THIS WEEK, the Chicago Tribune published a story on an abortion doula. For those of unfamiliar with the term, a birth doula is someone who provides emotional and physical support and comfort to a woman going through the birth process. The article explained that the idea of an abortion doula is the same – someone who can help demystify the procedure, give reassurance, and act as a kind of well-informed friend.
Last week, I was interviewed by Emily Varnam, a birth doula who also co-hosts the “Hail to the V” podcast. During our conversation she mentioned that she is keen to develop a new doula-based concept – a birth control doula. A birth control doula would assist women who are in the transitional phase between using one type of birth control and another. It’s another phase in a woman’s life wherein she can often feel disempowered, confused, and anxious about advocating for her own needs.
The period of time between stopping a specific birth control method and starting another one is when a woman is most likely to have an unplanned pregnancy. The number of women relying on less-effective methods of birth control, such as withdrawal or basic period tracker apps — essentially a digitized rhythm method — has increased in recent years. Not only that, but with women staying on hormonal birth control for longer, more are suffering from withdrawal effects when they come off, which can include acne, anxiety, and insomnia. For some, their periods do not return rapidly or they might return with symptoms of PCOS or endometriosis, problems that hormonal birth control has suppressed but not treated.
The most common birth control transition is from one hormonal method to another, as women try to avoid or skip out on side effects from drugs and devices. There’s a lot of support out there for women who want to do this. Planned Parenthood provides women with information on how to make that switch, and an increasing number of OBGYNs are advocating for long-acting methods like IUDs or implants. However, just as many birth doulas work with women who want to avoid the unnecessary intervention that can come with a hospital birth, birth control doulas could provide much needed support to women who want to choose non-invasive contraception, such a barriers and fertility awareness.
Women who choose this route tend to do so because hormonal birth control methods really don’t work for them. However, many report coming up against hostility over their choice from their doctors or healthcare providers — not to mention their partners. Coupled with a lack of information, this outright hostility and skepticism can oftentimes nudge a woman feeling isolated in her choice into getting back onto hormonal birth control and restarting the cycle. Most women might turn to their friends and family, but would more likely than not find misunderstanding and misinformation there as well. A birth control doula could provide additional assistance in the same way a woman might have a midwife assisted by a birth doula; after all, we already have all kinds of professionals providing elements of birth control doula-like care, such as nutritionists, acupuncturists, women’s health coaches, fertility awareness practitioners, and even app developers.
Women hold a lot of fear around the transition from hormonal birth control to non-hormonal birth control because we’ve been led to believe choosing the latter is irresponsible and misguided. At a time when feminism is all about supporting women’s choices, this one decision can be met with condescension, anger, and incredulity. Imagine a situation wherein women could take their doula to their Planned Parenthood appointment for a post-Pill gynecological exam or to discuss getting a prescription for a diaphragm? Or to their OBGYN appointment to discuss their PCOS diagnosis and options? Although we hear more about women needing support to avoid the pressures of anti-choice activists outside clinics, support is also needed for women working with those who don’t or won’t understand the choice not to use the Pill or an IUD. A birth control doula might also provide appropriate counseling for someone dealing with a partner who is not willing to cooperate with their choice.
Likewise, with the support of a birth control doula, women might be less likely to be scared back onto a drug or device they don’t want to use, and more likely to successfully use barriers and fertility awareness. A birth control doula fostering body literacy from the start of the transition could see women empowered to make the right decisions for themselves and for their whole reproductive health. Let’s not forget — women come off hormonal birth control methods in droves all the time, regardless of what’s in the news or available to them at the time. The issue is that they get very little help when making this decision.
There are many psychological barriers that arise when women look to learn fertility awareness and address reproductive health issues. A birth control doula could help a woman feel safe in her body and provide basic information that most won’t have heard or discussed since high school. With so much more information out there these days about fertility awareness — a whole lot of it incorrect, if we’re being honest — birth control doulas could help women navigate their education and choose the path they want to take. Although there are many good fertility awareness apps and lots of technological support out there — from Kindara to Daysy — a woman would be far more likely to find and understand these great options with a well-informed friend at her side.
As Emily suggested to me, this concept would work best with a national network of birth control doulas, enough of them that women would find the information right when they first plug “going off birth control” into Google. I think it’s the best next step in this burgeoning movement.