birth control

Ema of the Well-Planned Period Explains to XO Jane Editors Why Plan B is No More

Photo via Tumblr. Cached as a bandwidth-conserving courtesy
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Hormonal contraception expert Ema of The Well-Timed Period says the whiny "the stores are out of Plan B so I can't have sex" piece by the so-called Humor "Health Editor" at XO Jane has to be satire because... well... she's more generous than I'd be.

The upshot being that there's an exceedingly good reason why nobody can get Plan B anymore, in New York City or pretty much anywhere else once current supplies are gone.

Plan B isn't pining for the fjords, it's no more

Pharmacies are out of Plan B because Plan B has been discontinued by its manufacturer quite some time ago. So forget about Plan B and familiarize yourselves with the available emergency contraceptive pill (ECP) brands.

Source: The Well-Timed Period

Go read Ema's post for a nice, reassuringly long list of new and improved Emergency Contraceptives.

While there's been considerable back and forth about the "morality," sensibility, responsibility, and cost of using a $50-per-use method of contraception, Ema avoids all that and points out exactly why "morning after" type pills aren't a good idea:

ECP postcoital birth control is only to be used in an emergency for the simple reason that it's not as effective as the other available methods when used on a regular basis.

And then there's her bottom line:

Forget Plan B, remember Plan B One-Step, Nextime, Next Choice, Postinor, Postinor 1/Postinor2 Unidosis, and ella. Don't substitute ECP for regular birth control. And, last but not least, even in emergencies avoid attempts at satirical articles on birth control.

I love me that Ema-style expertise.


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When It Comes to Assessing Abstinence the Metric Isn't Rate of Failure, It's Rate of Use

Lynn Gazis-Sax points out that the problem with comparing abstinence with other forms of birth control or safer sex isn't about the typical vs. ideal failure rate of the method. As methods go, abstinence is an almost* 100% effective.

Instead what's important is the typical vs. ideal rate of use. (Emphasis mine.)

One flaw in arguments for abstinence is that they often compare perfect use effectiveness rates for abstinence with typical use effectiveness rates for contraception. Maggie Gallagher, for example, places great emphasis, when speaking of contraception, on the typical use failure rates, to supply an estimate that your chances of getting pregnant if you use the Pill are actually not that low. And she has a point. If you assume a typical use effectiveness rate, for the Pill, of around 92%, and if you further note that that typical use effectiveness rate is the chance that you successfully avoid getting pregnant for just one year, the chance that you will ever be pregnant, over the course of your entire reproductive life, while you were attempting to avoid pregnancy with the Pill, may not be that small. The same is true of condoms, which have a lower typical use effectiveness rate than the Pill.

...

Condoms are better at preventing AIDS than abstinence is, for the simple reason that, however often people may fail to use condoms, they fail to abstain even more often. And most methods of birth control have a better “typical use” success rate than abstinence, in the sense that people are much better at using birth control mostly reliably than they are at abstaining from sex until they’re ready for kids.

Source: Noli Irritare Leones

* Lynn mentions the obvious case where it didn't work when Mary had Jesus, and pretty much by-definition abstinence isn't effective for someone forced to have sex against her or his will.


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Steven Colbert: Birth Control the Way God Intended - With a Cold, Loveless Marriage


Head's up: the clip begins with an ad. Sorry about that. I think it's worth it anyway.


  • "A woman's health decision is between her priest and her husband."
  • "If you want to control your fertility, do it the way God intended – with a cold, loveless marriage."


Love it.


(Via Chloe at Feministing.)


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Hey, Figleaf's Dream Already a Reality? ContraVac Offers SpermCheck Male Fertility and Contraception-Effectiveness Test Kits

Speaking of easily-administered tests for a male contraceptive effectiveness, according to NewsMedical.net

SpermCheck Contraception, is now undergoing testing in a multi-center, NIH-funded study that is evaluating the effectiveness of a new contraceptive drug for men. Once a man starts using one of the current experimental male contraceptives, which are based on steroid compounds, sperm counts decline over a period of several months. The SpermCheck Contraception device could serve as a companion product to help men determine when sperm counts have reached safe levels should a male contraceptive drug or device become available in the marketplace.

