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Reproductive Writes: Keep Talking: An Interview with Laura Eldridge

Laura Eldridge is a women's health writer and activist. She began working with the founder of the women's health movement and author of The Doctor's Case Against The Pill, Barbara Seaman, when studying at Barnard College. Starting out as an an intern she progressed to become co-author on the publications Body Politic: Dispatches From The Women's Health Revolution and The No-Nonsense Guide To Menopause. This June Seven Stories Press will be releasing In Our Control: The Complete Guide To Contraceptive Choices For Women - a book Laura formed after Barbara Seaman's death in 2008 to provide a revaluation at the time of the Pill's 50th anniversary.

How did you come to write a book framed by an alternative viewpoint on the Pill?

When I started working with Barbara Seaman, at the end of 1999 and just in time for the 40th anniversary of the Pill, it was actually a shock to me to realize as a feminist she had been very critical of the Pill. I thought of myself as an up and coming young feminist and bought into the popular idea that acceptance of the Pill was an integral part of second wave feminism and as such allowed for many of the gains women have made. Working with Barbara I got to understand how criticism of the Pill was part of the feminist movement, and that this history has been lost over time. With the 50th anniversary of the Pill coming up, all the articles are very glowing and suggest the Pill made feminism possible, but I know it is much more complicated than that. I thought it was the right time to present a reassessment of our birth control choices, to encourage women to broaden the contraceptive conversation..

Seven years into working with Barbara and I was still taking the Pill. She wasn't judgmental and it wasn't like I was hiding it from her, but I had to learn the lessons she'd been discussing throughout her career for myself. I think it's hard to see that it's not just about what the Pill can do to your body, but also that this effect can change over the years. Contraception should be an inter-generational conversation, but unfortunately it is not. We could learn much by taking in the experiences of women older than us. We could be asking if hormones are increasingly unhealthy for you as you get older. I know as I got older the side effects I experienced got a lot worse. My symptoms – which started simply as painful breasts and worsened PMS when I started the Pill at 18 eventually extended to, among other things, constant mood swings,weight gain, erratic bleeding and severe cramping with amenorreah. Yet I still tried several more types of Pill until I finally decided enough is enough.

Barbara died in 2008, it was very sudden. We had been working on the menopause book together. I wanted to do something that honored her memory. I didn't want to just talk about the Pill. The Pill will probably always be with us, it's not going anywhere and I think we do women a great service by saying 'Let's not start and stop what we have to say about contraception with the Pill.' I do start with the Pill and its descendants – like the shot, the ring and menstrual suppressants - but then I also talk about non-hormonal methods like barriers, IUDs and fertility awareness, as well as discussing emergency contraception (ed.'s note: Eldridge does not mean to imply that emergency contraception is non-hormonal. See comments section). I think we need to talk about how gender and sexual difference inform how we feel about our bodies from menstruation to birth control, and of course eventually menopause. I also have a chapter on hormones and the environment, which I think is an up and coming issue.

Did you find it difficult to think critically about the Pill?

It's hard for anyone to be critical of the Pill, even if you've been studying this drug for years. Even now I feel I need to be cautious. I always want to be respectful of women's choices, even when they are different from mine. I want to say from the beginning that the Pill works really well for many many women. If a friend of mine is doing well on it, I would never tell her get off.

Many women, though, are living with a very problematic method of contraception that they don't like, even though there are other options out there. This has to do with their relationships with their doctors, their partners and how they see themselves fitting in to society in general. Analysis of women and the Pill can show both how far we have come and how far we still have to go.

An important part of In Our Control is your discussion of the lack of innovation that there is in the pharmaceutical industry when it comes to creating new contraceptive choices or improving the choices we have. Why do you think there's been so little progress in this area?

One reason there's little innovation is because the pharmaceutical companies have been burned before by law suits when new methods have gone wrong - look at the Dalkon Shield, Norplant and now, perhaps, Yaz. Women live with the unenviable reality of having to say 'this is good enough' and 'better the devil I know' - or they have to take the risk of trying something new, when they feel from experience the pharmaceutical company is probably concealing side effects and even dangers. We might want something different so much that we will take the risk regardless, but I think as long as the Pill is 'good enough' the industry won't look for alternatives.

There hasn't been much innovation and a lot of what we have now has been created by the relationship between pharmaceutical companies and international groups interested in population control. There's so much baggage in that relationship. The Pill was accepted in part because people were afraid of over population in third world countries, of the growth of communism, of unrest in minority groups in our own country. There was a lot of racism and classism bound up with that, which has never totally gone away - the language has just changed and the same anxieties keep cropping up. In a world where nothing is getting done in terms of contraception this does drive the innovation that has given us the choices we do have.

What do you say in the book in regards to hormones and the environment?

We are living in a chemical swamp. Our water ways are full of synthetic hormones - ethinyl estradiol from the Pill included. We can be confident that all these chemicals taken together can cause cancer - but it's difficult to say which chemicals are more likely to do this because the waters contain so many different chemicals – from pain killers to Alzheimer's drugs to agricultural estrogens and industrial contaminants.

Devra Davis, an amazing cancer researcher who studies environmental causes, always says 'Waiting for proof in the form of dead people is not good public health.' But until we can prove that ethinyl estradiol is an important problem pharmaceutical companies are going to deny it. And then they will probably just switch to an equally polluting estrogen alternative.

Women are used to hearing denials - we tell our doctor that we got depressed on the Pill and we are told there's no evidence for that. And it is very hard to show these things. You can get tons of money to do research into possibilities in a lab, but it's hard to get funding to look at real women in real life.

Of course with the barrier methods we have the issue of waste. I love the diaphragm, I really do. I switched to a diaphragm when I came off the Pill. A latex condom probably won't biodegrade - but a polyurethane one or a synthetic rubber one definitely won't - they are just with us forever. If you are committed to environmental issues the Fertility Awareness Method may be an option for you. It is the ultimate Green method, but of course you have to be committed to learning this system.

Look for the second part of this interview on the blog tomorrow!

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Comments

2 comments have been made. Post a comment.

Emergency contraception is not non-hormonal

and it's not a method of birth control either if by that is meant regular use. I posted this comment yesterday, and today find them gone. Why is that?

"I do start with the Pill and it’s descendants – like the shot, the ring and menstrual suppressants - but then I also talk about non-hormonal methods like barriers and IUDs, fertility awareness and emergency contraception."

Emergency Contracetpion

Hi Katha,

Thanks for commenting. Just to be clear: my book has a chapter on barriers, IUDs and other non-hormonal methods. In addition, there is a chapter on Emergency Contraception (which is hormonal - usually a big dose of progestin).

As you say, EC is not an "every day" method. As the name suggests, it is for emergencies and situations where primary contraception may have failed. But it is an important contraceptive development that we should be talking about. And not discussing it as birth control allows it to be inaccurately associated with medication abortion.

Part of what I try to do in the book is discuss everything that is out there. Many of the methods - not just the pill - do work through hormonal mechanisms. I wish there were more forms of birth control that worked in other ways, and part of the reason I wrote In Our Control was to get women talking about why that is, why after all these years we have so few truly new choices.