Melinda Gates wants 200 million women to have access to the contraceptives they need

Rachel, I woman I interviewed for Two is Enough: A Couple's Guide to Living Childless by Choice reached out to me and alerted me to the fact that the November issue of National Geographic magazine has an interview with Bill and Melinda Gates about their philanthropic endeavors. "I saw this quote from Melinda and thought of you":

"Family planning is crucial anywhere, in any community around the world,
because if a woman can decide if and when to have a child, she's going to behealthier and her child is going to be healthier. That's one of thelongest-standing pieces of research we have."
Then when asked what one thing she would fix if she could (poverty,malnutrition, education, HIV, etc.), Melinda said:
"So if I could wave a magic wand, 200 million women who are asking us forcontraceptives today would have them."


Rachel added, "I love that she said "IF and when to have a child" and that this is her #1 concern!" I love that too! I think we are finally moving away from the assumption that all women will choose to have children just because they can. The research mentioned by Melinda Gates confirms that health outcomes improve for both women and children when women are in control of the number and timing of births. If you would like to read more about the work of the Bill and Melinda Gates Foundation, click here for the full article.

Unplanned pregnancies linked to birth control failures or "less than perfect" use!

Used over 10 years, with less than perfect use, most birth control methods fail!

We know we are supposed to take the pill every day (or as prescribed) and use a new, well-fitting condom every time we have sex but how many of us do?

Apparently very few, according to the latest data on unplanned pregnancies.

In fact, used over ten years, less than "perfect" male condom use will result in an unplanned pregnancy for 86 of 100 women. The stats are even worse for ovulation method, spermicides, and withdrawal. Over 90 of one hundred women will have an unplanned pregnancy if they don't utilize these methods "perfectly" over 10 years of use. That is why they are called birth "control" methods, not birth "prevention" methods. If you don't use these methods properly and consistently, over time, the chances are very high that you will get pregnant.

So, what are the most effective methods of birth control?

Not surprisingly, the four most effective birth control methods are IUD's, Sterilization (male or female) and hormonal implants for females. These are not totally, 100%, effective but they are "fool" proof.

If you want to take a chance on any other methods, read the instructions carefully and be extremely diligent in proper use of them. And cross your fingers!

Photo by Jenny Lee Silver

Essure—Laura Scott Talks to Dr. Carrie Panoff about the Non-surgical Alternative to Tubal Ligation

I was invited by the public relations team representing Essure, a non-surgical, hormone- free permanent birth control procedure, to do a Q&A with Dr. Carrie Panoff, an OB/GYN in Rockland County, New York who has been doing this procedure for four years. Here's a summary our conversation:

Q: What do your patients see as the benefits of this procedure?
A: It's hormone and surgery-free and no recovery time or incision
risk. It's a five or ten minute procedure.

Q: Are any medications offered or recommended for discomfort during or after the procedure?
A: I use Motrin 24 hours before the procedure and Motrin during the procedure.

Q: In your experience has there been any instance where a pregnancy occurred after this procedure?
A: No. Three months after the procedure we perform a test that confirms the blockage.

Q: Which patients are the best candidates for this procedure?
A: Any woman is a candidate.

Q: Do you have any reservations about perform this procedure on a childless woman under the age of 30? If so, how do you handle patients who fall under this category?
A: Patients under 30 years old have a tendency to change their mind so I may give them other options. They have the right to make the decision but I would have to be adequately convinced that have had this decision for a long time and have evaluated all of the options.

Q: Have any of your childless patients changed their mind after having the procedure?
A: No.

To get more information about Essure, visit the FAQ page at http://www.essure.com/what-is-essure/common-questions. Click at the top right-hand side of the page to find doctors who perform this procedure in your area.

Why are We Still Fighting over Birth Control?

Recent outrages and political skirmishes over birth control access in the USA have opened up a dialogue about why we are still fighting over the right to have access to effective birth control 50 years after the birth control pill was made available to women in the US.

