According to the Ebers Papyrus from 1550 BCE, ancient Egyptians once used a mixture of “honey, acacia leaves, and lint” to block sperm from entering the vagina, while their European peers preferred “lily root and rue” (Cuomo, McTavish). Pregnancy planning has come a long way since these herbal remedies, and as an intern at Peace Over Violence, Los Angeles’s largest crisis center, I know all about birth control.
Rather than various plants, modern contraception relies mostly on hormones. As a wild and reckless teen, I also know all about hormones. Estrogen is a naturally-occurring sex hormone, while progestin is a synthetic hormone that mimics progesterone, another natural sex hormone. Some forms of hormonal birth control only contain progestin because some people can’t take estrogen, or it would disrupt breastfeeding, but most forms have a combination of estrogen and progestin. These hormones work to keep eggs from leaving the ovaries and mushing up with sperm, while thickening the cervical mucus to prevent sperm from getting too close to the eggs. Super hot!
There can be bad side-effects, ranging from bleeding to vomiting, so it’s really important to talk to your doctor or healthcare provider before making big hormonal choices. They can help you figure out the best day to start using HBC, taking your menstrual cycle into account. If used as directed, “less than 1 out of 100” people will get pregnant while using these methods, if you have the ability to become pregnant. But HBC just protects against pregnancy, not STDs and infections, so condoms are key! And if you’re just starting to use HBC while still engaging in physical intercourse that could result in pregnancy, or “shtupping” as my mother scientifically calls it, use a secondary form of contraception like condoms or spermicide. Or tertiary! Quaternary!
Each form of HBC has varying costs, depending on your insurance and income level, and time commitments.
This is the most common form of HBC: 53% of the 3.2 million teenage girls who use contraceptives in the US rely on the pill, according to the Guttmacher Institute. You get a prescription for it from your healthcare provider and pick it up from the pharmacy. There’s typically 28 pills per pack. The first three rows of pills contain either the hormone combination or just progestin. The last row is sugar pills, meaning they don’t do anything, meaning you get your period that week. Basically, you count down the days to your next period like an advent calendar! Chocolate not yet included.
It’s just one pill a day, most effective when taken at the same time every day (with a 3 hour grace period) and the packs are fun to decorate with stickers. Sometimes it’s hard to remember to take the pill at the same time every single day, but Planned Parenthood has a handy guide on what to do if you forget to take a pill.
This has a similar cycle as with the pill, but this one is like a magic band-aid filled with the combination of HBC hormones. You get a prescription and a set amount for each cycle, then slap a patch some place where it won’t bother you, typically the upper arm. The patch has to be replaced every week, and regularity is important, just like with the pills. Pick a day of the week to be “patch day”, and try to stick to it. The fourth week is patch-free, and that’s when you get your period!
This is a shot of progestin, by a healthcare professional, in the arm or butt. Your choice! It lasts for 3 months, and some people prefer it because it doesn’t involve any patches or packs, so it’s really private.
...Which is way less than Tiffany’s. This round bit of plastic releases the hormone combination, and it’s by prescription, so it’s self-inserted. You pop it in once a month, let it marinate for 3 weeks, and then remove it for the 4th week so you get your period.
This is a matchstick-sized bit of plastic inserted into the upper arm, releasing progestin. Unlike prescription forms, you have to go to your doctor’s office or the local clinic because it would be kinda hard to put it in yourself. It can be removed (by a professional) anytime you want, but should definitely be replaced every 4 years. That’s how long it can last!
Intrauterine Device, or IUD
3% of American teenagers on birth control use this, so it’s truly a rare jewel of the contraceptive kingdom. It’s T-shaped with an attached string, and fits snugly in the area around the uterus. There are two kinds of IUD: progestin or copper. A copper IUD can even be used as emergency contraception if inserted within 5 days after unprotected sex. Copper repels sperm, like some kind of ovary amulet, because its ions mess with the sperm enzymes. The uterine fluids and cervical mucus will absorb these ions and start popping sperm on their own!
So those are the herbs available in our pharmacies and clinics today. I was very anxious the first time I went to Planned Parenthood, and I still get faint when we discuss birth control implants at work. I have friends who take the pill, or had the shot, or just use physical contraceptives when they have sex. I have friends who have IUDs but get skeeved out something inserted into their arm, and I have friends who must watch 15 minutes of cat videos at the mention of a “device”. People use birth control to plan pregnancies, control acne, make menstrual cramps suck less, or for a number of other health reasons. All of our explanations, and all of us, are valid. What matters is that we can choose how, when, and where we want to use birth control. We need access to education so we can make informed choices about our bodies, and we need healthcare providers and politicians to support our decisions. And then, we can all keep growing.
McTavish, Lianne (2007). "Contraception and birth control". In Robin, Diana. Encyclopedia of women in the Renaissance : Italy, France, and England. Santa Barbara, Calif.: ABC-CLIO. pp. 91–92. ISBN 9781851097722.
Cover Image by Hana Haley