New Book on Birth Control Overlooks Evidence

September 11, 2013

The new book “Sweetening the Pill: or How We Got Hooked on Hormonal Birth Control” by Holly Grigg-Spall has generated a lot of discussion and critical response — with good reason.

Grigg-Spall argues that the birth control pill is actually making us sick, and feminists don’t want you to know this.

As a feminist women’s health organization that puts a premium on evidence-based information, we disagree.

As noted in the most recent edition of “Our Bodies, Ourselves,” modern oral contraceptives, which are among the most intensely researched pills in history, are safe for most users. That’s not to say the pill is for everyone — as with any medication, some people’s bodies don’t react well — but in general the pill is an excellent option for many women.

Women who use oral contraceptives are at increased risk of having a blood clot; however, the overall risk is still very low (about six women in 10,000 over the course of a year). In fact, the risk is much higher for women who are pregnant or who have recently had a baby. In addition, the pill carries a number of long-term health benefits, including lowering the risk of ovarian and endometrial cancers.

Our Bodies Ourselves has consistently monitored the safety aspects of the pill and has been critical when the evidence has called for it. OBOS has, for example, helped to spread awareness about the safety concerns of newer drospirenone-containing contraceptive pills like Yasmin and Yaz, and has questioned the FDA’s review of these drugs, which carry higher risks for blood clots (about 10 women in 10,000 taking contraceptives with drospirenone over the course of a year) than older versions of the pill.

The National Women’s Health Network, which advocates for the FDA to take drospirenone pills off the market, has likewise has been a longtime advocate for cautious approaches to contraceptives. (Its co-founder, Barbara Seaman, literally wrote the book on safety concerns about early — 1960s — higher dose versions of the pill.) OBOS and NWHN share a common value as organizations in favor of evidence-based approaches to the risks of any drugs targeted to women.

Fortunately, numerous reviewers are calling out the problems with “Sweetening the Pill.” Lauren O’Neal writes that Grigg-Spall overlooks real benefits of the pill, while Jill Filipovic raises concerns about “scaring women away from highly effective forms of birth control with inaccurate claims.”

Grigg-Spall’s essentialist argument is also under fire. Over at Slate, Lyndsay Beyerstein asserts that “Sweetening the Pill” “offers an insultingly reductive account of what it means to be female:

“If we shut down the essential biological center of femaleness, the primary sexual characteristics, then can we say that women on the pill are still ‘female’?” Grigg-Spall muses, casting ovulation as the sine qua non of femaleness. If so, postmenopausal women, pregnant women, girls, ovarian cancer survivors, and transwomen aren’t really female.

It’s easy to write off Grigg-Spall’s inaccurate and reductionist account, but it’s worth noting that this perspective threatens to distract from the discussion that needs to be happening: Instead of promoting fear, women should be offered more evidence-based information on the benefits and side effects of all contraceptive methods, along with more comprehensive sex education and improved access to their method of choice.

To learn more about the pill, check out:

To learn more about safety issues related to pills containing drospirenone, see these previous posts:

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