Source:

At least one company already manufactures a home-test product, SpermCheck Fertility, for checking general male infertility and another for confirming sterility after a vasectomy.

As I've said over and over, this kind of antibody-tagging test is pretty great. And while at least initially the price tag will be way too high (their current kits cost about $34 each from Amazon) one would expect that higher volume and/or market competition from other brands could drive the price down to a point where they could be used for spot checks.

I expect most people imagine the main use would be before an episode of "causal" sex. Although really, for casual sex any contraceptive should be used to backup the condom everyone really, really should be using. (And if the price ever came down enough it actually might be nice if they could be inexpensively sold in condom machines.)

But in practice, since like a lot of hormonal contraceptives for women there's a lag begin when you begin using it and when it starts working I think the more useful application for a spot check for male contraception would be to see if it's started working. Or, towards the end of the effectiveness cycle, to know when it's no longer working.

Anyway, good do see some version of my fantasy male-fertility test is already on the market and that tests that even more closely target male contraception is in the works.


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"Open Embrace," Closed Mind, and the Failure of Radical Natural Birth Control as Ideology

In a poignant, heartwrenching essay on Natural Family Planning method birth control use in the alt-conservative Protestant counterculture Sarah Morice-Brubaker of Religion Dispatches reflects on her own experience and that of a couple, Sam and Bethany Torode, who's book Open Embrace: A Protestant Couple Rethinks Contraception is a best-seller in it's small but ideologically passionate niche.

Morice-Brubaker makes the awesome case that "an ideal method for the couples who can make it work" isn't the same thing, at all, as ideal period.

I know couples who say that they’ve had a very positive experience with NFP. I don’t second-guess their reasons for saying so. There’s no reason not to take them at their word, as far as I’m concerned. But would their testimonies have made for a telling rejoinder to Oppenheimer’s column? I don’t think so.

Remember, Open Embrace does not advance the view that natural family planning might be a fun thing for married couples to try just for kicks—like a book club or dance lessons—on the off chance that you might be one of the married couples that turns out to bond over it. Open Embrace presents natural family planning as a really good thing for married couples, as such, to do. It is predicted to bring them closer. Married couples. In general. As a group.

In their early 20s, the Torodes believed they could predict this—about themselves, and about all the potential married couples who might read their book; including, presumably, couples facing mental or physical health problems, lack of support, or simple inability to reliably take body temperature at the same time every day.

So, really, the question is not: “Are there NO couples out there who ever have a positive experience avoiding artificial contraception?” Surely there are. Rather, the question is this: “Can every married couple everywhere really benefit from avoiding artificial contraception—and more to the point, who in the heck could possibly be in the position to know this?”

Source: Religion Dispatches

In other words? No.

In fact, so "no" that just a few years after writing their "classic" pean to NFP as the ultimate bonding experience the Torodes were divorced! Sam Torodes now says "I am out of the business of trying to tell people what they should do. I am out of that business for good."

Good rule for authors of parenting books to live by? Don't write a book about the success of... well, pretty much anything related to parenting or domesticity when you've only been doing it two years. And definitely don't wait only two years to start bragging about how radical, bonding, nurturing, and foolproof your controversial method of birth control method is until, you know, you've successfully managed to, say, space two pregnancies.

Say what you will about the (smug? extremist?) Duggar parents with their 20-odd children but at least they had the sense to wait till their first four children were out of high-school before starting to issue propaganda tracts about white Christian men's duty to keep their wives continuously pregnant and white Christian wive's duty to let them.

As Morice-Brubaker puts it

[A]s I read them, the authors of Open Embrace have thus presented their own “balance.” In 2002, they proffered the view that natural family planning is an inherent benefit to marriage as such, with the implication that it’s possible to honestly make such pronouncements about people’s lives whom one does not know. Now, in 2011, they’re saying that it’s more complicated than that

Yeah, that.


