Avoiding an unwanted pregnancy far outweighs any side effects of contraception? How dare you say it’s that simple!

Women on hormonal contraception are more likely to be treated for depression

fullsizerender-1Recent research has shown that women taking hormonal contraception are more likely to be treated for depression. And we already know that those with pre-existing depression may have their symptoms worsened by the pill.

Tell us something we don’t know.

I’ve avoided hormonal contraception completely since a devastating experience in my teens. Mood changes are the top reason why people discontinue using the pill.

But some of the responses to this research have made me pretty angry. I’ve been trying to make sense of why for the last couple of days. Maybe this is really obvious stuff. But maybe it needs to be said again and again until people start to listen.

Avoiding an unwanted pregnancy far outweighs ALL side effects?

The worst comment I‘ve seen is “avoiding an unwanted pregnancy far outweighs all the other side effects that could occur from a contraceptive”. That’s the sort of thing someone who hasn’t experienced depression might say. I wonder if an equally debilitating (and potentially life threatening) physical health problem would be treated so casually.

I was prescribed the combined pill in my teens with no guidance, no discussion of side effects and without being offered alternative options (I wrote about it in an old blog post here).

The causes of mental health problems are complex and under-researched – but I’ve always felt that the six months of desperation, confusion and trauma I suffered before realising the pill was to blame was the start of long term problems with depression and anxiety. I still occasionally have nightmares where I’m trapped in that time and those feelings.

I had an abortion in my twenties. Unwanted pregnancy can be awful (and can be associated with an increased risk of mental health problems too). But the mental health consequences of getting medication like hormonal contraception wrong can also be devastating – and can last a very long time.

When I posted these thoughts online, others immediately agreed – “Yes, yes, yes! I’ve had both an unwanted pregnancy and a termination and long-term mental health problems aggravated/caused by the pill. And it wasn’t the first one that was more traumatic and terrifying”.

I feel the need to clarify that I’m not suggesting people have terminations instead of taking the pill – but that I need to do this at all just shows how reductive the discourse on this topic tends to be.

It’s not about unwanted pregnancy vs. depression – it’s about choice.

And whether an unwanted pregnancy or depression is worse isn’t really the point

This kind of broad-brushed and simplistic response makes me cross because it is harmful. It diminishes the impact of mental health problems. It makes it so much harder for women of all ages to have their experiences taken seriously. It stifles open conversations with doctors. It prevents women making genuinely informed choices about which of the enormous variety of effective contraception is right for them (and their partners – let’s not forget that men can take responsibility too).

Since this research came out hundreds of women have described how their experiences were affected by this kind of approach. One woman said that her GP refused to remove the implant from her arm (despite the negative physical and emotional effects she reported) because ‘it gets better after six months and it’s worth putting up with it until then’.

How could that GP possibly make that choice for her? What right have they to decide how much her mental health was being affected and whether it was ‘worth it’? They should accept her decision and support her to choose a different contraceptive method. That also made me pretty angry.

It’s still overwhelmingly down to women to manage contraception. Would men put up with the same assumptions about protection vs. side effects? I doubt it – but they shouldn’t have to – nobody should.

We should be given real choice about our lives and our bodies. Choice based on discussion, understanding and research. Yes, well-funded research into both mental health and women’s reproductive health would help – and would be more likely if people took our experiences more seriously.

Of course, there’s a decision to be weighed up and a line to be drawn. But we need all the information we can get to draw it for ourselves – and when we’ve made that decision we need it to be respected. We don’t need reductive comments that try and make this issue into a simple binary choice – whether you are better off pregnant or not pregnant.


A version of this article was also published in Standard Issue.

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