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Emmerson Winfrey
Laying in tears with a heating pad over her abdomen, sophomore Emma Aubuchon felt as if she couldn’t escape the period cramps. After racking up over two weeks of absences due to her cramps, she questioned if she’d ever feel safe from her own body.
But what if Emma didn’t have to fear her cramps? She’d heard of birth control regulating her friends’ periods, even the heavy ones. If it meant no more doubling over in pain every time she left her bed, then one hormone-infused pill a day would be worth it.
“You can’t start birth control,” her doctor said. “You haven’t had your period long enough.”
Aubuchon couldn’t help her frustration when she couldn’t get a prescription — which she attributes to the doctor’s lack of knowledge on contraception. She’d had her period for two years, how can that be too early? An excuse. That’s how Aubuchon saw it. She knew people that started birth control even earlier into having their periods. Why was she any different?
“It was nonsense,” Aubuchon said. “Neither [me or my mom] could understand [why she wouldn’t give me birth control].”
Aubuchon was just one of the 19 million women in the U.S. who struggle to obtain contraceptives, according to Power to Decide. While the Biden administration proposed a new rule on Jan. 30 to expand access to birth control, contraception can still be inaccessible to youth due to misinformation, healthcare barriers, high prices or a lack of access to primary care providers, according to a survey by The National Center for Biotechnology Information.
Included within the Affordable Care Act, the proposed rule would reverse the 2018 regulation allowing private healthcare insurers to deny coverage for birth control for moral reasons. Under the new law, insurers could no longer use moral convictions as exemptions for birth control prescriptions, but could still cite religious reasons. The act would also allow providers to offer free contraceptives to those whose insurance doesn’t cover it.
The public has the opportunity to give thoughts on the proposed rule over the next few months before it’s finalized.
Without insurance, birth control options aren’t cheap, with intrauterine devices ranging from $500-$1000, the list price for Nexplanon, or the implant, at $1,092. Birth control pills are the cheapest option at $20-$40 per pack, but a survey done by the Kaiser Family Foundation showed that one in five women aren’t using their preferred method of birth control. A quarter say it’s because they can’t afford it.
This proposal affects women like senior Emily Rocca, who was unable to get the birth control implant she wanted due to her insurance not supporting birth control and its implications of underage sexual activity.
“I initially wanted the implant [instead of the pill], but my insurance is Catholic, so they refuse to cover any of that,” Rocca said.
Rocca’s only other affordable option was the pill — a form of birth control medication that contains hormones such as estrogen and progestin to prevent pregnancy and balance hormones. These hormones can potentially have negative side effects such as mood changes or irregular bleeding — unlike implants or IUDs which don’t contain estrogen.
The difference impacts women’s preferred contraception method. A survey by the American Journal of Obstetrics and Gynecology shows that 60% of women stop taking birth control pills within the first three months due to the effects of the estrogen. While women must also swallow the pill around the same time daily, alternatives like an implant don’t require maintenance.
“I was definitely frustrated because I know how I am with pills,” Rocca said. “I was definitely ticked off. Especially with college coming up, spending a grand on an implant would not be ideal.”
Dr. Melissa Miller — a co-director of research at Children’s Mercy Hospital who focuses on birth control research, access and education — agrees that contraception needs to be accessible to teens to destigmatize it and ensure safe sex practices.
“[Birth control] is part of everyday healthcare,” Miller said. “They shouldn’t be separate. To be a whole healthy person, you need to think of all your body systems and the care that they need.”
When Aubuchon saw an obstetrician-gynecologist — a doctor specializing in women’s reproductive health — after getting denied by her pediatrician, she easily obtained the birth control that her primary care doctor refused to give her.
Miller agrees that doctors can be unnecessarily hesitant to prescribe birth control. In her own discussion with doctors, she finds that many clinicians are uncomfortable with the topic or lack training with contraceptive counseling. Miller also encounters clinicians who are biased toward contraception with judgments about birth control’s role in “proper” adolescent behavior.