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Hey, I Got a Comment of the Week Award at Em and Lo's Regarding the ACOG's New Broad Approval of IUDs

So while I was jet-lagging in Greece I ran across this cool post from Em & Lo

illus. of Paraguard IUD via Med.unc.edu

Move over, Pill! According to the American College of Obstetricians and Gynecologists (ACOG), the IUD is a whole lot more effective — and safer than was traditionally thought. For a long time IUDs have been recommended only for women in long-term monogamous relationships who’d already had children — this was based on concerns that IUDs raised the risk of pelvic inflammatory disease (PID), which, left untreated, can cause infertility. But according to ACOG, the evidence does not support these concerns — meaning, IUDs do not cause PID.

When you combine this news with what we already knew — the overwhelming effectiveness of a device that you insert once every five or ten years, as compared to a pill that you have to remember to take daily — it’s kind of a no-brainer. Or, at least, the IUD is definitely a contender. Currently it’s the redheaded stepchild of the birth control world — in 2008, IUDs, were the chosen method of 5.5% of women using contraceptives (and only 1.3% in 2002). But as more and more women find out that (a) IUDs are a lot safer than they’d been warned and (b) a lot more effective than the Pill or condoms, we’re guessing that will change.

Source: Em & Lo

And since I was jet lagged... and since the rest of my family traitorously were all sound asleep, I wrote the following... which I just discovered got Em & Lo's comment of the week award a day or two later.  Here's what I said then.  And since it was only a week or so ago it's still true. :-)

It’s been, what, 45 years since sales of the infamous Dalkon Shield IUD were suspended. And virtually everything we “know” about how bad IUDs are comes from… the Dalkon Shield. It’s also been roughly 40 years since the first copper-wrapped mini-IUD was introduced.

This is still not to say the IUD is perfect for everyone, but as you say it’s more perfect for more people than The Pill or other heavy-duty hormonal contraceptives like shots or Norplant.

If the ACOG has greenlighted it a lot of caregivers who’ve been reluctant to prescribe IUDs are more likely to get on board.

For what it’s worth, one of the biggest arguments against IUDs is that they don’t protect from STIs. But since hormonal contraceptives don’t either that’s always been a wash. But with IUDs you can use condoms for what they do best: minimize risk of STI transmission, while leaving the IUD to do what itdoes best: preventing pregnancy when there are condom slip-ups.

Finally, speaking of condoms, for people who could be “fluid bonded” but still rely on condoms for contraception, the up-front cost of an IUD might be relatively high but five to ten years worth of condoms aren’t exactly cheap either.

---

I ought to add that whereas I've always thought that if I was a woman I'd use an IUD it's also the case that since I'm a man I got a vasectomy at age 21, a reversal around age 42, and a second (and final) vasectomy around age 45.  What the ACOG is saying is that you no longer have to think of yourself as a risk taker or a pioneer for seeing if it would work for you.


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With Paternity Revision Comes Great Paternity Responsibility -- Good Thing New Male Contraceptives Are Finally On the Horizon

The need to adjust our pre-feminist notions of paternal responsibility notwithstanding, this unpublished draft from last December is a reminder that we need to adjust pre-HIV notions of "sexual freedom" in relationship to condom use.  (The context was the Julian Assange incident.)

Anthony McCarthy of Echidne of the Snakes, who remembers the impact HIV had on his community of gay men, brings his bitter understanding of condom-avoiding "knowing transmission" to heterosexuality.

...as you know, women are infected with HIV through vaginal sex as well as through anal sex by men who are infected. Straight men are often infected through anonymous sex with women or men just as gay men are. I suspect that for many women, who have grown up with the idea that AIDS is primary a problem for gay men are at the stage gay men were in the early days before the syndrome even had a name.

