While some young women are fortunate enough to have discussions with parents or other trusted adults, others are left in the dark regarding healthy and effective methods of contraception. Physical health, mental health, relationship status, future plans, government policy; these are all factors in the decision-making process for better or for worse. Shame is also, unfortunately, a factor and often deters young women from asking questions and reaching out. But thankfully, even if an in-person conversation can’t be had, young women today have access to a wealth of knowledge and resources online. “There is more acceptability for folks to get their own information, which lets them make their own decisions,” says comprehensive sex educator and sexual assault and trauma expert Jimanekia Eborn. “I think it is amazing that our good girlfriend Google has allowed many folks to find out about contraception and all of the options. I also believe that the conversations have gotten so much louder.”
Who’s Taking Birth Control?
The most recent data from the Centers for Disease Control and Prevention, collected from 2015-2019, shows that nearly 65% of women aged 15-49 were using a method of contraception at the time. And that number varied with age: 37% of women aged 15-19 and 73% of women aged 40-49 used birth control. The survey also found that female sterilization, the pill, long-acting reversible contraception and male condoms were cited as the most common methods of birth control.
Factors in Decision-making
Birth control isn’t something to be chosen at random or because it’s trendy. Choices in contraceptive methods are personal and, sometimes, painstaking. For Natalie in New York City, changing relationship dynamics initiated her switch in birth control. “Before I was in a relationship, I was fine with just using condoms,” Natalie says. “But once I started getting serious with my partner I wanted something more reliable. I assumed I’d have to take the pill, but after a lot of research I went with a copper IUD that I wouldn’t have to worry about for another five years.” Mary Kate in Los Angeles also made the choice to get an IUD because she didn’t want to worry about taking a pill every day. At that time, she also felt an IUD was a safer choice in the longterm as a new presidential administration took aim at contraceptive access. “I was worried I wouldn’t have the pill covered under Trump,” Mary Kate says. Intrauterine devices (IUDs) were a common choice among the women interviewed for this article. Ohio-based obstetrician and gynecologist Kim Langdon, MD, who has more than 20 years of clinical experience, says IUDs are much more accepted now than they were 20 years ago. In her experience, one major factor in a woman’s contraception decision-making is how long they want to wait before having a child or how many children they already have. “IUDs are removable at any time and you revert back to fertility quicker than depot injections of hormones or implants,” Langdon says. Many of the women interviewed for this article cited physical and mental health reasons for their choices in contraception. Morgan in Chicago uses the Nuvaring, a hormonal birth control, because it helps tremendously in easing symptoms of premenstrual dysphoric disorder (PMDD). But coming to this solution was the result of both professional help and trial and error. Years ago, Morgan’s psychiatrist suggested PMDD as the potential cause of her mental health symptoms and prescribed selective serotonin reuptake inhibitors (SSRIs) as treatment. “But it wasn’t until speaking with my gynecologist that she suggested a hormonal birth control in conjunction with SSRIs” Morgan says. “I have had trouble with the pill in the past so I was scared to try another method, but the Nuvaring is perfect for me I think because the hormones released are more localized to the uterus.” Some birth control choices call for greater trust in the partner, as is the case with wearing condoms and using the withdrawal method or “pulling out.” While long considered ineffective in preventing pregnancy, the withdrawal method was found to a popular back-up method in a small study conducted recently, as 89% of participants reported relying on withdrawal at some point in their lives. Researchers found that withdrawal use had become normalized in hook-up culture on college campuses, and most women assumed their partners would pull out, regardless of whether they were in a committed or casual relationship. Participants reported using this method alongside other contraceptive options like condoms or the pill.
Learning About Birth Control
Fewer teenagers today receive formal sex education than in the past, according to research from the Guttmacher Institute. In fact, the data showed an increase in the amount of young women receiving instruction solely on how to decline sex, not about birth control. “The idea of if we do not talk about it, they will not do it is unreal,” Eborn says. “While giving them the information for when sex may come up it allows them to choose how they want to take care of their bodies. And with that, what kind of contraceptives are out there will be a part of letting them choose what works for them.” Women interviewed for this article cited television, friends, family, the Planned Parenthood website, doctors and girl scouts as some of the sources from which they first learned about birth control. A few mentioned middle school and high school. Unfortunately, systems can’t always be relied upon to deliver information on this topic. While everyone’s experience differs, and the internet can be a helpful resource when all else fails, Eborn notes that community can be a powerful source of awareness and empowerment. “Having open communication with communities, as well as families, allows for young women to ask questions,” she says. “Creating a space where this can happen is really beautiful.”
