Analysis

Is being on birth control safer than being pregnant?

pregnant, abortion, CDC Hyde Amendment, birth control

We’ve all heard the now-debunked claim that abortion is 10 or even 14 times safer than childbirth. But recently, the executive director of the Illinois Pharmacists Association made the unusual claim that taking hormonal birth control is safer than being pregnant. In an August 5 State Journal-Register article, pharmacist and IPA executive director Garth Reynolds dismissed safety concerns regarding the implementation of Illinois’ new law allowing pharmacists to dispense hormonal birth control — even an initial prescription — without a doctor’s office visit.

In an attempt to downplay the very real safety risks (previously covered here) of dispensing hormonal birth control (even to minors) without patient-doctor contact, Reynolds commented, “You are much more likely to die if you get pregnant than if you take birth control pills, and much more likely to form a blood clot when you are pregnant than when you are on birth control pills. So it is safer than what it is preventing.”

Pregnancy is not a disease

Reynolds made an apples to oranges comparison when he seemingly weighed two dangerous things and judged one (hormonal birth control) to be the lesser of two evils, because pregnancy is not a pathology or disease. Pregnancy is a natural physiological condition and is vitally necessary for the continuation of the human race.

Leah Jacobson, founder of the Guiding Star Project, calls the female ability to gestate a “feminine superpower” along with the abilities to menstruate, ovulate, and lactate. And while a devaluing of the miracle of pregnancy has been an unfortunate consequence of abortion advocacy over the years, the fact still remains that each and every pregnancy is the carrying and development of a unique, unrepeatable life with infinite dignity and worth.

Hormonal birth control use has real risks

Reynolds’ statement that pregnancy has a higher blood clot risk than hormonal birth control (HBC), while objectively true, is an incomplete assessment of total risk from hormonal birth control. While pregnancy and the first six weeks after delivery have a five-fold increased risk for blood clots, hormonal birth control increases risk by two to four-fold, and the highest risk is for women using the transdermal estrogen patch or the vaginal ring.

Of further note, while pregnancy is time-limited and the average woman has two children in her lifetime, women tend to be on hormonal birth control continuously for multiple years in a row. Consequently, their lifetime risk of ever having a blood clot could easily be higher from taking hormonal birth control versus from being pregnant. Blood clot risk for both pregnant women and women on HBC is higher with increasing age, obesity, family history of blood clots, having certain genetic mutations, or history of smoking.

But HBC has other serious, potentially life-threatening side effects. Hormonal birth control also comes with a significantly increased risk for new-onset depression and even suicidal ideation, especially among young women. Disturbing research from Denmark quantified the severity of this risk, as “Women who were on hormonal contraceptives [in the eight-year study] were twice as likely to have attempted suicide” as those not on HBC.

READ: Teen’s massive stroke and subsequent coma attributed to hormonal birth control

HBC has also been associated with increased risk of breast and cervical cancers, and combined oral contraceptives are classified by the World Health Organization as a Class 1 (known) carcinogen. Notably, women who took HBC appeared to have decreased risk of endometrial, colorectal, and ovarian cancers, but increased breast cancer risk from HBC is particularly concerning as it is more likely to kill women (especially young women) than cervical, endometrial, colorectal, or ovarian cancer.

Also importantly, HBC that is prescribed for reproductive issues functions as a Band-Aid and does not actually solve anything. While going on the Pill may stop a woman from having painful periods, for instance, it cannot address why she is having painful periods in the first place. While HBC covers up what’s wrong, women who learn to chart their cycles with fertility awareness methods (FAMs) and work with trained medical professionals, such as those certified in FEMM Health or NaProTechnology, seek actual solutions that restore reproductive health and overall wellbeing. HBC use for contraception encourages the exact opposite of health literacy, as the whole point is to “set it and forget it.”

READ: Two dads whose daughters died from hormonal birth control are educating women on risks

While HBC risks are highest in women who are obese, smokers, or have other medical problems, cycling through multiple methods of HBC due to unpleasant side effects is common for healthy women too, even healthy young women.

Pregnancy has risks, too

Certainly, pregnancy is not without certain specific, potentially serious risks, like preeclampsia or eclampsia, HELLP Syndrome, gestational diabetes, and gestational hypertension (high blood pressure). Complication rates have logically risen as older women — many of whom delayed childbearing for the sake of a career or attainment of other personal aspirations — are getting pregnant. Women are most likely to experience these complications if they are over age 35, smokers, drug users, obese, or have other preexisting medical conditions such as heart disease, uncontrolled high blood pressure, diabetes, etc. before they get pregnant.

But the majority of pregnant women are young and healthy, and are consequently unlikely to experience life-threatening complications — because, again, pregnancy is a normal, natural physiological process. In fact, research suggests that pregnancy is often a motivating factor for women to make necessary lifestyle changes such as stopping smoking and improving nutrition. Research has also found that pregnancy and motherhood lead to increased “perception, efficiency, resiliency, motivation, and emotional intelligence.”

The preference against pregnancy influences the comparison

Sadly, the push for greater female representation in various professions, graduate-level programs, and the like has sometimes led to a societal misperception of pregnancy as a liability or a burden — something to be avoided at all costs if a woman is to succeed or advance personally or professionally. The broader societal ripple effects of this attitude of pregnancy discrimination have had devastating consequences for real-life women who do become pregnant, particularly for female competitive athletes and actresses who have felt tremendous pressure to abort their children. The “easy” way to avoid the seeming burden of pregnancy is through the use of HBC. It’s clear to see how this societal view could influence people to inaccurately view pregnancy as a risk while minimizing the dangers of HBC.

Certainly, pregnancy changes the mother in countless ways. Physically, her blood volume increases, her oxygen requirements change, her immune system downshifts to accommodate the genetically separate person inside her, and her breasts, cervix, ligaments, and skin all adjust to accommodate this new life. These physical changes have real-life consequences and can lead to a need for real-life accommodations at work or school. But a society that values motherhood understands and expects these changes and supports pregnant women through them, rather than penalizing or judging them for these expected needs.

Comparing the risks of birth control to those of pregnancy is an apples to oranges comparison, especially given that pregnancy is a rare event for the majority of women while HBC use for years, even decades, on end is common. A better comparison would be to assess the health of nonpregnant women on HBC versus nonpregnant women not taking HBC.

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