This inaccessibility is widespread. A 2022 Advocates for Youth survey with 243 participants from 42 states found that 88% of young people struggled to access birth control and 55% experienced so many barriers that they were unable to start taking birth control on their preferred timeline.
“There’s a lot of people that don’t have insurance and can’t access birth control or get to a primary care doctor,” Miller said. “And then if you do have insurance and your physician or provider could prescribe a medicine for you that’s safe and legal, then there should be no reason that an insurance company should be able to deny access to medication.”
Crouching on the floor of her bathroom throwing up, sophomore Jordan Fuller ripped off her Xulane birth control patch. She was done.
Fuller has been on five different birth controls in a year’s span, each presenting a slew of different — but still dreadful — side effects.
While not everyone reacts negatively to hormonal birth control, the majority of women experience some form of the side effects — especially within the first two to three months, according to Medical News Today. Hormonal contraception can cause effects from bloating to blood clots, potentially leading to strokes or pulmonary embolisms.
But some students still use birth control knowing its hazardous effects because it helps counteract certain medical conditions, period cramps and acne while stopping the user from conception.
But for women like Fuller, hormonal birth control is a necessity despite side effects. She has Von Willebrand Disease, a blood disorder that causes her blood to not clot, possibly inducing uncontrollable bleeding, anemia and low iron.
Fuller has been menstruating for a year straight and has tested different forms of birth control to stop it — a transdermal contraceptive patch, Depo-Provera — a birth control shot, combination and progesterone only birth pills and an IUD. Over the summer, she was taking the shot, pill and had an IUD all at once.
“When I was on three, my skin was breaking out so bad,” Fuller said. “And my family, like every night, would say I was losing my mind.”
Her birth control regime has led to daily mood swings, irritability and acne even though her skin had been previously clear. Plus, she considers herself permanently infertile due to all the different birth controls she’s been on.
“At school I keep it real together; all day I’m tense,” Fuller said. “Then at home, just total hormonal ups and downs. I get really angry, then will just start sobbing. You’d think I was going crazy.”
The hormones in birth control affect everyone differently and may not cause an immediate response. When senior Melissa Ainslie first started the combination pill two years ago, she experienced no side effects. Six months later, her anxiety increased and moods became more volatile — earning her the nickname ‘Mute Melissa’ from her friends during her down swings.
She began hating her normal activities like diving and meeting friends. On her worst days, she was too anxious to even attend math class.
“I kind of became a new person,” Ainslie said. “I just felt more and more depressed and not like myself to the point [where] I wasn’t enjoying normal activities anymore.”
After six months on the pill, Ainslie was vomiting weekly due to the anxiety resulting from the pill’s hormonal influence, eventually losing 12 pounds in a two-month span.
After quitting dive, dropping a math class, starting Lexapro, seeing therapists and discussing her symptoms with her doctors, Ainslie switched from birth control pills to an IUD three months later. Finally, her lingering symptoms disappeared for good. According to gynecology nurse Sarah Wareham, no form of birth control causes long-term reactions like mood disorders or infertility as hormone levels should balance out after a person stops taking a contraceptive.
“None of them should really have a long-term side effect, even with an IUD or Nexplanon that’s inserted in the arm,” Wareham said. “Once you stop taking that pill or stop the patch or remove the device, if fertility is what your goal is, as long as you’re healthy otherwise, things should go back [to normal].”
Junior Holly Bell* — who went to the emergency room for severe period cramps after starting birth control pills to counteract acne — has felt normal since stopping.
“I think just having those hormone imbalances changed the way my body worked,” Bell said.
Those unhappy with their current hormonal contraception or suffering from various side effects should see a healthcare provider before stopping the birth control, according to the Center for Young Women’s Health. Doctors may be able to offer different forms of birth control with less side effects depending on each individual.
“There’s so many great methods available, if you try a method and you have a side effect or you don’t like, please don’t give up,” co-director of research at Children’s Mercy Hospital who focuses on birth control research, access and education Melissa Miller said. “Talk to your doctor or nurse about what you did or did not like about that method and try something new. There’s really a lot of great methods that can also help.”
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