In 2022, the U.S. Supreme Court overturned Roe v. Wade, which had solidified abortion as a federal constitutional right. Ever since, abortion bans have been sweeping the nation, but the ripple effects of the Dobbs v. Jackson Women's Health Organization decision have trickled into other reproductive services.
Contraception is one example. According to a study published in April by JAMA Network Open, contraception services in the United States decreased in the months following the Supreme Court decision.
This drop could be attributed to myriad reasons—from the lack of practitioners in states where reproductive health services have become limited, a lack of reliable information regarding different birth control methods and their side effects, and a recent wave of misinformation on social media about birth control.
Rampant misinformation about the safety and efficacy of birth control has been a result of a lack of education and the prevalence of incorrect information about birth control methods in a post-Roe United States, leaving women at risk for unwanted pregnancies as state abortion bans emerge. Although access to contraception is federally protected by the likes of Griswold v. Connecticut and Eisenstadt v. Baird, the recent restrictions surrounding abortion care services have others worried about whether contraception access could be next, especially following the reelection of Donald Trump as president. Some states with abortion new bans and restrictions have already made accessing contraception more difficult.
Why the Shift?
According to a January 2024 study released in The Lancet, 1 in 4 Americans who use contraception are not using their preferred method, and one of their reasons is concern about side effects. Much of this uncertainty comes from the lack of reliable and complete information regarding the side effects of hormonal birth control use, leading some users to express interest in natural family planning.
Oral contraception works by using the hormones progestin and estrogen to prevent pregnancy and is taken once per day. The birth control pill can be up to 93% effective in the prevention of pregnancy and can also be used to alleviate conditions such as acne, bone thinning, ovarian cysts, endometrial and ovarian cancer, and iron deficiency, among others. Almost one-third of contraception users experienced side effects from birth control in 2022, the most common being headache, nausea, sore breasts, changes in menstrual cycle, and spotting. Less frequent but more serious outcomes include high blood pressure, blood clots, heart attacks, and stroke, which are more usual among those who already have cardiovascular conditions.
Natural family planning does not use external hormones and relies on tracking ovulation to prevent pregnancy. This is accomplished by closely following the menstrual cycle, monitoring cervical mucus, or tracking basal body temperature. When done correctly, this approach can be highly effective at preventing pregnancy, but the risks of error are high and those with irregular menstrual cycles may find this method difficult. If not done properly, the risk is an unwanted pregnancy. The discussion surrounding birth control methods has brought to light the lack of reliable information surrounding the safety, effectiveness, and side effects of birth control options.
Given this lack of reliable information, the perfect storm is created for misinformation. Across social media platforms such as TikTok many people have documented their switch to natural family planning, which they call natural birth control. Many cite a variety of side effects that they experienced while on hormonal birth control being resolved by switching to a natural family planning.
No person is the same, and no birth control option will fit the needs of everyone who opts for it
This growing pool of misinformation, along with the pressure of social media influence promoting natural family planning, could dangerously mislead women when they are in search for an effective birth control option because many fail to explain how to use this method effectively to prevent unwanted pregnancy. This situation underscores the need for better comprehensive sex education and reliable information surrounding birth control methods. No person is the same, and no birth control option will fit the needs of everyone who opts for it, but what can be done is to encourage people to decide in a safe and informed manner.
How to Prepare
The Lancet study urges the need for a person-centered approach to contraception tailored to the needs and wants of patients so that the conversation surrounding the choice is not a one-size-fits-all and patients can be given viable information about a variety of methods before they make their decision.
Another option is comprehensive sexuality education, or a "a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality–enables young people to protect and advocate for their health, well-being and dignity by providing them with a necessary toolkit of knowledge, attitudes and skills." Young people from 15 to 19 were found to be 50% less likely to experience pregnancy than those who received abstinence-only education.
Having conversations about sexuality and contraception with its side effects gives people the opportunity to make informed decisions about their care and bodies. Doing so can also provide a reliable avenue for information to combat the slew of misinformation surrounding contraception across social media.