Of course this is all by way of explanation for my comments on the accusations made about Julian Assange. Being a witness to the deaths of dozens of gay men I knew, knowing that just about all of them with a few exceptions, likely were infected through casual sex with someone they didn't know, knowing that women can be infected by men, all of that informs my thinking on whether or not people should be having casual sex with people they don't know in 2011. And the fact is they shouldn't. Women deserve better than they're going to get from men under those circumstances, men who have sex with men deserve better than they get from it. There is nothing liberated about being infected with HIV or hepatitis or chlamydia or any number of other infections that can injure and kill you. Having sex with someone who can persuade you to engage in sex you don't want or who can trick or force you into it is the opposite of free choice. No more than getting robbed by a conman. And there is no law you can make that will protect you from any of that which is stronger than protecting yourself. And there is nothing that is more likely to protect you than knowing who it is you're agreeing to have sex with.

Source: Echidne of the Snakes

At the time I drafted this I was on a real tear about "knowing transmission" not only of sexually transmitted diseases but pregnancy.  The more diligently men pursue reproductive responsibility the easier, both socially and biologically, it'll be to advocate for revision of paternity statutes as well.

(Good news on the paternal contraception front, incidentally.  Via Beth Saunders, it sounds like in addition to condoms, withdrawal, and/or surgical sterilization men will soon have not one but three reversible hormonal contraceptives to pick from, which means that men will finally be able to use double contraception without help from a partner.)

Will we ever be able to ditch condoms? Not as long as there continue to be multiple partners and sexually-transmittable illnesses. But with the possibility of new male contraceptives we can dramatically reduce the possibility of knowingly or even just carelessly transmitting paternity.


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Note to Central Illinois Readers: Kate Clancy's Researching Hormonal Contraception Use in the U.S., You Can Help

Professor Kate Clancy, who's doing research about attitudes towards hormonal contraceptives in the U.S., is looking for focus-group participants in central Illinois.

Women in the United States use hormonal contraceptives more than any other nation in the world. Doctors and patients in other countries report a hesitance to prescribe hormonal contraceptives for off-label use (to improve the skin, or regulate the cycle) where most pharmaceutical advertisements in the US celebrate exactly those uses.

Why do women in the US use hormonal contraceptives more frequently? How did you and your doctor decide that this prescription was right for you?

If you live in or near Champaign-Urbana, we would like to have you come participate in a focus group on exactly this topic! We would like to validate a survey that will be used online, but also get freeform responses from real women about their real experiences.

Source: Context and variation

I think this is a great idea!

What I was taught by sex educators, who often still remembered when The Pill first came out, was assumed (probably with justification) that it was easier for conservative parents to accept hormonal contraception for their daughters when the "official" reason was to moderate acne or even out periods.  Same for some more progressive but still-traditional Catholic healthcare providers.  And so that was the line a lot of us learned and were encouraged to pass along back in the day.

But!

That's an awful long time to let an assumption like that go unchallenged.  Which is why I think it's a very good idea to stop assuming and actually inquire.

Details of the study including contact information can be found by following this link.


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Will Anti-Choice Activists Be as Frantic About Hormonal Contraception for Men? We Might (Finally) Find Out Soon

Speaking of emergency contraception, and the tendency to blame women for using it, and the tendency to blame women, for that matter, for just about any choice they make regarding their reproductive choices and/or opportunities, and especially for anti-choicers to blame them for all of the above because they're convinced that hormonal contraception is really a closet abortion conspiracy, Jenna of My Sex Professor brings a little potentially welcome news

Many men are disappointed with their lack of contraception options: between the barrier method and vasectomy lie few other choices. A new method (RISUG) is being tested, which entail a one-time reversible injection that prevents sperm from penetrating the egg. The procedure would take five minutes and be effective for at least ten years

Source: My Sex Professor

While for years we've heard stories about how male contraceptives are just around the corner, and are thus justified in feeling a little wary, it's worth pointing out that at least the stories are coming closer and closer together.  And this one actually sounds fairly promising!