The recent dialogue focuses on the fact that the people who are making moves to limit access to conception are men. Why is that? And where are the women? In her article published in AlterNet titled Why Patriarchal Men are Utterly Petrified of Birth Control and Why We’ll Still be Fighting about it 100 Years from Now, Social Futurist Sara Robinson offers her unique perspective on why men remain in the forefront of the push to limit access to birth control:

Until the condom, the diaphragm, the Pill, the IUD, and all the subsequent variants of hormonal fertility control came along, anatomy really was destiny — and all of the world’s societies were organized around that central fact. Women were born to bear children; they had no other life options. With a few rebellious or well-born exceptions (and a few outlier cultures that somehow found their way to a more equal footing), the vast majority of women who’ve ever lived on this planet were tied to home, dependent on men, and subject to all kinds of religious and cultural restrictions designed to guarantee that they bore the right kids to the right man at the right time — even if that meant effectively jailing them at home.
Our biology reduced us to a kind of chattel, subject to strictures that owed more to property law than the more rights-based laws that applied to men. Becoming literate or mastering a trade or participating in public life wasn’t unheard-of; but unlike the men, the world’s women have always had to fit those extras in around their primary duty to their children and husband — and have usually paid a very stiff price if it was thought that those duties were being neglected.

Robinson makes the point that a woman's ability to control her fertility challenges historically entrenched patriarchal systems. For women this is seen as a positive development but for some men… not so much.


Flickr photo by WeNews

Another Childfree Person Falls Through the Cracks

Earlier this month I wrote a post titled “Are We a Family?” Most childfree couples say “Yes, we are!” However, our social institutions sometimes don’t see it that way and some of the government agencies that are set up to help families in need overlook the families of two.

An example of this came to me by way of email by a woman I will call “Susan” (as she didn’t want her real name to be used). Susan wanted to share “a terrible experience” she recently had when a horse-related accident left her with limited use of her right arm.

I was collecting unemployment at the time from an earlier work lay-off. [My husband and I] were struggling financially and I was without health insurance when the accident occurred. I had four surgeries post accident to repair my shoulder/clavicle/arm. Though I was fortunate to not break my neck or lose my arm, the accident changed my life.

To make a long story short; with no health insurance and limited income, I turned to DSS/Medicaid for assistance. This was extremely defeating to me, but the system is there to help people through crisis (even though it’s widely abused). However, what occurred during my DSS interview was disturbing to me. I was unable to qualify for Medicaid because my unemployment earnings were too high for this county's cut off ($706 for a woman with no children).

During the interview I was also screened for any possible social service help that I might qualify for, and I qualified for NONE...... however, a social worker came into the [cubicle] where I was being interviewed and told me I qualified for ONE program - "Reproductive Counseling". I immediately asked if this included any gynecological services (pap smear etc), and it did not. Upon questioning exactly what this program was, it was explained to me that it is a program offered to all women that consists of counseling on abstinence and safe sex! The irony; I'm 40 with NO children....and I got to that age birth-free BY CHOICE. Did they think I'd be interested??! Hell no.

The moral of the story is--if I had been pregnant or had any amount of children, I would have qualified for many services that I desperately needed due to consequences from my accident. To me, this sends a 'back door message' to get pregnant so the system would WORK FOR ME! How ridiculous!

When I read Susan’s story, I wondered “How did this social worker come to the conclusion that a person seeking help with a limited mobility disability and medical care access would need reproductive counseling?”

A Birth Control Shot for Men

I’ve been waiting for the day when some drug company would introduce a new birth control method for men. We’re not there yet but this day is getting closer with a Chinese study designed to test the effectiveness of a new formula birth control shot for guys.

I thought this was pretty exciting stuff so I did a bit of research into this development, a summary of which was published in this month’s edition of Unscripted. Here’s an excerpt:

In a recent study, 1,045 Chinese men between 20 and 45 years of age were given testosterone injections for over two years. All these men had fathered a child within the last two years and their partners did not report any fertility problems. Yet these shots where able to prevent pregnancy 99% of the time, coming close to the success rate of female hormonal contraceptives.

It been know for years that testosterone shots suppress sperm production but in most previous studies men were subjected to weekly shots instead of the monthly shot given to the men in the Chinese study. Previously researchers and marketers had doubted that men would sign up for a weekly shot so the testosterone shot never really got traction as a viable method for male birth control. And, even though the men taking these shots reported very few side effects (acne and higher sex drive are two), there remains some concern about the long-term effects of testosterone on the prostrate gland and heart, and on the behavioral effects of testosterone.

