As a postpartum mom of three children, I am very familiar with the routine recommendations for hormonal birth control (HBC) offered to new mothers. With my first son, I was told that HBC was the only answer to my continued irregular bleeding at three months postpartum. Only minutes after the birth of my second son, I was asked if I wanted an IUD inserted in-hospital to ensure I didn’t get pregnant again too soon.
Even though I turned down HBC in both of those circumstances, I recall the fears instilled by this medical advice. What if there was no way to stop my bleeding, and I wasn’t making the right medical choice? What if my fertility awareness method (FAM) failed me, and I did get pregnant again too soon? It was only after this most recent pregnancy and birth that I had the confidence to decline HBC without any nerves. I knew the research, and I had successfully avoided and achieved pregnancy three times now using FAM. I knew that synthetic hormones were not the right option for me, my breastfeeding journey, and my family planning intentions.
The number of women rejecting HBC is on the rise
The number of new moms shunning hormonal birth control is on the rise. According to the New York Post, women, particularly those in Gen Z, are increasingly recognizing that synthetic hormones may not be their healthiest option for family planning. A recent article by Romper, a website all about navigating motherhood, looked at the journey of multiple mothers as they decided that HBC was not the right choice for them.
Even though many women feel confident that the synthetic hormones in HBC aren’t good for their bodies, the decision to forego birth control (especially right after having a baby!) still comes with many fears. Women have not been properly educated on how their bodies function, and many wonder, like I used to, if they’re making the right choice. Will they be able to successfully avoid pregnancy without chemically suppressing ovulation via HBC?
HBC risks lead many new moms to seek more natural family planning options
Why are so many moms choosing more natural family planning options? According to Romper, the answer lies in women’s discovery of the unfavorable side effects the various forms of HBC carry. There are many side effects to birth control in general, but did you know there are risks specific to the postpartum period? HBC that contains both synthetic progestin and estrogen increases a new mom’s risk of blood clots in the first few weeks after birth, and even progestin-only birth control pills (i.e., the “mini pill”) and devices may have an effect on breast milk supply. Additionally, postpartum women, especially those who are breastfeeding, are at an increased risk of migration, expulsion, or uterine perforation of IUDs. Some new moms are uncomfortable having an invasive device put into their bodies shortly after delivery, when they’ve not even had any time to heal from childbirth.
But the two biggest concerns many new moms have over HBC risks center on breastfeeding and/or mental health concerns.
Breastfeeding
Can HBC decrease milk supply? And do the hormones leech into breast milk? Most doctors will not prescribe breastfeeding mothers combined HBC (i.e., those that contain both synthetic estrogen and progestin) as those are known to decrease milk supply. And this doesn’t just apply to oral contraceptives. The Nuvaring is known to cause the same issue, as well.
However, inadequate research has been done to determine the effects any form of HBC can have on breastfeeding. One of our previous articles written by an International Board Certified Lactation Consultant (IBCLC) notes anecdotal evidence that even HBC claimed to be “safe for breastfeeding” may not truly be safe. Rather than assuring women that their HBC use won’t impact breastfeeding, a more honest answer, based on existing research, may be simply “we don’t know.”
Mental health
In the Romper article, one mom commented on the irrational rage she felt while on HBC during the postpartum period. Hers is not an isolated experience. More and more moms are sensing that HBC could be affecting their brains and moods, and they are not wrong. From mental health to libido concerns, research is finally catching up with what women on HBC have been experiencing all along.
Postpartum depression affects an average of 1 in 8 women. The connection between depression and birth control alone is well-known, so postpartum women using HBC have an additional risk of developing anxiety and depressive symptoms. With the already-increased risk for mental health struggles in postpartum women due to the rapid drop in hormones following birth, it is no wonder so many new moms are shunning HBC. It is only natural to want to feel your best while taking care of a new little human–or, at a bare minimum, to avoid anything that might make you feel worse.
What some moms are choosing instead of HBC
The growing trend amongst the newest generation of mothers appears to be towards “more natural” family planning alternatives. The Romper article shares about some new moms’ journeys to using fertility awareness methods (FAMs) as a natural alternative to birth control. As a FAM instructor and user myself, I can attest to the many benefits of practicing fertility awareness not just for my confidence in family planning, but also for my mental, physical, and relational well-being. The health benefits of ovulation alone, on which women on HBC miss out, are a major benefit for FAM users. But FAM also helps a couple to recognize that family planning is their shared responsibility.
“How dare you ask me to do anything else?”
Many new moms feel like HBC puts the weight of family planning entirely on them. They are tired of having to carry the load of putting synthetic hormones in their bodies or undergoing invasive procedures to avoid getting pregnant. After all, a mother’s body undergoes enough challenges, stress, and strain during pregnancy, birth, and postpartum.
Emily, a new mom quoted in the Romper article, used birth control for 15 years before conceiving her first child. She commented, “My whole reaction to [having to use contraception after being pregnant and giving birth] is ‘how dare you ask me to do anything else?’ I took the Pill to keep us from getting pregnant when we didn’t want to get pregnant. When we wanted to get pregnant, I created and birthed and nursed our children. My body has been through the wringer. I have done my part.” It makes sense for Emily (and every other postpartum woman) to be able to honor her body and allow it to recover and adjust to its new normal, rather than pumping it full of hormones that may interfere with that process in untold ways.
Thankfully, FAMs are an evidence-based solution to this problem that allows couples to avoid either partner going through temporary (via HBC) or permanent sterilization. When used correctly, FAMs are intended to be a practice shared by both people in the relationship to help them acknowledge their shared fertility.
What’s the best first step to come off the Pill?
For many new moms, coming off HBC can be daunting. They may have been on the Pill since high school or have always used HBC as their preferred method of family planning. If this is you, and you want to start the journey to more natural family planning options, we have a multitude of resources to help you along the way! The first step is simply deciding to make the change.
Additional Reading:
What does birth control do to women’s ability to process fear?
Strategies to help prevent Postpartum Depression (PPD): The Mismatch Hypothesis
Concerned about postpartum mental health and milk supply?
IUD placement right after birth might be unethical—and unnecessary
