Imagine seeing a doctor who always prescribes you the same medication, no matter your symptoms. Stomachache? Heartburn? Chest tightness? Always the same prescription.
For too many women, this is what happens with hormonal birth control. It’s prescribed to avoid pregnancy, to treat complicated problems such as endometriosis or polycystic ovarian syndrome, or simply to reduce acne and PMS.
Two documentaries—one released in 2007, one in production now—have inspired debate over whether modern medicine treats women’s biology as a disease to increase profits.
But this debate shouldn’t be understood as an attack on doctors. Rather, it is an expression of women’s desire to use natural methods to improve their health and plan their families without having their complex problems be treated with the same automatic prescription. The Pill isn’t a one-size-fits-all solution, and women are tired of being forced to treat it as such.
Empowering the Consumer
In 2007, Ricki Lake and Abby Epstein produced “The Business of Being Born,” which took a critical look at modern childbirth and suggested that the medical profession often recommends invasive procedures that increase profitability at the expense of women’s health.
A New York Times reviewer observed, “As the film enumerates disadvantages of hospital births, conspiracy theorists might detect a plot by the medical establishment to take control of a process for both economic and psychological reasons.” This aspect of the film inspired a strong negative reaction from some physicians. Believing that the film put women at risk by encouraging home birth, one OB/GYN went so far as to allege that “Ricki Lake has blood on her hands.”
The response of the American College of Obstetricians and Gynecologists (ACOG) was more measured. In 2011, it issued an opinion saying that while it “believes hospitals and birthing centers are the safest setting for birth, it respects the right of a woman to make a medically informed decision about delivery.”
Women are increasingly demanding that doctors work with the natural processes of their bodies during childbirth instead of performing unnecessary procedures. Many hospitals and OB/GYNs responded by adding certified nurse midwives (CNMs) to their teams and instituting more natural and “baby-friendly” practices, such as delayed cord clamping, immediate skin-to-skin contact, and postpartum lactation consultation. The Centers for Disease Control reports that, in 2013, nearly 9 percent of all births were attended by either a CNM or a direct-entry midwife, up from 3 percent in 1989.
Hospitals are making concrete changes to accommodate the growing number of women who want to give birth more naturally. They should be just as responsive when it comes to other fertility issues.
Not an Attack, But an Opportunity
Lake and Epstein are now partnering with Holly Grigg-Spall, author of the 2013 book “Sweetening the Pill: Or How We Got Hooked on Hormonal Birth Control,” for an upcoming film of the same title. In a recent interview, Lake explained: “What we did for birth, we’re trying to do for birth control. And that’s to empower the consumer with information. Not tell women what to do, but offering access to information and choice.”
Just as “The Business of Being Born” raised questions over whether the medical community has women’s best interests at heart, “Sweetening the Pill” is likely to encourage distrust of “big pharma.” Some of its criticism may be excessive or unsubstantiated. However, the film is also likely to expose legitimate shortcomings in current medical practice.
Rather than viewing it as an attack, physicians and medical students should see the release of “Sweetening the Pill” as an opportunity to rethink their current practices. Often, medical students are trained to prescribe hormonal contraception at the first sign of any “feminine” medical issue. Epstein explains,
It’s similar to birth in that the whole premise of birth control is ‘Periods are bad. Ovulating is bad.’ Like the female cycle is this horrible thing and we have to shut it down! Essentially, you are trying to prevent one thing with birth control: an egg from meeting a sperm. And instead of preventing that one thing, we’re medicating the entire system.
Medical professionals are given the hammer of hormonal contraceptives, and, unsurprisingly, everything looks like a nail. Studies indicate that “Most physicians…underestimate the effectiveness of natural family planning and do not give information about modern methods to women.” For those who are interested in more natural methods, even ACOG’s educational information on fertility awareness-based methods of birth control is incomplete, failing to mention high-tech methods such as the Marquette Model, which uses a fertility monitor to measure natural changes in hormone levels throughout a woman’s cycle.
Women Deserve Better Information
If many physicians lack in-depth knowledge of a woman’s cycle, it’s no surprise that women’s knowledge of their own bodies is often woefully incomplete. One 2014 study found, “Approximately 40% [of women] were unfamiliar with the ovulatory cycle.” As a result, they are forced to treat symptoms with medication that may not address the underlying causes.
One positive development is NaProTECHNOLOGY. This system, developed by Thomas W. Hilgers—a clinical professor at Creighton University School of Medicine—trains women and physicians to work together to monitor cycles, identify irregularities, and find solutions. The system is extremely effective in both preventing and achieving pregnancy. However, the number of physicians who receive NaPro training is small, so many couples remain unaware that in vitro fertilization isn’t the only way to overcome infertility.
As consumers become increasingly wary of the pesticides, genetically modified organisms, and hormones in the food they buy, it’s not surprising that women are eager for natural methods of family planning and fertility treatment. It’s up to the medical community to choose how it will respond. Will it defensively double down on hormonal birth control as the best choice for women? Or will it react to the increasing demand for in-depth knowledge of women’s fertility by improving medical school curricula and continuing medical education for physicians?