Every year I go to the gynecologist and have the same conversation. It goes something like this:
Me: “So, do you think I should go off birth control?”
Me: “Well, I’m not having sex with anyone. Ever. So it seems kind of silly.”
Me: “I’ve been on it for ten years now. Maybe I should take a break.”
Doc: “It’s not good to go off and back on. It’s better just staying on it.”
Me: “Really? It’s not doing weird things to my body, constantly pumping myself full of hormones?”
Doc: “Nah, you’re fine.”
Me: “Okay. If you say so.”
From what I understand, the pill works by releasing hormones that are usually released during pregnancy. Essentially, you don’t get pregnant because your body has been tricked into thinking that it’s already pregnant. This means that for the past eleven and half years, I’ve been tricking my body into thinking it’s pregnant. What will happen when I actually want to get pregnant? Will my body accuse me of crying wolf and refuse to comply?
And, let’s be honest, the number of times that I’ve needed birth control for its intended purpose of preventing pregnancy is depressingly low. I’m all about contraceptives for those who need it, but isn’t it kind of ridiculous that I’ve been taking a drug every single day for over a decade that I don’t actually need? My doctors say no, this is perfectly fine.
Doctors often don’t take my concerns seriously. Last year I had a strange growth on my leg. I thought it was an ingrown hair and went digging around in it with a safety pin I’d dipped in rubbing alcohol. Naturally, that didn’t make it better, so then I just waited for it to go away. Five months later, it was still there, so I went to see a surgeon. The conversation went something like this:
Me: “What is it?”
Doc: “I don’t know. We’ll just cut it out. Go set up an appointment with the front desk.”
Me: “Well, now, wait.” [I was beginning to feel panicky. My legs were what I used to attract men.] “Cut it out, you say? Is there going to be a scar?”
Doc: “Yeah. About two inches.”
Me: “Will it be noticeable? How are you going to cut it out? Don’t we need to know what it is and where it came from?”
Doc: “Nah, it’ll be fine.”
Me: “Okay. If you say so.”
After my experience with the surgeon, I began to notice how nonchalant all my doctors were about everything. When I went to them with a medical concern, like should I go off birth control, or should I be worried about this weird rash, they waved their hands and made some sort of general, “don’t worry, you’re fine” type of statement, often accompanied with the offer to write me a prescription for something. I suppose that, me being a relatively healthy person, my concerns seemed to them like small potatoes, but still, I didn’t like being treated as if my worries weren’t even worth discussing.
Lately I’ve been thinking that a doctor’s advice might not always be the best advice. After all, they’re only human. They don’t know everything. Plus they’re often tired and overworked. And they’re not immune to bias. They’re swayed by drug companies and incentive programs and their own opinions. And sometimes they’re swayed by what’s quick and easy. Last year, when I complained of a reoccurring headache, all my doctor did was write a prescription. It was easier for her to prescribe pills than to work with me to figure out what was causing the headaches in the first place.
My best friend from high school, Anita, is a midwife, and she believes that many doctors are not doing what’s best for women during hospital births. The epidural, she says, numbs the woman so she doesn’t know when to push. This often causes complications which can lead to a C-section. When a woman is induced, this also tends to end in a C-section. “Doctors love doing C-sections,” Anita says. “Because they can schedule them. They can do the procedure and go home. It’s easier for them.” Also, I found out, many health care providers pay doctors and hospitals more for a quick C-section than for a vaginal birth. So doctors have incentives for recommending a C-section, incentives that have nothing to do with the health and well-being of a woman and her baby. A C-section is a major surgery that takes much longer to heal than a vaginal birth, but when a doctor recommends it, the woman assumes that the doctor knows what’s best. I imagine the conversation goes something like this:
Doc: “Let’s cut you open and take out this baby.”
Woman: “What? Right now? But I wanted to try for natural child birth!”
Doc: “Here’s the nurse with the epidural.”
Woman: “I’m not sure if I want the drugs. Is it going to harm the baby?”
Doc: “It’ll be fine. We’re going to take you into surgery now.”
Woman: “Is it going to take long for me to heal? Am I going to have a scar?”
Doc: “Eh, you’ll be fine.”
Woman: “Okay. If you say so.”
Of course I’m exaggerating, but I do think it’s true that many doctors don’t take the time to explain things fully. They don’t always take the time to make sure their patients understand all the pros and cons of a certain drug or procedure. After all, they are trained to provide drugs and procedures. They have seen so much – death and debilitation and terminal illness, that they mean it when they say, “eh, you’ll be fine.” Because yes, there are many health concerns that are much, much worse, than the little ones I have. But still. It’s my body, and I have concerns about it, and I want those concerns to be treated with respect.
The other day I went to CVS and learned that I had run out of refills for my birth control. I thought the prescription ran through October, but apparently not. “Do you want me to call your doctor and see if she’ll refill it over the phone?” the pharmacist asked. “No,” I said. I was taking this as a sign. It was time to stop taking a drug I didn’t need it.
I’m one week in to my life without birth control, and so far I don’t notice any differences. Will my acne come back? Will I start having longer periods with those horrible cramps I remember from my youth? Will I meet someone tomorrow with whom I will want to eventually have unprotected sex? Will I have to go to the gyno and ask to be put back on birth control? Luckily, if I do, I imagine the conversation will go something like this:
Me: “Are you sure it’s okay? You said going off and on isn’t good.”
Doc: “Eh, you’ll be fine.”