Beyond contraception

It started in her mid-teens. Olivia Mitchell’s once manageable menstrual cramps became increasingly painful — so much so that it began to severely hinder the her ability to get through the school day. On her worst days, she couldn't even make it to school.

“I was 16 when I first started taking birth control,” said the now 19-year-old MSU student. “It was only during my period week, but that week of school I would be either miserable all day or at home in bed for a week. I couldn’t sleep at night because I would just be holding my stomach in pain. I couldn’t even focus on doing schoolwork at home.”

In lieu of prescription painkillers with a variety of potentially harmful side effects the Cleveland Clinic lists as ranging in severity from depression to constipation, Mitchell and her parents, desperate for a solution, opted to try birth control pills.

“I’ve always been prone to migraines, but being under so much stress and all that pain would start to trigger migraines,” Mitchell said. “The first step was managing the cramps, but from there (birth control pills) solved all the other problems too. I didn’t need to start taking medications for migraines or abdominal pain, it just kind of stopped it at the source.”

Mitchell is not alone in taking birth control for other than contraceptive reasons. According to a 2011 study by the Guttmacher Institute, 58 percent of birth control pill users between the ages of 15 and 44 found that they experienced benefits beyond the prevention of pregnancy. These benefits range from the prevention of acne to regulation of menstrual cycles, alleviation of menstrual cramping and even relief from endometriosis, a disorder where uterine tissue grows outside of the uterus and may cause severe pain.

Birth control pills are classified as hormonal contraception, according to the Washington-based American College of Obstetricians and Gynecologists. There are a variety of other birth control methods, such as patches, injections and intrauterine devices — better known as IUDs — of which the health benefits have been known to the medical community for years.

“We’ve known for many years that hormonal contraceptives have health advantages beyond preventing pregnancy,” says Robert L. Reid, MD, of Kingston, Ontario, in a 2009 press release for the American College of Obstetricians and Gynecologists. “These recommendations examine the scientific data supporting the non-contraceptive uses of hormonal contraceptives to treat specific conditions.”

Still, even with all their benefits, birth control pills are not without side effects. For most women, these are mild or unnoticeable and usually correct themselves within the first 90 days of starting the pill. Some people, however, can experience effects ranging from nausea and soreness to headaches and severe pain.

The fear of a potentially negative reaction to contraception keeps some women away from using it altogether, like 21-year-old MSU student Ellen McCartney.

“I wanted to go on it a couple of times before but decided against it, because the only reason I could think of that I would want to be on it was for acne health,” McCartney said. “When I did look into it, it had side effects like extreme nausea and vomiting. In some instances it made cramping worse, but not around your period, just cramping because of the hormones. I also know that fluid retention was a big part of it — it was just not something I wanted to deal with. I didn’t want to be bloated all the time.”

McCartney, who was raised Catholic, said that she isn’t closed off to the idea of using birth control, but she stays away from it for now because of her family’s beliefs.

“My mom is very, very against birth control,” McCartney said.

That stigma about birth control is something that McCartney said she has carried with her for a long time, but her views are changing.

“I definitely was raised to think that there was a stigma, but the longer I’ve been on my own and in a different environment, the less I believe that there truly is,” McCartney said. “I think that I was raised to believe in a stigma that no longer exists.”

Ruth Lednicer, director of media and communications for Planned Parenthood of Michigan, said that she’s seen this stigma lessen over the years but hasn’t seen it go away entirely.

“I do think it’s become more the standard that women will go and get birth control when they become sexually active, but by the same token, there are others on the right who are working really hard — someone just admitted on an interview this weekend on MSNBC that their goals are to make forms of birth control illegal,” she said.

Lednicer was referring to Students for Life President Kristan Hawkins’ in terview with MSNBC’s Joy Reid. In the interview, Hawkins was asked if hormonal contraception like IUDs should be legal.

“I don’t think they should be legal,” she answered. “They put women at risk and they kill children,” Hawkins said.

According to Lednicer, the goal of Planned Parenthood’s services is to ultimately decrease the number of abortions, both legal and illegal, by providing women with contraception, sex education and other services.

“The majority of what we do is prevent unintended pregnancy, which would reduce the number of abortions required,” Lednicer said. “We’re in the news a lot because of the abortion services that we provide at many of our locations. Overall, that is 3 percent of the services that we provide to patients.”

For many women, access to reproductive health services is limited because of barriers like the inability to pay for services, lack of accessible healthcare, or language barriers. Lednicer said that President Trump’s efforts to repeal the Affordable Care Act, commonly known as “Obamacare,” scared many women into scheduling appointments to get IUDs, which can provide contraception for three to 12 years, depending on the device.

“We did see a real spike after the election, and continuing on, of women calling and looking into the idea of getting IUDs,” Lednicer said. “They were afraid ACA would be repealed. Obamacare provides no copay for birth control, so it makes it much more affordable to get an IUD. And also they were worried that access to birth control in general would be limited, so they wanted to do something that they knew would last throughout the entire presidential term.”

Many women continue to support reproductive health organizations through events like the Stand with Planned Parenthood rally, scheduled in Lansing for Feb. 11.

That worry about healthcare access was likely heightened by Trump’s expansion of the “global gag rule,” which removes U.S. family planning funds from foreign groups that are involved in abortion services, even in referring patients to get them. And then there’s the longstanding Republican efforts to defund Planned Parenthood which could make receiving quality healthcare, especially for low-income women, even more difficult. Lednicer said that of the thousands of women who come to Planned Parenthood, people qualifying for Medicaid would have the most difficulty if Planned Parenthood is defunded.

“Right now, patients who qualify for Medicaid can come to Planned Parenthood to get their services. If they’re successful in ‘defunding’ us, what it means is that it we wouldn’t be eligible to get Medicaid reimbursements,” Lednicer said. “That means if you are a Medicaid patient, you wouldn’t be able to come to us. You would have to find another provider willing to take Medicaid reimbursement.”