This article originally appeared on VICE France.
“It’s almost worth doing just for the beauty of it. It’s a militant, feminist, political act.” That’s how Lucile, 29, sums up a vasectomy — a procedure her partner is now contemplating.
Like many women, she has been on hormonal birth control for most of her adult life, though she’s taken a break from time to time. After all, hormonal birth control has many side effects, including (for her) bouts of depression and reduced libido. During these breaks, she opted for condoms or the pullout method — although that comes with its own set of risks. “Eventually, I let my gynaecologist convince me to get back on the pill,” Lucile recalls. “No doctor I saw ever said anything bad about it. There was always just this consensus: the pill is the contraceptive to use.”
Lucile quit the pill for good four years ago. Now in a new relationship, she’s made sure to raise the subject with her new boyfriend, who is a similar age. “I realised it was also his responsibility. He’s a man — no one has ever spoken about birth control with him. This isn’t a woman’s problem to face alone.” After deciding they didn’t want children, they started talking about a vasectomy. He was “a bit scared”, but has agreed to undergo the procedure.
Like Lucile, women are increasingly parting ways with the pill. Bérangère Arnal, a gynaecologist practicing for 36 years, says those asking her for alternatives are getting younger too. “They’ve been studying up on the dangers of hormones,” she says.
Sabrina Debusquat, author of the French book, J'arrête la pilule (I’m Quitting the Pill), points out that between 2000 and 2016, use of the pill went down 20 percent in France. Similar but less extreme trends are visible in the US and the UK, where usage is down 6 percent. “When you’re young, you do what people tell you — doctors, parents, society. You don’t start thinking critically about hormones until much later.”
One medical alternative, often offered by professionals to those wishing to come off the pill, is an intrauterine device (IUD). But Marine, 30, tells us she had a disastrous experience. After going on the pill at 16, a dip in libido plus nine kilos of weight gain led her to an IUD. “After five or six months, I started getting horrible period cramps and intestinal issues,” she says, “I knew something weird was going on – I know my body.” An ultrasound revealed she had suffered severe swelling and an IUD expulsion, in which the device moved inside the uterus. Her doctor wanted to put her back on the pill again. “I said, ‘No way’,” recalls Marine. “I’m never going to worry about birth control again. It ruined 15 years of my life.”
Now she uses an app to track her cycle. She and her husband sometimes switch to condoms while she’s ovulating, but her general rule is: “When I think it’s safe, we don’t worry about being too careful.” The couple is aware of the risks, “but if a pregnancy happens, it’s not the end of the world for us”.
“I’ve become so much more aware of my body,” Marine says. “You become conscious of your whole cycle; you understand your body better. Plus, as a couple, it’s helped us explore more sexually, and discover what we can do without penetration.” In the long term, after they have children, Marine’s husband plans to get a vasectomy and take the birth control burden off of his wife.
Debusquat, the author, has made it her mission to defend natural contraception methods, which are still seen as unreliable by the general public. “When these methods are practiced correctly, they’re very effective,” she insists. In her book, she recounts her own experience using the “symptothermal method”, which requires scrupulous tracking of your own body temperature and cervical mucus to know when you’re ovulating. “I wanted to find a method that would avoid having to constantly use a condom or a diaphragm. This way, I could use protection just during fertile periods.”
That said, Debusquat is annoyed she had to find that solution on her own, without any help from a gynaecologist. “Listening to patients is honestly the biggest challenge for them – they really have to work harder on that,” she says. “Women tell me they’ve stopped going to the doctor because they just aren’t listening to them. The ‘pill-is-everything’ paradigm just doesn’t cut it these days.”
Debusquat’s research also convinced her that smartphone apps aren’t going to be the thing that tackles this issue for women. “An algorithm can’t understand the subtleties of the human body,” she points out. Her personal battle is for women to be able to make their own choices. “I became a militant feminist because of my research into this.”
Natural contraception can be one way to escape the burden of birth control burden, which currently falls predominantly on women. But sharing a hormone-free sex life also necessitates your partner’s cooperation. Amandine, 35, wanted to “give [her] body a break from the pill” after learning it had given her co-worker a heart attack at the age of 25. But Amandine’s partner insisted she stay on the pill, telling her she needed to “take responsibility”. He wasn’t happy with pulling out, calling it a “form of sadism”. Ultimately, Amandine relented and resumed taking the pill, against her own wishes. “When I went off it I felt so guilty, so alone. I remember thinking it wasn’t normal not to use contraception.”
The relationship became increasingly troubled, and finally the couple split. “I really didn’t deal well with starting the pill again. I was having so many negative feelings about male-female relationships, about the way I was having sex.”
Today, Amandine is in a three-year relationship with a man who is happily on board with natural birth control. “We know accidents can happen, but when you’re in a stable relationship, it feels a lot less scary. Plus it’s really interesting to discuss the subject. My partner has learned so much about my cycle, its effects on my mental health, and all of that. He’s taking responsibility, and everything just feels so much more equal this way.”
For Amandine, the choice to use natural contraception “went beyond what was at stake health-wise. It also kind of reshaped my ideas of what sex can be”.
Of course, both women and their partners who use natural contraception are aware of the risks involved. Edwige, who has been with the same man for 20 years, got pregnant while using natural contraception, three years after she’d stopped taking the pill. “It was more or less an accident,” recounts Edwige, “but we decided to keep it, and we’ve never regretted it for a moment.”
She and her partner recall that when she stopped taking the pill, they started “touching each other in a different way. We told each other new things, too — we started talking about our bodies more. He understood my point of view; he was always at my side”.
However, for all its advantages, natural contraception may not be the best option until later in life. Gynaecologist Arnal, who is currently writing a book on natural health for women, advises her youngest patients against starting their sex life with natural birth control methods. Instead, she recommends condoms, or a progestin-only form of the pill. “You really have to know your body well before you try natural contraception. But the professionals don’t bring it up with their patients… it’s hormones or bust! That’s why the gynaecologist’s point of view is important.”
Arnal says that a number of women are now opting for IUDs when they quit the pill. Not many are brave enough to try the symptothermal method, despite Arnal arguing it’s “the safest natural method out there”.
For Debusquat, it is a no-brainer. “You have better sex, better communication. You get to rediscover your body and explore non-penetrative sex. There are so many benefits to natural birth control, the women who choose it almost never turn back,” she says. “Plus you’re not risking your life or carrying the birth control burden alone. That’s what the feminist fight is about.” And if you have to fight that fight for the long term, you might as well do it while enjoying a good sex life.