Birth Control is a Class Issue: On Ricki Lake’s New Documentary

About six years ago, I began crying everyday around 3 pm. I’d be sitting at my desk in my downtown Washington, D.C. office, and would feel hazy and distracted. Then I’d get choked up. By the time I took the elevator to the lobby and started walking around the block outside, desperate for privacy, I was sniffling and my eyes were spilling over. At the time, I was in my mid-twenties. I’d been on anti-depressants as a young teenager, but hadn’t felt clinically depressed in over a decade. Six months earlier my longterm relationship had ended, but I was by then basically fine. So why was I crying every single day? Not knowing was deeply weird.

Eventually I remembered that I had recently switched from one birth control pill to another. I switched back, and sure enough, the 3 pm crying ended, pretty much immediately.

So you don’t have to convince me the pill can have side effects. I get it. I’ve probably tried 10 different prescriptions over the years in the search for the one that works best for me. None were perfect.

I’m thinking about this because a friend recently forwarded me a crowd-funding page for “Sweetening the Pill,” an anti-hormonal birth control documentary by Ricki Lake and Abby Epstein, the team behind the home-birth manifesto “The Business of Being Born.” Here’s their promotional video for the new birth control project:

The film will be based on a book by Holly Grigg-Spall, also called Sweetening the Pill. (I haven’t read it, but Lindsay Beyerstein has a smart and critical take at Slate.) I’m guardedly excited about the conversation this film could start. When I started to learn about fertility awareness, I was angry that I was never taught – sorry to be graphic – about how fertility is indicated through cervical mucus and body temperature. These are basic facts about female biology, and it is a serious failure of mainstream sex education that most young women are only passingly familiar with them.

But I’m also anxious about this documentary, not least because it’s sure to get a lot of attention, and this team’s last effort was more of a one-note attack on traditional obstetrics than a balanced take on women’s options for labor and delivery.  My problem with the documentary’s promotional material so far isn’t just the reflexive defense of the “natural,” as Amanda Marcotte notes at Slate— even though what’s natural isn’t always what’s best for women or anyone else. The truth is, one shouldn’t really talk about birth control in America without acknowledging that abortion is becoming less and less accessible to poor women, those who can’t afford to travel to access medical care. Just last month, a federal appeals court issued a ruling that would effectively shut down 80 percent of Texas abortion providers. Women are being prosecuted for helping their daughters access abortion pills, or for ordering them for themselves.

Against this backdrop, let’s remember that hormonal birth control is 90 to 99.5 percent effective, according to the CDC. In comparison, the male condom – which is controlled by men – has an 18 percent failure rate under typical use, while the failure rate for natural family planning is 24 percent. When birth control fails and abortion is inaccessible, the result can be forced pregnancy.

I’ve read Taking Charge of Your Fertility, the classic book by Toni Weschler about fertility awareness, the method the Lake/Epstein documentary promotes. Weschler acknowledges that it’s mostly more affluent, highly-educated women who have been interested in her system, which entails charting one’s physical signs day by day in order to track fertility cycles, whether to avoid or achieve pregnancy. It’s easier to remember to take your temperature in bed, at the same time every morning, if you work one job instead of two; if your work hours are regular; if you don’t work the night shift; and if you have a partner who can hop up to grab the crying baby. (To be sure, fertility apps are beginning to make some of this a little easier, but this type of technology is also disproportionately used by the well educated and affluent.) A failure rate of 24 percent is no joke. If I use natural family planning and get pregnant by accident, I am okay with getting an abortion or having a baby. But a woman with fewer resources may have fewer options.

I hope this new documentary acknowledges that.