Why I'm Pro-Birth Control Access and Pro-Choice

I previously blogged about my thoughts on birth control and why it was medically necessary for me.  Now that I've had a hysterectomy, I no longer have to worry about those issues--for myself, anyway.  Unfortunately, I find myself confronted by an even larger worry looming on the horizon--how birth control options and access, and abortion restrictions will affect my daughter.  Yes, I know, she's only 3 (almost 4).  I can hear your incredulity.  However, I want to talk about this because I want to provide another perspective to the social discussion on sex, birth control, and abortion--one that highlights why this issue is much more complex than many of the people making the decisions about it are considering.

So, why am I talking about birth control and abortion with respect to my preschooler?  First, because I started menstruating at 9, so we are easily a mere five years away from her being able to get pregnant.  Do I anticipate her having sex at that age?  Heck no!  But, I am a realist and know it happens--my mother taught a 7th grader with three children!  I will do what I can to educate her and impress upon her that the repercussions of this decision is even more weighty for her than her peers.  Nevertheless, I cannot control the world, so I have to consider that she could be sexually assaulted, like I was at age six.

I imagine you are thinking, "But that's true for everyone.  What's the big deal?"  The big deal is, for most people, pregnancy is not a death sentence.  Given her unique anatomy and PAH, a pregnancy will likely kill my daughter.  Her body won't be able to handle the increased blood flow and lung function necessary for a baby to grow, let alone tolerate labor and birth.  And, even if she somehow survived pregnancy, the medications she takes for her heart condition are contraindicated for pregnancy; indeed, one of them is a black box drug that causes severe birth defects.  Unfortunately, it also cannot be used in conjunction with hormonal birth control.

Given that most states are passing abortion restrictions that don't include rape or health of the mother exceptions, I cannot simply hope that it won't happen to her.  Under these conditions, I feel I must take a proactive approach to keep her safe.  So, how do I protect my daughter?  Since hormonal birth control is out, and most of the other forms require reliance on the other party or aren't effective enough, in my opinion, when death is the alternative, I will likely get her an IUD.  The only other more effective alternative would be to sterilize her and that's not going to happen--medicine advances all the time, and it's possible something could change in the future that would make her able to safely carry a pregnancy.  Given my own struggle with infertility, I am not going to do that to her.

I get how crazy it is to be talking about getting an IUD for my child.  Still, I can't think of any other acceptable options.  Not when the alternative--whether by mistake or violation--is a death sentence.  I'm not telling you all of this to get you to change your beliefs or your position on these issues.  Instead, I'm simply offering you the background to understand why my position is pro-access, pro-choice.

Birth Control

My apologies about the controversial nature of the following post, but I have reached the point where I can no longer stay silent on this topic.

Women's increased access to birth control has been in the news a lot recently.  Honestly, it never occurred to me that a mandate that insurance cover birth control would be so controversial.  Why?  Because it was always medically necessary for me.  Indeed, it still is.  As I previously mentioned:

Whether it was ruptured ovarian cysts, extremely severe Mittelschmerz, endometriosis, or excessively long and heavy periods, I have always felt at war with myself.  My cycles started when I was 9 and I was on birth control by age 16 to regulate my body and stop the cysts.

Flash forward to yesterday.  Yesterday, I ovulated.  (Honestly, before all this crap broke out in the media, I might have thought telling people that bit of information was TMI.  Now, it seems rather tame.  And, given how interested those in politics appear to be in what happens in my uterus every month, now they know.)

For most people, ovulation isn't a big deal.  There are women who pay big money for digital kits to tell them when it's about to happen.  Not me.  I just wait for the giant pain that feels like my appendix rupturing.  Yup.  Totally serious.  When my appendix ruptured in 1996, I didn't go to the hospital for 24 hours because I honestly thought it was my regular ovulation pain and only realized something was wrong when it didn't get better.  I dread every month wondering where I will be and what I will be doing when it hits me.  I keep heating pads and Aleve in my purse, my car, and my home so that I am likely to have them at a moment's notice when the pain starts.  And when it starts, it just hits.  There's no real build up.  I have roughly one minute to decide if this is about to be "it."  And Lord help me if I'm wrong.

So, back to yesterday.  As I sat on the sofa last night waiting for my husband to bring home my child, "it" began.  By the time Phil got home, I was curled up in a ball in the hallway, crying quietly so as not to freak out my daughter.  Phil fed Lil' Bit and gave her her first evening medication, but he had to leave to lead Wednesday night services and I was in no condition to take care of her.  Fortunately, my dear friend was nearby and came over to give Lil' Bit her meds, bathe her, and get her to bed while I lay on the couch waiting for the pain to stop.  We got lucky someone was available yesterday.  That won't always be the case.  And not knowing when and where I am when it hits is an even bigger problem now that I have to think about being able to take care of Lil' Bit.

And so it was that today, the infertile woman who cannot get pregnant from having sex went on birth control.  Why?  Because the way that birth control works is by making you NOT ovulate.  For me, it is a singularly magic pill that will make my life so much better and does what no other medication can.  But, because insurance is NOT required to pay for it, I have the privilege of paying roughly $50 a month so that I don't become incapacitated and feel like my appendix has ruptured.  Because it's OPTIONAL.  Because it's not medically necessary.  I call bullshit.  Insurance covered my accutane to get rid of my severe cystic acne and that was WAY more optional than birth control.  [Incidentally, it was while I was on accutane that insurance HAD to cover birth control--because it was medically mandated that I be on it given the severity of birth defects associated with pregnancy during accutane use.]

Furthermore, even assuming that every woman in the world used birth control only to prevent pregnancy and not to treat any other medical condition, it would SAVE insurance companies money because they wouldn't have to pay for all the medical costs involved with pregnancy and it would SAVE taxpayers money by having fewer women with unintentional pregnancies requiring welfare, medicaid, and other social safety nets.  And, quite honestly, if birth control were covered by insurance and more widely accessible, resulting in significantly fewer unintentional pregnancies, wouldn't that go a long way toward making abortion unnecessary?  I can't understand why on earth anti-abortion advocates aren't running around fighting harder for insurance companies to cover birth control!

But, back to my main point.  Birth control is prescription medication that treats multiple medical conditions.  Whether it is appropriate is a medical decision made between a patient and her physician.  Anyone who says otherwise is selling something.  And I'm not buying.