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Barbara & Shannon Kelley

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Freedom, Fertility and Feminism: The Real Cost of the Pill

Posted: 08/ 2/2011 3:25 pm

At long last: your birth control pills will finally be covered by insurance! The U.S. Department of Health and Human Services has announced sweeping new guidelines for women's health care to take effect Aug. 1, 2012. Among other things, these new guidelines will classify birth control pills as preventative medicine, meaning they'll be covered without co-pay or deductible. "Victory!" the email from Planned Parenthood cried. Huge news, hugely important -- and it has us thinking about something else. Something that might surprise you.

With the co-pays soon to be off the table, we got to wondering about the real cost of birth control.

It's tricky territory, touched upon in a recent issue of New York Magazine, which screamed from the cover: Fifty years ago, the pill ushered in a new era of sexual freedom. It might have created a fertility crisis as well. And again in the form of a personal essay by Elaine Gale, called Breaking up with feminism: A heartbreaking loss led to a new and deeper relationship-with the Feminine.

At issue: the not-so pleasant side effect of the power to impose a little control over our reproductive lives: that while we indeed have incredible control to suppress our fertility (while still expressing our sexuality) while we establish ourselves professionally, or financially, or just allow ourselves to get the sowing-of-the-wild-oats out of our systems, well, we don't have control over when our reproductive systems time out.

Just typing that out loud feels like we're traitors to the cause. Because, you know, the Pill is a good thing, as we've mentioned before. As Vanessa Grigoriadis writes in the NY Mag piece,

...the Pill, after all, is so much more than just a pill. It's magic, a trick of science that managed in one fell swoop to wipe away centuries of female oppression, overly exhausting baby-making, and just marrying the wrong guy way too early.

True, dat. Quoting Kelli Conlin, president of the National Institute for Reproductive Health, Grigoriadis goes on:
"Today, we operate on a simple premise -- that every little girl should be able to grow up to be anything she wants, and she can only do so if she has the ability to chart her own reproductive destiny."

...These days, women's 20s are as free and fabulous as they can be, a time of boundless freedom and experimentation, of easily trying on and discarding identities, careers, partners.


And, you know, why shouldn't we take equal part in that experimentation -- a time that's become so fundamental to the American experience, science types are trying to get it distinguished as an entirely new life stage? The Pill gave women power and freedom and equality -- and what could possibly be more empowering than that? These very things were the great promises of feminism.

Which brings us to Gale's story:

I loved all the things Feminism whispered to me at night when I couldn't sleep:

"You deserve the world on your own terms."

"I will take care of you and make sure that things are fair."

"You can have it all!"

...Meanwhile, my life had a repeating narrative: professional success, romantic mess. There was Mr. Right Now, Mr. Adorable Slacker, Mr. Too Bland, Mr. Has Potential, Mr. Too Old For Me, and then Mr. Artistic But Unstable.

I always thought that I had plenty of time to get married and crank out some children. Women can do anything they want when they want, right? That's what feminism was always whispering in my ear.


Then, at age 36, she married her husband. She writes:
We decided that we wanted to have a child, although at the time, I partly saw it as another box to check off. After the miscarriage, feminism and I had our falling out.

What's feminism got to do with it? Here's Gale's take:
Feminism was always going on and on about the importance of having choices. But I found that my biological choice to have a child was snatched away from me while I was being liberated.

I had been told that I could have my career first and have children second. That it wasn't either/or. I thought that it was going to be better for us than it was for our mothers. But my mom ended up with a wonderful career as a university professor and had three children.

Confused, I rued the day I fell under feminism's sway. How could I have been so naive? How could I have put off having children so late that I have possibly missed the opportunity to have children at all?


Tough stuff. And props to Gale for that kind of blunt honesty. And, in terms of delaying pregnancy, she is hardly alone.
The CDC, which surveyed data between 2007 and 2009, found that the birth rate for women over 40 in the United States rose steadily in those two years. In other age groups, it fell by 4 percent. Researchers claim that it is the sharpest decline in three decades.

...women aged between 40 and 44 experienced a 6 percent increase in births. Meanwhile, women aged 20-24 ("peak childbearing years") apparently decided to put babies on hold, as birth rate in that age range plummeted 9 percent.


One analysis attributes this phenomenon to fertility medicine. Makes sense. The study itself draws a link to the economy. That makes sense, too. And, when looking at such steep changes over such a short period of time, those things are likely no small part of the story.

