Regardless of Obama's new bill, between walking dogs in Brooklyn and prepping watches with lighter fluid at the Macy's photo studio, I have no healthcare--which means, firstly, that I no longer can afford to see a private gynecologist. But, never fear, healthcare-needy folks! Planned parenthood offers pelvic exams, paps, prescriptions and even maternity care for free pretty much everywhere. The problem is, it's a clinic environment; if you have an appointment, you still have to wait 30+ minutes to see someone, and then you are shuffled between receptionists and doctors for ages. Going to Planned Parenthood, at least in Manhattan, takes up your whole day.
Rants aside, once a doctor at PP did end up seeing me, she quickly was not only able to prescribe me birth control pills but also give me a year's supply (in packs of three) for free. However, she could not prescribe my original combination-hormone pills (estrogen and progesterone), the kind of pill most girls are on these days (e.g. low-ovral, ortho tri-cyclen). She said she could not give estrogen pills to a patient with any history of migranes--my first time hearing of this--so, the alternative she could prescribe, is the mini-pill, or the progesterone-only pill.
After reading that this "mini-pill" had to be taken at the exact same time every day (if you take it 2 hours later than usual, you must use condoms for 48 hours) and that 8 in 100 who take the pill end up pregnant (as opposed to 1-2 in 100, as with combination birth control pills), I panicked. What good is a pill that makes you paranoid that you'll get pregnant? With or without condoms (additionally), 8% is far too high.
These kinds of pills do serve their purpose, however. They are mainly distributed to women who are breastfeeding or are particularly sensitive to hormones so that they have a birth control pill option for their condition. And, progesterone-only methods outside of the pill (shots, implants) are proven to be even more effective than combination pills. Clinicians who study progesterone implants, for example, have found NO women who have gotten accidently pregnant while on said method.
But who cares--when only 2% of pill users actually use the "mini-pill" over combination? Well, with "all" the new healthcare laws springing up, as I briefly mentioned above, Planned Parenthood has attempted to contribute to the bandwagon of changes. According to their 9/14 press release, Planned Parenthood, in conjunction with the National Latina Institute for Reproductive Health (NLIRH), will be working "tirelessly" to include birth control prescriptions under the basic preventative plan universal to Obama's reform law. What this means is that, if achieved, basic health care will provide birth control pills without gynecology and without co-pays. Birth control pills will then be available to all those too afraid, ashamed, or barred from accessing them through gynecological means.
However, this idea has, of course, struck a cord in many. Most argue that birth control pills are NOT preventative care; in fact, the use of hormones outside of their natural production can cause moderate to serious side effects and can even lead to cancer. Some also argue that making the Pill available without a physician's in-between could not only lead to a more rapid spread of STDs throughout America but also a pap-test diminuendo. Without the necessary gynecological check-ups to ensure your pill refills, would women still feel compelled to do those check-ups on their own time?
Somehow, in this great debate, the mini-pill has marked a middle ground between those opposing universally accessible birth control pills and those promoting them as a real way of combating unwanted pregnancy. Because the mini-pill does not contain estrogen, taking it is not associated with heart disease, gynecological cancers, deep vein thrombosis or other serious side effects associated with combination pills. Thus, the mini-pill can be taken by pretty much any woman. In addition, the effectiveness of the mini-pill does not decrease when taking other medications. It is taken every day of the month with no placebos, and is also proven to reduce menstrual bleeding, cramps and other associated discomfort. It is, on paper, a fool-proof prescription to be applied to the masses.
However, when any type of birth control pill is prescribed by a doctor, the patient is instructed to take it at the same time every day. This does not differ with the mini-pill except that it is 100% true. As I mentioned above, if you miss a mini-pill by over 2 hours in one day, you are at a much higher risk of an unplanned pregnancy until your next period. If you miss a combination pill entirely (24 hours), you can take two pills the next day and continue without much increased risk. This difference between the two kinds of pills is apparent to physicians and some women, but to adolescents or inexperienced pill users--it might seem slight, slight enough to cause an unwanted pregnancy. Although the mini-pill is a great invention of science for many reasons (hey! people with sickle-cell anemia can now take birth control!), as the one easy-to-obtain form of birth control under new health care reforms, the little green things might cause more harm than good. What fifteen-year-old can remember to take their pill at exactly 10:53 every single day? What 33-year-old working two jobs and a night shift to pay the rent? 8 pregnancies out of 100 women is far too high of a statistic.
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