed. That means the first two steps did not effectively prevent the egg from reaching the sperm. That means conception happened. We know that birth control “fails” on occasion, because 2-8% of women will get pregnant while using the pill with typical use, and 1% of women will get pregnant with perfect use. 

The key thing here is the endometrium. In a abstract of a study performed by doctors studying endometrial thickness and successful IVF, they include this statement: “there is little doubt that a physiologically thickened endometrium is critical to a successful implantation and pregnancy.” A healthy endometrium should be least 8 mm to support pregnancy. 

But we know the lining of the uterus decreases under the influence of birth control, although the exact amount is debatable. One study observed the lining of the endometrium under the influence of an implant was less than 4mm. I found some other charts below to show you the obvious difference between the endometrium under the influence of an IUD and an oral contraceptive.

If the endometrium thins, that means it is lacking the nutrients to support a child. If up to 8% of women can still have a successful pregnancy with an “unhealthy” endometrium, how many other fertilized eggs might have tried to implant, but couldn’t?

In natural circumstances, this would be considered a miscarriage, but because the environment is being affected by a foreign device or chemical, it is considered to be an abortion. While many people argue that it is not true (including Planned Parenthood who, by the way, doesn’t even mention the thinning of the uterus on any of its explanation of how birth control works) there is enough evidence to make many some women change their minds.

When I asked the women on my survey if they would consider changing their form of birth control if they found out it was abortive, 81% said they definitely would, and the other 19% said they would at least consider it. One of the women, a nurse, wrote: “I believe life begins at conception. Fifteen years ago, I didn’t know about the abortive effects of the pill.” This was the very reason she stopped using it.

It’s because of this reason, I never went on it.

Still interested? God bless you. Read on to hear personal interviews here.