But. We think there are other factors at play here, too, part of a larger trend. The same kind of things that we believe to be behind the Extended Adolescence phenomenon, the same kind of things that we believe to be behind the kind of commitmentphobia New York Magazine and Lori Gottlieb have written about.

Namely, that having a whole lot of options (or being told you have a whole lot of options) breeds a certain reluctance to commit. And what could possibly be more of a commitment than a baby? Real estate? Marriage? A job? A move? Bangs? Please. With the possible exception of a tattoo (although I hear they're doing impressive things with tattoo removal technology these days), a baby represents the ultimate in commitment. Women today have been sent out to conquer the world. We've been told we can do anything, that we can have it all! And that we are so very, very luckyto be able to do anything, to have it all! And, given those messages, is it any wonder we're a little gun-shy when it comes to commitment? Is it any wonder we want to get our fill of the world and it's opportunities before we sign on to settle down?

But it's more than that. A baby represents a far greater lifestyle change for a woman than for a man: even if the woman and the man are parents to the same child. In all likelihood, it'll be mom who'll take a time-out from the working world (and she'll probably-and by "probably" I essentially mean "most definitely"-get dinged for it) -- but most families today can't afford to have one-half of the breadwinners at home forever. Especially with a bonus mouth to feed, a mouth which may one day need braces, a mouth in a head that will one day require a college education... So it makes a lot of sense that a woman might want to wait until she gets a little more established, professionally, before she takes herself out of the game, even if its only temporarily. Because once she jumps back in, she'll find she'll be paying a price.

Back to Grigoriadis:

The fact is that the Pill, while giving women control of their bodies for the first time in history, allowed them to forget about the biological realities of being female until it was, in some cases, too late... Inadvertently, indirectly, infertility has become the Pill's primary side effect.

And ironically, this most basic of women's issues is one that traditional feminism has a very hard time processing the notion that this freedom might have a cost is thought to be so dangerous it shouldn't be mentioned.


And that, we tend to think, is the real trouble here. Not the cost itself -- but the reluctance to admit to it. It seems to me that we're shying away from what may be the biggest challenge for women today: admitting that freedom might -- no, does -- come with a cost. In the reproductive realm, yes, clearly -- but in the larger sense too: We're missing the rather nasty message that every choice entails a trade-off. That we can't have it all.

You read that right, sister. You can't. I can't. No one can. It's an ugly message, so is it any surprise so few of us want to go there?

So often, when we talk about "choice," we focus on all the options, and the things that we choose. But, by its very definition, making a choice entails not choosing something else. (It's no coincidence that the word "decide", the very word we use for making up our minds, ends in -cide -- which means to kill.) We just like to leave that part out; we don't talk about it.

But we think we should talk about that. Not least because there's something about talking about stuff that makes even the suckiest of stuff suck a little bit less. Seems like Grigoriadis might agree:

Sexual freedom is a fantastic thing, worth paying a lot for. But it's not anti-feminist to want to be clearer about exactly what is being paid. Anger, regret, repeated miscarriages, the financial strain of assisted reproductive technologies, and the inevitable damage to careers and relationships in one's 30s and 40s that all this involve deserve to be weighed and discussed. The next stage in feminism, in fact, may be to come to terms, without guilt trips or defensiveness, with issues like this.

The reluctance to discuss the very real consequences of putting off getting pregnant because we're afraid doing so would somehow discount the very important freedom that comes with being able to put off getting pregnant does us a disservice. Is that freedom of any less value because it comes with trade-offs? When we talk of choices only in terms of what we choose-and never with a nod to our feelings over what we consequently choose to leave behind... well, how empowering is that, really? (And when we talk of "having it all" as though all "all" entails is a big bowl of cherries, how are we to feel when we realize that, in aiming to have it all, what we've really wound up with is all of the work?)

They're tough questions, and they require tough honesty. Isn't there some kind of pill for that?

 
 
 

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At long last: your birth control pills will finally be covered by insurance! The U.S. Department of Health and Human Services has announced sweeping new guidelines for women's health care to take effe...
At long last: your birth control pills will finally be covered by insurance! The U.S. Department of Health and Human Services has announced sweeping new guidelines for women's health care to take effe...
 
 
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03:27 PM on 08/05/2011
Anyone know how the research is coming on freezing eggs like sperm? A male friend of mine went into nuclear engineering, and some of the older guys suggested freezing his 25 year-young, low radiation sperm, rather than waiting for his tellomeres to frazzle down the line. He was not in a long term relationship, but thought he would want the choice later in life.