The main benefit of the testosterone shot is, like the birth control pill for women, this method is reversible. So for those guys who want to take responsibility for their own reproductive lives but aren’t ready to be snipped, this could prove to be the answer.

The question is: Are there enough men out there ready and willing to take a monthly shot?

You tell me…

Flickr photo by stevendepolo (cc)

It’s Not Realistic

Back in the 70’s, I had a very brave health teacher who decided to offer her 10th grade class frank and accurate information about sex—both the benefits and the consequences. I recall that my parents had to sign a release form giving me permission to attend this class, which they did, quite happily.

It was in that classroom where I saw my first condom and I learned how men get erections, and learned that women have “little penises” called a clitoris and this tiny bit of anatomy was the key to female orgasm. As I write this I marvel at all the information I was given in this short series of classes. This information later allowed me to challenge much of the schoolyard sexual mythology—such as the “blue ball” myth that guys would practically die if they couldn’t satisfy an erection—and allowed me to protect myself from unplanned pregnancies and act as my own advocate when I was ready to go beyond first base.

I mourn for the generations of men and women who didn’t get this information, or got it too late. I speak not only as a childless by choice woman but also as a mentor of young women. More than once I’ve had to explain to a young woman, as my teacher did, why you can’t use a condom twice, or confirm that it is possible to get STDs from oral sex. Too many go out in a world, where 30 percent of American teens have sex before they are old enough to drive a car, unarmed and misinformed.

This is why I have always resisted the notion of abstinence-only education. I fear that by limiting sex education in schools we rob children of critical knowledge that will keep them safer, and I feel it is grossly naïve to think abstinence-only education can reduce premarital sex. Sadly, my fears were confirmed in a recent article titled Abstinence-Only Education: Just As Much Sex, But With Less Condom Use written by Melanie Altar citing a study by Janet Rosenbaum, a researcher at John Hopkins, which found that “teenagers who pledge to remain virgins until their wedding night are just as likely to have premarital sex as those who do not. Moreover, pledgers in the study were less likely to take precautions against STIs and unwanted pregnancies than a peer control group with similar backgrounds who did not make a pledge.”

Rosenbaum’s findings were echoed in Greta Van Susteren’s interview with Sarah Palin’s daughter Bristol, a new teen mom. Although her mother is a proponent of abstinence-only education as Governor of Alaska, Bristol, when asked how she felt about contraception, said, “Everyone should be abstinent or whatever, but it's not realistic at all.”

From the mouths of babes to our ears.

Choice has its Limits

Recently I was contacted by a journalist who was writing an article on young childfree males who had a vasectomy in their twenties. He asked me if I knew a male in his twenties who had recently signed up for this procedure. I did not.

I knew from my interviews with childfree couples that it is possible to get a vasectomy in your twenties but it isn’t easy. I had heard stories about twenty-something childless by choice men being turned away by doctors who said, "Come back to me when you’ve had a couple of kids."

Hello!? It’s true. You will likely have to doctor shop to get a vasectomy if you are a young childfree man. The same is true if you are a young childless woman seeking a tubal ligation. Some doctors are reluctant to perform a tubal ligation on a woman under twenty-five years old, even if she does have kids. Woman and men have been asked to undergo a year of counseling, write a letter to the child they will never have, and are generally expected to jump through hoops to convince a doctor they are sincere in their desire to remain childfree.

Why is it so hard?

Because there are assumptions, crusty with age, that are operating here:
1) You may think you don’t want children, but you will change your mind (and sue me).
2) You will divorce and your next spouse will want a baby, and you will acquiesce.
3) You’re immature, and you don’t know your own mind.

If you really, really want to be permanently sterilized in your twenties you must find a way to overcome these objections, or wait until you turn thirty. In the meantime, do what many of my particpants in the childless by choice project have done.
1) Double up on birth control (I know, you are already very careful).
2) Discuss your wishes with your partner (it takes two to be this diligent).
3) Do an extensive discernment process. Do you really want to remain childless? Why? When you’ve answered these questions, write a letter to yourself, and print a copy for the doctor and bring it to the initial consultation.

It takes a a good pitch, and a lot of thought, to make this life-altering decision, but if it is what you really, really want to do, remember you can always adopt, foster, or mentor. A life without kids doesn’t necessarily mean a life without kids. (See the previous post).