Tell me a little about your background in public health, specifically the family planning aspect.
I’ve worked in public health for over 35 years with a focus on social and behavior change to address public health issues in low resource settings. In this work, I’ve covered many topical areas including family planning, malaria, TB, HIV, safe motherhood, child health, COVID, etc. But at the beginning I was primarily focused on family planning and reproductive health.
I still have a very strong commitment to this particular issue. This stemmed in part from a year I spent in a country in Latin America where I realized that I had privileges that many women don’t have, including the opportunity for education and, of course, reproductive choice. This I think put me on the path that I ended up on.
In the many different settings around the world in Africa, Latin America and Asia, I’ve worked with colleagues in country to create demand for family planning, helping to inform women in couples about what the options are. But oftentimes much of the work is also focused on addressing some of the social and cultural barriers that exist around using contraception.
In many places, family planning is not accepted. Sometimes it is rejected on religious grounds or for fear that it will make a woman promiscuous, or that it is not safe. And people are often unaware of the value of family planning in terms of poverty alleviation, child survival and the overall health of a woman. Spacing children at least two years apart can help prevent maternal both infant mortality and morbidity.
Adolescent girls who find themselves pregnant are also at high risk as their bodies have not had adequate time to mature and they have difficult deliveries, In addition to being deprived of education opportunities. Unwanted pregnancies also often lead to unsafe abortions. These also put the lives of women at risk.
What are your thoughts about birth control? From a public health perspective? On a personal level?
From a public health perspective, family planning is one of the most cost effective interventions. I think it’s important to recognize the terminology is “family planning” not “birth control.”. Birth control was one of the tools used in the early days and the point is that it’s not about controlling population or size of families but it is about ensuring that families and women have the choice to decide when to have children and how many children to have.
Not surprisingly, I am an advocate both personally and professionally of family planning. I have used family planning throughout my reproductive years. And I used both the pill for many, many years and then condoms.
I think it’s safe to say that had I not been able to make the decisions about when to have my children I would not have been able to pursue the career I’ve had or decide at what point I wanted to have my children and to make sure that I was fully ready for the responsibility of raising them. And in fact in my early 20s I did have an abortion and had I not done that I would not have the life I have today.
What’s your experience being on birth control? Did you have noticeable side effects — physical or emotional? How long were you on it and in what forms?
Fortunately I never had any issue with using the pill and found it to be you know easy to use and quite effective. Of course, everybody responds differently. I didn’t have any major side effects. Yes my boobs got a little bit bigger but I wasn’t so worried about that.
For me the pill was the best option. I was never a fan of the IUD personally but that doesn’t mean it’s not good for other people and I think when it comes to family planning, the important thing is is that there are a multitude of choices and there is going to be a method that works for a woman and it really is a decision that should be informed by what the woman is comfortable with.
What was the standard birth control when you were in your twenties? Was it normalized in your social circle?
I think quite a few of my peers probably used the pill as well.
How old were you when roe v wade passed and what was it like to be a woman in America at that moment? What’s it like to be a woman in America now witnessing it being overturned?
Roe versus wade was passed in ‘73, at which point I would have been about 15 or 16. And I have to say while I knew it was happening, I think because I wasn’t engaging in sex at that point and I wasn’t really that conscious of reproductive health issues, I didn’t really have any strong feelings about it one way or another, except to understand that it was beneficial for women.
Frankly it’s horrifying that it’s been overturned and I am beside myself trying to figure out what I and others can and should be doing. It makes me angry to think that our country would strip this right from women and that women are not allowed to make decisions about their own bodies.
What was your own mother’s experience with birth control? Opinions on roe v wade etc.?
I don’t know what contraception my parents use but I suspect after I was born they were using something and I do know at some point in time my dad had a vasectomy. So I don’t think there was any objection in any way to the use of family planning among my parents.
Does it feel like a slap in the face to have a daughter privileged enough to access whatever birth control she chooses and who has the full support of everyone in her life to be on birth control opt against it?
Well yes, I didn’t know that you were opting out of family planning and I can only say that you clearly have your reasons for doing so but I hope and trust that you are taking the proper precautions to both protect yourself from pregnancy, as well as STDs.
What about when I told you I got an abortion? Did you think, “how could she be so stupid?”
When you told me about the abortion I just felt bad because it’s not a pleasant situation to find yourself in and it’s painful on a number of different levels but there’s no question in my mind that that was the right decision.
What are your thoughts about birth control being a hormone disrupting mechanism that can have dangerous repercussions on the female body?
With regard to hormonal contraception again, everybody responds differently. Some people have absolutely no issues whatsoever like myself. Some people have very strong reactions so I think it is very dependent on your body and how it makes you feel but there’s no need to throw the baby out with the bathwater because there are millions and millions and millions of women who successfully use hormonal contraception and have no downside to it. I had no problem getting pregnant when I wanted to after I stopped the pill and I had no issues with it when I was on it.
What are your thoughts on the privilege of birth control / access to safe abortions and the obstacles women who don’t have access face in their day to day lives — either in America or abroad?
I think Roe v. Wade puts a lot of women at risk. Unfortunately it puts women who have less resources, less access and are more vulnerable. It is going to cost women their lives – whether through accessing an unsafe abortion or whether their life becomes tied to the embryo that they are forced to carry to full term.
What are your thoughts about women being able to avoid pregnancy simply by tracking their cycle? I personally feel like health class lied to me when they said I could get pregnant any time of the month. In recent years, I’ve become more attuned to my body and cycle. Do you feel like birth control can make women out of touch with their bodies because they are kind of just going on autopilot and accepting hormonal disruption?
Yes, I think the cycle can be predictable and if you are conscious about understanding your body and have the ability to control when you are engaging in sexual activity, that can work for people. Again, it’s one of the choices out there.
But many women don’t have a choice. If they are married and if their husband wants sex, the man is often legally entitled to have sex, even without the woman’s consent. If this happens when you’re ovulating, it can put you at risk for an unwanted pregnancy.
What’s the most common form of birth control promoted in your line of work? How does it vary by region / culture etc.?
In our work we don’t promote one method over another. What we do is to talk about all the methods and focus on ensuring that access to different methods is there, so a woman can find something that suits her needs.
With that said, in many regions and countries there are preferences for different methods. In India for example, pill , vasectomies, and tubal ligations are popular. In many African countries Depot-Provera implants and IUDs are more popular because they are more convenient and more discreet than having to take the pill everyday.
For those with the privilege to access any form of birth control safely, what would you recommend?
I can’t recommend any specific method. That’s why it’s important for women to talk to providers to understand the benefits, the potential side effects, and the downsides of each method so that they understand what the options are and have the option to try something and say, “no this isn’t working for me, I want to move on to another method.” There is no one method that is going to be right for every woman. It’s a personal decision.
I notice the new gold standard seems to be the hormonal IUD, which entirely gets rid of your period. Does that seem unnatural and unsafe to you at all?
Yeah that’s interesting about the hormonal IUD. I don’t believe that not having a period is such an awful thing and had that been an option when I was in need of family planning contraception I may have opted for that. Hard to say.
Any closing thoughts?
Final thoughts – it does pain me to think we’re going backwards in the US, in that women who for very good reasons do not want to carry a pregnancy to term, will be forced to do so. It is also very concerning to me how the law will be applied, as many pregnancies naturally end in miscarriage in the early months and I fear that women will be potentially prosecuted for abortion when in fact she miscarried. It is simply unfathomable to me why the government and those in these positions feel the need to control the lives of women.