When can women have a similar choice?
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jf12
When I saw her I marveled greatly.
12:30 AM on 08/05/2011
According to the current issue of Psychology Today and references
http://www.psychologytoday.com/magazine
smart people are having much less sex than dumb people in America, like half or less. For women, much of this effect can be attributed to hormonal birth control. For men it is undoubtedly the nerd factor, although one of the woman researchers assured readers that she tried to control for attractiveness in some unspecified manner.
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12:59 AM on 08/05/2011
I think that smart people have always had less sex than the less smart ones. Generally, the smarter one is, the more inhibitions one has.

Glad to hear you both had a restful (and marvelous :) vacation.

BTW, the link to PT does not work (at least does not show an article on the subject you mention).
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jf12
When I saw her I marveled greatly.
08:10 AM on 08/05/2011
Yes, it's a pay article, but the title is on the cover.

Anyway almost all studies show that intelligent people (present company excepted, perhaps) tend to be *less* sexually inhibited due to three main factors. 1) They are slightly less religious, among other potentially inhibiting ethical things. 2) They are much more sexually imaginative. 3) They tend to know a lot more sexually, and somewhat more people, i.e. to talk to about sex. It's not due to inhibition on the men's part.

Although smarter women apparently have lower sex drives, (e.g. 20% of female MIT students self reported masturbating http://www.gnxp.com/blog/2007/04/intercourse-and-intelligence.php), not so for men. Also besides generally higher frequencies of masturbating, intelligent men visited prostitutes more often. (http://www.halfsigma.com/2006/07/sex_drive_decre.html). It's not due to sex drive on the men's part.

On the men's part, it is entirely the nerd factor, and nothing else. Women do not like smart men for sex.
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HUFFPOST COMMUNITY MODERATOR
KJLSanDiego
12:28 AM on 08/05/2011
I, for one, am very grateful to the pill.
The only thing I will be glad about is when I'm trying to have kids - later down the road - I can finally burn off these lbs.
The pill makes you retain a lot of weight, but it's worth it!
Plus more ladies on the pill = less welfare moms!
Better for our economy!
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dancerctry
I love Gardening and Decorating
03:34 PM on 08/04/2011
In my case, we can only afford the one kid we have for now so the pill helps. I'm 31 so if in a couple of years my husband does a little better (I'm a SAHM) then we can talk about going off the pill.
11:40 AM on 08/04/2011
I'm not a woman so I may be very off-base, but what's the big deal with having babies? I thought a tenet of feminism was that your femininity doesn't depend on whether or not you are a mother, wife, Cosmo girl, etc.
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french queen13
my beloved is mine and I am his
08:20 PM on 08/04/2011
For me, there's nothing special about the breeding - it's not like getting pregnant is something unusual or clever or even necessarily intentional! - but the big deal is the massive changes and demands of pregnancy and parenting. I mean big deal as in major impact on a woman's life. But I certainly agree about it not being reflective of one's feminity, womanliness, completeness or anything else, save as one sees it for oneself.
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crowepps
05:39 PM on 08/05/2011
Some women actually like children and have them voluntarily because they enjoy them.
03:36 PM on 08/03/2011
let's not forget the other cost of letting all these lab-created hormones course through our veins each month: increased rates of reproductive cancers. nifty.
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catmagnet
Independent thinker
01:27 PM on 08/04/2011
Better than suffering in agony every month, with the bonus of an ER visit and morphine...
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El Chingaso
Fighting for mental superiority...
02:24 PM on 08/03/2011
I'm just waiting for my monthly health insurance premium to rise.
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wagymfan
03:04 PM on 08/03/2011
Right, because covering the co-pay is so much more expensive than paying for a pregnancy!
08:11 PM on 08/03/2011
When can I start getting those condoms free from the Pharmacy?
01:50 PM on 08/03/2011
Women who have gotten old enough to be infertile can simply adopt. There are some people who never are fertile, for a variety of reasons. Adoption gives you the option to parent, even if your ovaries are out of the game.
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Adamcs
Don't Panic
04:27 PM on 08/03/2011
Although I applaud adoption, and wish that more adults would consider it, there is nothing "simple" about what you describe. As a father I can tell you that realizing your dream of having your own children is rewarding in ways that nothing else is. As the friend of several people who are unable to create their own children I can also tell you that for many the inability to satisfy this most basic of human drives can be devastating. In some cases adoption can make the difference, and we should rejoice when that happens. In others, adopting when you can't (or won't) come to terms with your own grief over not creating life is the worst of all worlds. This isn't going to the market and selecting "boy, girl, or none of the above". This is an immensely complex situation of emotions, capabilities (can you *afford* to adopt?) and legalities. Let's not whitewash it, OK?
12:59 PM on 08/03/2011
I don't think there is every a "right time" to have children. If you wait for this right time you will likely watch it fly by you. This has largely been advertised with birth control though, side effects do include infertility later on. It's one of those things that must be weighed prior to deciding to use birth control. At the same time, with the new law making birth control more readily available, society should weigh the thought that using birth control will benefit everyone, in the sense that for every 1 person who is financially better off and cannot have a child, there may be 5 low income people who should just not be having any more children who may have become infertile. There is a larger amount of people with low income having babies then there should be (and by this I mean non contributing members of society who do not necessarily want more children or have them for the wrong reason). I say it's all a matter of a cost- benefit analysis. This is why using birth control is a very personal choice, but again one that should not be weighed lightly.
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Lady1genius
No se puede tapar el sol con un dedo
06:04 PM on 08/03/2011
Infertility "later on" is a reality for ALL women, not only those who take the pill. I had three children within six years in my twenties and at that point made the decision to become infertile forever through the miracle of tubal ligation. My sister on the other hand, never used birth control, had her first child at age 39, rapidly followed by two more in the following three years. No IVF, no infertility treatments of any kind, no birth defects.
All women are different, and you shouldn't feel pressured to become a mother until you're ready. As a previous poster pointed out, some women are never fertile. Since most young women don't get fertility work-ups prior to starting OCPs why would anyone assume the reason for infertility following pill-usage is because of the pill? Correlation isn't causation.
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sunnybunny
03:12 PM on 08/05/2011
I always wonder about people who say they never used birth control, and then they didn't have a child until they were pretty far along in age(in this case 39? wow). What do do you do? not have sex? just randomly end up not hitting the fertile days? Explain???
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FaceTheTruth00
I'm a girl.
12:53 PM on 08/03/2011
So, it's the pill's fault, rather than the woman who opts to take them, and how she plans for her future?

