Some TikTok influencers are encouraging women to stop using hormonal birth control. Photo via Getty Images.
There’s a corner on TikTok encouraging women to get off birth control and try “natural” contraceptive methods that’s become even more dangerous at a time when millions of people across the U.S. are no longer able to access abortions.On TikTok, videos with #naturalbirthcontrol have been viewed nearly 30 million times. Some of the content creators advertise themselves as “holistic healers” or “hormone coaches”—euphemisms for “not a doctor.” They stare into the camera and call hormonal birth control “toxic” or “unnecessary,” while saying the pill causes cancer and other illnesses. They share their own stories about getting off hormonal birth control, and encourage other people to do the same.
One of the first videos that comes up when you search “natural birth control” on TikTok is of a woman who excitedly shares that she nearly made it through her first year without the pill. “You cannot get pregnant every day of the month, so why do you need a whole pill to prevent you from getting pregnant every day of the month?” the woman says. In a video from March, viewed nearly 80,000 times, a TikToker says, “Our system has failed us. I'm going to blame the schools. I'm going to blame doctors. I'm going to blame my parents.” The same content creator has promoted natural birth control multiple times post-Roe. An influencer with about 72,000 followers, promotes natural methods on her account and directly addressed abortion bans in the U.S. “If you are wanting to switch to a form of natural birth control but you're a little bit scared due to recent legislation and news, here are the top things I would want to know: your body will tell you when you are fertile and when you are not,” she says in one video before promoting the method. In a different video she also says, “This is now more than ever important for us to take control of our own bodies.”Another TikTok, viewed 1.1 million times and pops up in searches, says, “The birth control industry ain’t gonna like the fertility awareness women UPRISING,” while claiming natural methods are 98 percent effective at preventing pregnancy. (Effectiveness is more complicated than that because it relies on perfect use. One doctor told VICE News imperfect use can result in a 20 percent failure rate.)
Most of the TikTokers are women and few acknowledge the role men play in family planning, placing the onus of avoiding pregnancy almost entirely on people with uteruses. It runs counter to a different corner of the internet, which features men getting vasectomies post Roe to better protect themselves and their partners. All this is happening at a time when unintended pregnancies carry more risk than ever in states like Texas, Alabama, and Georgia, which have imposed draconian abortion laws following the Supreme Court’s decision to oveturne Roe v. Wade. “Getting pregnant now has enormous consequences. I don’t even know how these influencers sleep at night now,” said Dr. Jennifer Lincoln, an OB-GYN in Portland, Oregon, who runs an informational TikTok account and wrote a book on female reproductive health.Lincoln called the trend a “chronic problem” because she’s noticed similar TikToks over the years. “It’s always been harmful to have misinformation out there, but now it's even more concerning,” she said. Such health and wellness content creators have been peddling fertility awareness-based methods or natural family planning. Strategies vary, but the point is to track ovulation. That way, people with uteruses can avoid unprotected sex during days when they ovulate and conception is more likely.
It’s a method that can work when done right, but failure rates are high because doing it right requires a lot of time and effort. “If you need very effective birth control, this might not be the option for you,” said New York City-based OB-GYN Dr. Colleen Denny. With imperfect use, people can expect a failure rate between 10 and 20 percent, Denny said. Perfect use isn’t easy: For cycle tracking to work, you need to have a regular menstrual cycle, otherwise it’s harder to tell when you’re ovulating. It’s also worth noting that unprotected sex is risky for nearly half of the month—which can be difficult for couples and requires a lot of buy-in from everyone involved. “If you have a partner unsupportive of having protected sex for half the month, it’s not going to work,” Denny said. Natural family planning also requires daily monitoring of the body, including through temperature checks or cervical discharge, which takes time. That’s a lot for someone with multiple jobs or a household full of children. “It’s totally privileged to assume everyone has this ability. It might not cost money, but it costs time,” Lincoln said. While cycle tracking works for some people, the one-size-fits-all approach doesn’t address differences between patients, including the ways potential financial and emotional burdens of an unintended pregnancy will affect some people more than others.
“‘Unintended’ pregnancy doesn't always mean ‘undesired,’ but for many people it might not be easy or safe,” Denny said, adding that limited abortion access creates yet another logistical challenge in some states. In short, some people can take on more risk than others. “Educate yourself about the options, even if you're not ready to sign onto something yet. Birth control can be a way of self-empowerment, as well, to take control of your fertility,” Denny said. Denny said she understands that social media can incite fear and confusion about birth control but it’s good to remember that “modern contraception options are safer than they've ever been.”And to be clear: studies show that birth control pills likely lower risks of various cancers, including ovarian, endometrial, and colorectal. And while there is evidence that suggests they increase the risk of breast cancer, the increase is marginal and decreases over time once a person goes off the pill, Denny said. Also, hormonal birth control won’t make you infertile, which is another myth that’s often tossed around, she said.Different forms of birth control carry various risks of side effects, including cramping, irregular bleeding, nausea, decreased sex drive, and weight gain, and they can be downright awful. Lincoln said people who experience side effects should speak to their doctors because they can offer evidence-based advice and solutions. It’s also more than OK to seek out a different doctor or health professional if and when support is lacking, she said. Sites like Planned Parenthood and Bedsider also offer free information about birth control methods, including effectiveness and potential side effects. According to Lincoln, reporting and blocking misinformation online also keeps similar content off your feed. “Not very often is anything so good or so bad for you that it should be used or avoided at all costs,” Lincoln said. “Things are getting so polarized and putting birth control in that category is confusing people more and it's just not fair.”Perhaps the anti-hormonal birth control TikTokers inadvertently highlight that there isn’t a one-size-fits-all approach to birth control. Scan through the comment sections under the TikToks encouraging women to swap out their IUDs for natural family planning and every so often you’ll find a comment like this one: “I did this and I had my son lmfaoo.” Follow Anya Zoledziowski on Twitter.