Have you ever wished that someone would just sift through the mountain of scientific data out there regarding the risks and benefits of oral contraceptive use and just give you the bottom line? HA! Yeah, me too. While I have yet to find the time to pull off that monumental task, I am attempting to use my knowledge base and resources to do some digging and bring you the highlights (or lowlights, as it were).
The story is a complex one, full of controversy and heated debate. As is true of nearly any heavily researched topic in the sciences, you will find a variety of studies that often yield wildly different conclusions. It’s no wonder that young women are confused. It’s no wonder that, faced with a towering heap of conflicting data, most women take the word of their healthcare providers at face value and assume that the benefits outweigh the risks.
As a physician-in-training, I have become aware of an entirely new perspective on healthcare – that of the medical “establishment”. As valiantly as healthcare providers may struggle to keep the best interest of each individual patient in mind, we cannot know each of our patients as well as we’d like to, particularly when it comes to making highly personal decisions concerning such issues as reproductive health. This disparity often leads providers to make general recommendations from a broader public health standpoint, and that is an important point for the patient to understand.
When evaluating the evidence for contraceptive-associated health risks, the “establishment” weighs the relatively small risks to women’s health against the broader socio-economic impact of unwanted pregnancy. The economic burden on society grows with every free abortion and every pregnant teen loaded onto the public assistance payroll. The outcomes for teen pregnancies are just dismal, for both the young woman and her child. In third world countries where it is not uncommon for women to die in childbirth, the public health impact of oral contraceptives is of tremendous consequence. These are the kinds of issues that play into the perspective of healthcare providers when it comes to contraceptives. The percentage of women experiencing adverse side effects would have to be quite substantial to trump these benefits from a public health standpoint. Given this perspective, and the decades over which it has become engrained, it is easy to see how the risks have become a finely printed footnote in the pages of real-world medical practice.
You, on the other hand, know yourself intimately. You know your individual circumstances and reproductive intentions. None of these public health considerations are of any consequence to you when considering risks to your own health, but without receiving any explicit warnings from your physician you may never find cause to question the safety of any medication you’ve been prescribed. Hopefully your doctor will (at the very least) screen you for risk factors prior to writing a prescription, but after a blood pressure check and a brief family health history questionnaire most physicians are eager to hand out contraceptives, particularly to young women. Unfortunately, ladies, we bear the burden of digging up the information necessary to make our own personal health decisions. And when it comes to contraceptives, the decision is certainly a very personal one.
With regard to contraception, the burden has always fallen on women (despite the fact that men are fertile every day of the year, while women have only a few fertile days per month to control). Along with that burden comes a choice – a choice to follow the crowd, allowing artificial hormones to sterilize that which makes us life-giving creations of God, or to seek out other means of “protection”. Being the self-sacrificing lot that we are, women often choose the route of least resistance and opt to pop a little pill once a day and forget all about our fertility. We are told time and again that it’s no big deal – that we don’t need that part of ourselves until we’re ready to have children anyway. But what if that very Pill made it impossible for a woman to conceive when that long-awaited time came? What if, after leaving the Pill behind and conceiving several beautiful children, that very Pill still had the potential to ravage a woman’s body (and that beautiful family that she has built) through a devastating battle with cancer?
It is easy to put off the consequences of contraception because we don’t feel them today. Ironically, we won’t experience those consequences until it comes time to take back what we so willingly gave away in the first place – our fertility, our ability to create life, our desire for children and family.
For me, those things are a rather HUGE deal. I’d bet a paycheck that most women feel similarly. Perhaps the until-recently-highly-male-dominated medical establishment didn’t quite “get” the profound gravity of a woman’s fertility. Perhaps women have been kept in the dark for selfish reasons (the mainstream alternatives to the Pill being abstinence or condoms, neither of which are particularly pleasant). In any case, it is time to close the gap between the information (or lack thereof) disseminated in birth control clinics and GYN offices and the reality of oral contraceptive use. Not only because women deserve to know, but because they may need a kick in the pants to acknowledge the significance of their own future health and fertility.
Stay tuned… the information you’ve been missing is on its way. I haven’t quite decided how to present it – perhaps in “mini-series” form to keep the posts at a manageable length. In any case, I hope that at the very least you’ll find it eye-opening… and maybe even life-changing.
*UPDATE*: Catch the next post in this series here! Topic: The Pill and Vascular Health
*UPDATE*: Catch the next post in this series here! Topic: The Pill and Vascular Health
No comments:
Post a Comment