It's the pill's fault for forcing women to explore all of life's options and put off child-birth for the time being?

Say what?

The pill is not robbing anyone of anything. You choose to take it because you're not ready to have a baby. It's not like once you start taking the pill it erases your memory and you forget where babies come from and what you need to do to get one.

So basically some women wanted to exercise this freedom to live their lives without children, and then by the time they were ready, their fertility wasn't what it used to be.

But that blame goes to a pill instead of the person who took the pill?
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Adamcs
Don't Panic
04:30 PM on 08/03/2011
It's not the pills fault. However, the pill is marketed as a panacea of choices and often women (and their husbands) are not told about this reality when they make the decision. Yes, you are absolutely right that women need to own their decisions, but they also have the right to make informed decisions and often that is not happening because the information is just not being put out there.
11:55 PM on 08/03/2011
I think it is pretty much common sense that if you take the pill you are putting off having a child. It is not marketed as anything other than birth control. When you get the prescription you are told straight up that you will have a 1% chance of getting pregnant. There is no mystery. This is an informed decision. Blaming feminism or the pill is absolving yourself of responsibility for making the decision.
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Adamcs
Don't Panic
09:30 AM on 08/04/2011
Sorry, let me be more specific. What is not always being shared is the fact that the pill may interfere with *ever* having children. If you take the pill (depo, etc...) long enough, or into a certain age range your body may never regain viable fertility. I know people who have had this happen and never knew the risks. It is common sense that if you take the pill you are putting off having a child. But as this article points out you may be putting it off permanently without ever being aware of that risk.
04:30 PM on 08/03/2011
She was not blaming the pill... She was blaming feminism:

"Confused, I rued the day I fell under feminism's sway. How could I have been so naive? How could I have put off having children so late that I have possibly missed the opportunity to have children at all?"
07:01 PM on 08/03/2011
Feminism doesn't take away her ability to think for herself either. She made the decision to put off having kids, and every woman should be able to make it for herself. Blaming feminisim is just an easy way to avoid taking responsibility for her own decisions. After all, blaming feminism for everything is the cool thing to do these days.
12:14 PM on 08/03/2011
I am surprised there is anyone in the US in 2011 who was unaware of reproductive science. I started taking the pill as a teenager in 1997 and i knew exactly what the reality was (and still is). If you are informed, there is no mysterious fertility snatching attached to using the pill.
12:12 PM on 08/03/2011
I don't understand this need for "freedom" everyone has. With more freedom, comes more consequences, I'm afraid. I don't see anything wrong or unnatural with becoming an adult at 18, or AT LEAST when you graduate from college. I had plenty of fun during college, but by the time I got done, I was pretty sick of partying. It's so nice to come home and sit with my husband and watch the news, and I'm 27. I want to have kids before I'm 30--I always have--because we learned in Human Anatomy in 12th grade that after 30, it's already significantly more problematic to have kids. There could be birth defects, it may take longer, there might be miscarriages. I think there's a greater fear of growing up and being responsible than a fear of not have freedom and choices. We're basically letting people get away with being completely ridiculous for an entire decade--their 20s. I don't understand it; it's just my opinion.
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nikanj
free the fnords
11:16 AM on 09/24/2011
People are basically getting away with being ridiculous for an entire decade . . .

Not always the case. A lot of young women are working very hard in their twenties
to get established professionally, in fields where a pregnancy might temporarily
or permanently sideline them. My daughter will be turning 27 this fall, and is an
intern at a large teaching hospital. She has had serious relationships in the past,
but not at present; her medical training pretty much consumes her life. But, if
you live in St. Louis, she may be the one delivering your baby !

She would like to have a family. But when ? Realistically, her best choice would
be to marry someone who wants to stay home with the kids, and hope that her
pregnancies are uneventful so that she does not have work-related absence issues.
recless
Evidence first. Believe later. Maybe.
11:32 AM on 08/03/2011
Hm. In a way this is an issue with a shortening shelf life. In '67 when I was born there were 3.5 billion and now, 44 years later, 7 billion. Child bearing is going to be come a true privilege, in no more than 2 generations.
04:41 PM on 08/03/2011
You should be looking at the American population instead of the global population. We only have 4.5% of the worlds population and are only projected to hit 448 million by 2050. Our population density is not high, we have plenty of space, food, and water. Energy is a problem we can solve by then.

Compare population growth rates 2000-2010:
Europe had .8%, North America had 10% , Asia/South America/Oceana around 12-13%, Africa had 26% . As Africa develops that rate should go down. Europe for all it's wealth is dying.
09:54 PM on 08/03/2011
Europe is not dying. It is WAY overcrowded. They are SAVING themselves by having so few children, as there is not room for the people they already have.

Africa, with all the babies, is the place where people are dying en masse - from starvation, disease, rape, poverty, despair. Africa is dying. Europe, by contrast, is thriving.

Here in America, one of the wonderful things we stil have is open space. The last thing we need is a higher birth rate. Feminism is another sign of our progress and our ability to save ourselves from ourselves.
recless
Evidence first. Believe later. Maybe.
11:58 AM on 08/04/2011
Nation statistics are becoming less and less relevant. We are a global economy or at least nearing one. What people do in other nations matters. It isn't that we will end up with no land space... it is the resource wars that are coming which will be needed because we will not be able to support this population growth on the planet.
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enlightenedgirl
the truth will set you free
09:57 AM on 08/03/2011
Education has everything to do with infertility, NOT the Pill!  Girls today think they can have babies until they are 50 and it's just not so.  Education about fertility and what the time-line is to have children, that's more important than anything.

At 28 Fertility starts it's decline, slowly but surely, 28!  By the time you reach 38 your fertility rate has dropped to 35% and then every year after that it's cut in half.  That is just Fact.  Not unless you want to use Invitro, Surrogacy or Adoption, it's all the roll of the dice.  50 year olds don't get pregnant, that's why girls start their periods at 12.
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HockeyMom
I was here before SP and will be long after her.
09:44 AM on 08/03/2011
Less is more. We will deal with the time factor. It will take awhile for society to adjust but we will learn. It's easy to see why pregnancies are put off when you realize how hard it is to be a parent and how little support you will get. We might start appreciating what a woman goes through to deliver a healthy baby and then grow it to adult hood. We already make way less than a man and then take a big hit when we stay home to raise the next generation. Did you want children to know numbers and colors and letters before kindergarten? Well that takes time and commitment and money.
12:07 PM on 08/03/2011
Well said.
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JacksonJones
Absit iniuria verbis!
12:39 PM on 08/03/2011
Well said, HockeyMom.

- A grown-up kid of a hockey mom.