My birth control odyssey

Before most women in American culture today embark upon their birth odyssey, they embark upon their birth control odyssey. Most of us do not have sex for the first time intending to get pregnant. I certainly didn't.

If I had, I would probably have gotten pregnant around age sixteen. My mother started having sex at fifteen, and most of the women in my family are known for having a relatively high number of sex partners -- something I do not consider shameful or worth hiding. Because of this history (I think there's some sort of genetic incredible sex drive in our women!), my mother talked to me about birth control for the first time when I was only thirteen.

Now, I'd known about birth control existing for a long time. My mother never made a secret of hers; it was in one of those cool plastic holders (they don't give them out with pill packs any more) and I even knew about the placebo week, since my mother never took those pills and I asked her why, once. But the first time we really talked about it, I was headed off to high school at a boarding school (no, we weren't rich -- my parents only paid $800/year for that school!). She knew that there would be opportunities, no matter how much the school said there wouldn't be, since it was, after all, co-educational. Frankly, at that age, while I had a somewhat active fantasy life and a fine sex life with myself, I was a little grossed out by the entire idea of sex. But my mother said: "If you ever need birth control, you let me know. I won't tell anyone, we'll go to the doctor and get it together. I'd rather you have sex with a boy you love and really care about and want to stay with, but even if you have sex with someone else, I will not ask questions, I will just get you the pills and condoms you need." I was embarrassed, but grateful. How many moms were like that? Not many, as I found out in high school: most girls' mothers were absolutely against getting them any kind of birth control.

The summer I turned sixteen and graduated high school, I went to the gynecologist's office for the first time. Because my mother had PCOS and because my weight was high, he diagnosed me with it as well (I am still uncertain of this diagnosis, especially since I believe I am ovulating and my cycles are regular like clockwork!). As a side effect of this diagnosis, he put me on my first birth control pills. Even though she'd always said she'd get them for me, I saw the look of worry cross over my mother's face as she gave me the first pill pack, saying that if I needed condoms, please let her know. I thought birth control would always be this easy to get. I was wrong.

I was on the pill through most of my early sex life, when I was sixteen and seventeen. But at age 18, jolted by a couple of unremembered pills and a brief but memorable pregnancy scare, I walked into a Planned Parenthood office in Northern California and requested Depo-Provera.

Now, there are horror stories about "the birth control shot," but my story wasn't so much horror as...simple growing dislike over time. The first two months of the shot saw me moodier than I had ever been, but over time that effect lessened. However, in the first year I was on the shot, I gained about 70 pounds and ended up at my current weight of approximately 330 at a height of 6', going from a size 20 to a size 26. It's worth noting that this was the year in my life I probably ate healthier than any other: lots of steamed vegetables, lots of fish (and sushi!), red meat only once a month or so, no processed or artificial foods, mostly organic produce. I also walked a mile each way to work for most of this time. The weight gain, as far as I can see in retrospect, was due to the shot. At the time, I blamed myself for not eating well enough, not exercising enough, but today I can see that I have remained at the same weight ever since that first year on the shot, regardless of my diet or exercise regimen.

And yet, I'm lucky. My sex drive didn't take a nosedive, as some women's have done on the shot. My depression lifted. My weight gain stopped. And because of that, I used the shot for several years.

It wasn't always easy. In one Planned Parenthood clinic, I was refused the shot because it had been one day more than the three months it's said to be valid for. That's right -- I was refused birth control because I was late with my birth control. Another time, in a private clinic, I was harangued by a doctor about my weight when I came in for a simple pelvic and birth control. Instead of asking about the Depo Provera and it possibly causing weight gain, or my history, he started saying that I clearly didn't need birth control, since I probably couldn't get a boyfriend. When I told him I in fact did have a boyfriend, one who had moved in that week, in fact, he said that I still wouldn't need the shot, since women as fat as me just couldn't have babies. I never felt so humiliated in my life. I ended up getting the shot, finally, after pleading and even crying. And after that, I ordered my Depo Provera shots from an online pharmacy where I didn't need a prescription, and had my boyfriend (now my husband) inject them for me. While I wouldn't recommend this option, it was the only one I felt like I had: I just couldn't face that doctor again, and he was the only one I could see with my insurance at the time.

Last year, I began to wonder if I'd want to have a baby soon. Knowing that Depo Provera can take months, sometimes even a year, to wear off, I decided to switch methods. After research, I came to the conclusion that the Nuvaring was a good option. I didn't want to have to remember daily pills, because I knew I'd forget sometimes. I didn't want a method that took a long time to reverse, and because I thought I might want to get pregnant in the relatively near future, I didn't want an invasive method like an IUD only to have it taken out a few months or a year in the future.

When I went to get the Nuvaring, the first clinic I went to (with the same gynecologist I had gone to for my first pelvic and pill pack) was quick and easy to get a ring from. I liked the way it didn't feel like anything and was easy to use without having to remember it daily. But when I came to the Planned Parenthood clinic in Minnesota to get more, the gynecologist pursed her lips when she looked at my health history. "We're not supposed to put women with a history of migraine on Nuvaring," she said. "We could put you on the mini-pill instead."

If you don't know anything about the mini-pill, let me enlighten you: they must be taken not only daily, but within a couple of hours of the same time every day. I don't have a schedule that even permits this, much less the patience or memory to commit to this. I looked at the gyno and flatly told her that if I used the minipill, the next time she saw me, it would be for a prenatal appointment, and that besides, I'd been using Nuvaring for nine months with zero side effects. She sighed and said: "well, if you're really convinced, okay, I guess, but I want to see you on something else soon."

She didn't ask me about my migraine triggers, or whether I had migraines related to my menstrual cycle. She didn't care that my body was happier on Nuvaring (which releases a lower amount of hormones than pills, and in a more targeted area) than on any other birth control.

To me, the most important thing about birth and women's bodies is choice. But what strikes me about my birth control odyssey is that, in many of these places, the only reason I had a choice at all is that I was pigheaded and stubborn. If I had stumbled out of the office of the fat-hating gynecologist crying and hurt, and had stopped using any birth control but condoms, or if I hadn't pointed out to Planned Parenthood the ridiculousness of refusing my shot because it had been too long since the last one, or if I had gone on the minipill as was not so subtly recommended by the most recent gynecologist I have seen, I have very little doubt I would already have had an unwanted pregnancy. Could I have decided to be abstinent? With my husband? For years? Really? That's not realistic. I made every attempt to be responsible about birth control and was still almost denied the birth control that worked for me and that was my informed choice, three different times for three different reasons in three different states with three different healthcare providers.

This is why I can't help but laugh at some of the "choice" and "responsibility" rhetoric that gets tossed around when talking about accidental and unplanned pregnancies. Choice needs to start before pregnancy. I am glad that the choice of whether to keep a pregnancy or not still (in most states, for women with a certain amount of privilege) resides with women. I wish that choice was available to everyone, regardless of location or socioeconomic status. And I am glad that I had the courage to fight for birth control whenever I've had to. When I have my own child, I want to be able to tell him or her: "I wanted you. I planned you. You were not an accident, even though if you had been, you'd have been a happy one. I made a choice that I wanted you to be here."