The New Nature of Birth Control: Sustainability and Equality in Contraceptives
Political and other ideological strife has a way of distracting people from the true significance of fundamental issues. A perfect example of this is seen in birth control, which, thanks to unwarranted stigmas and a lack of necessary funding, has become a topic widely debated for increasingly trivial reasons.
According to the Guttmacher Institute, 99% of sexually active women between the ages of 14-55 report using some form of birth control. Although typically regarded as a purely social issue, the use of contraceptives has ecological implications at a variety of levels. Unfortunately, political turmoil and societal pressures force many women to make hasty decisions when it comes to contraception. This causes the focus of birth control to become overly politicized, thus excluding important environmental factors from the conversation.
Melinda Gates alluded to this problem in her TED Talk on the topic.
“If we're going to make progress on this issue, we have to be really clear about what our agenda is,” said Gates. “There's a global movement waiting to happen and ready to get behind this totally uncontroversial idea.”
Looking at contraception through an ecological lens shifts the focus from ethics and accessibility to sustainability and efficacy. An analysis of birth control in this way does not only encompass the regular use among sexually-active women, but further encourages a move away from oral contraceptives and toward long-acting reversible contraceptives (LARCs) such as the intrauterine device or implant. Although oral contraceptives are, according to the CDC, the most common form of birth control in the US, they are neither the most effective nor the most eco-friendly.
Oral contraceptives are 99% effective only when used with total accuracy, which is something that is highly unrealistic for many women. Because the pill requires that users take it every day at the exact same time, The Cleveland Clinic reports that about 9% of users experience unwanted pregnancies while on the pill each year. This requires that women maintain extreme levels of discipline in their usage. Since the pill comes in packs that are calculated to the month, this also implies that women must have access to their prescription every single month, which becomes more difficult as healthcare providers and politicians engage in discussions about the importance of protecting accessibility to birth control.
On top of availability complications, oral contraceptives have environmental drawbacks, including the fact that they typically come in single-use plastic packaging and contribute to the deposition of synthetic estrogen in water. This leads to imbalances in the chemical composition of water and can harm ecosystems and the animals and microorganisms that inhabit them.
When examined in contrast with LARCs, the reasons in favor of options like the IUD or implant become immediately apparent. For one, the American Sexual Health Association reports that both the implant and the IUD have a 99.9% prevention rate that is in no way affected by or dependent on the behavior of the women who use them.
An IUD is a particularly attractive option for many women because, depending on which type a person opts for, the effects can last for up to 10 years without any depletion of functionality. There are two different types of IUDs: low-hormone plastic and no-hormone copper. Both are inserted in a woman’s uterus, where they prevent sperm from contacting the egg. Additionally, hormonal IUDS can halt ovulation and free a woman of her monthly period. Since the hormones are localized within the uterus, very minimal amounts are excreted in a woman’s urine. Even more significant, the absence of a period means no more paper period products, thus limiting both paper waste and the financial burden of having to purchase these items every month. While some people might not feel comfortable with indefinitely skipping their period, the most serious side effect is occasional unscheduled spotting.
As one of the leading developed countries in the world, the United States serves as a model to other countries that might be considering how to establish their own norms and laws regarding birth control. Bringing LARCs into the mainstream in the US could increase the likelihood that they popularize in some developing countries, where they would adequately serve the needs of women who want continuous birth control but might not have easy access to regular medical services like prescriptions.
IUDS could also be extremely valuable to women in countries with oppressive governments where gender inequality contributes to a societal belief that women should not be allowed to use contraceptives, even when they might themselves want to. There is no physical evidence of an IUD once it has been inserted, and no way that it can be removed without medical tools. This would protect a woman if she chose to pursue an IUD in an unsafe social environment.
The same goes for the injectable, which Gates cites as a favorite form of birth control among women in Africa who do not want their husbands to know about their use of contraception. However, the demand for injections greatly exceeds the supply, leaving many women out of luck.
“Every other time a woman goes into a clinic in Senegal, that injection is stocked out,” said Gates. “It's stocked out 150 days out of the year.”
In their book Half the Sky, journalists Nicolas Kristof and Sheryl Wudunn analyze the issue of birth control and gender equality as it exists at the global level to better elucidate the concept of contraception as a means of empowerment and progress.
“Women's empowerment helps raise economic productivity and reduce infant mortality,” said Kristof and Wudunn. “It contributes to improved health and nutrition. It increases the chances of education for the next generation.”
Birth control is not simply a way in which women can prevent unwanted pregnancy. It is a way that they can employ autonomy and experience equality, while simultaneously mitigating the environmental impacts that ensue from a lack of family planning. Men might be excluded from the risk of becoming pregnant, but they are in no way less affected by the consequences of unplanned pregnancy, population growth or sexual oppression. Nobody is exempt from issues that derive from misguided attention and lack of action regarding contraceptive research and usage.
Reni is a writer for the Lifestyle team.