It's great news, obviously, for at least the following reasons

1) There really aren't a lot of contraception options available for men.  Worse, of the three available -- condoms, vasectomy, and withdrawal, the most recently developed, vasectomies, were introduced nearly 200 years ago! Since then?  Nothing.  And say what you will about condoms (I say they're pretty good at preventing disease and pregnancy if they don't break and if you use them correctly) they're kind of hard to use correctly until you've really gotten the hand of it, by which point... but I digress.  What I was going to say is this sounds promising because it would be really, really nice to have something intermediate to the permanence of vasectomies and the uncertainties of condoms

2) The introduction of reliable, realistic, reversible and hard to screw up contraception for men will change the blame-women-first-and-always dynamic.  Because once solutions become available for men there won't be that sort of shoulder-shrugging "what can ya do, man" resignation men who fuck up are able to rely on from their peers.  Because, in part, the obvious answer to "what can ya do, man" would then be "what you can do, asshole, is get a shot once every ten years.  You're not getting any sympathy from us."  So that's a big deal.

3) When it comes to the situations where emergency contraception is most likely used (condom breaking, or not using a condom for first-time sex after a long drought, or when functionally incapacitated by drugs or alcohol) the odds of neither party being on some form of contraception can be way lower.

4) Taking items 1-3, above, into account, the focus of responsibility for contraception can shift away from 100% women to more like 50/50 men and women.  (If the product Jenna mentions is as effective and non-intrusive as promised responsibility could shift further onto men.  Although, obviously, an easily used saliva- or semen-based test to quickly confirm effectiveness would be welcome as well.)

But then there's

5) The beauty of the proposed method is that by robbing sperm of the ability to merge with eggs it'll make "conception" impossible! Which ought to shut the ugly pie holes of the "contraception is really abortion" covens.

And, if I can put on my speculative psychopathology-of-the-anti-choice crowd had for a moment, it could even be that...

6) If contraception happens inside men's bodies the anti-choice crowd won't actually care.  Or at least if they do they'll have to start basically from scratch.  And while yes, as a matter of fact it would be better if the anti-choicers were really anti-choice and not just anti-women-as-autonomous-agents, as most evidence suggests. But even then...

7) If the anti-choicers did turn on men and start running the same ill-willed intrusions at least it would put men squarely on the front lines  with women, as opposed to the status quo where most men have basically been confined at best to the sidelines.


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George W. Bush's Mom, Dad (George H.W. "Rubbers" Bush), and Grandparents Have Always Strongly Supported Reproductive Choice

Jodi Jacobson of RHRealityCheck.org pulls together some fairly binding evidence that George W. Bush wouldn’t know the truth if it bit him on the ass the staunchly Republican Bush family has always been strongly pro-choice.

The Bush family has a long history of support for Planned Parenthood.  Prescott Bush, father of George H. W. Bush (Bush 1) and grandfather of Bush 2 was the treasurer of Planned Parenthood when it launched its first national fundraising campaign in 1947. Birth control being controversial in the period pre- Griswold v. Connecticut (and yes, history obviously repeats itself), Prescott Bush was attacked for his pro-choice position and knocked out of the running for a Senate seat in Connecticut.

Writing at SFGate.com in 2005, Vicki Haddock recounts the history:

Prescott Bush won a Senate seat two years later, and his son George and daughter-in-law Barbara continued to support Planned Parenthood even after George’s election to Congress from Texas.

“In fact,” writes Haddock, “he was such an advocate for family planning that some House colleagues gave him the nickname “Rubbers.”“ 

Source: RHRealityCheck.org.

That sounds about right. It’s still very possible that when presented with a jar containing the remains of his mother’s miscarriages he decided to become anti-abortion. But it’s not likely that then or now his mother has ever opposed choice, and there’s no reason to believe at all that she intended for her son to oppose it.

That shouldn’t even be controversial! Not all that long ago Republicans were at least as likely as Democrats to support family planning. And of course somewhere between many and most Republicans, like most Americans, period, still do. It’s just now political suicide rather than a minor setback for them to admit it.


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