December 19, 1967 marked the date when France adopted a new law on contraception. Although access to contraception has become widespread, the new generation of women is starting to voice complaints of having their bodies over-medicated, while unwanted side effects remain underestimated. As the most widely used method in France, the pill has been the subject of heated controversy. As underlined in the GISA (General Inspection of Social Affairs) cumulative report on abortion in 2010, there is gradual acknowledgement that “A total control of fertility is illusory“.
France holds the record for one of the world’s highest contraception rates. According to the 2010 Health Barometer, 90.2% of sexually active French women (15-49 years old) admitted using contraception. The percentage was 91.2% among 15-19 year olds, and 92.9% among 20-24 year olds. The 2016 Health Barometer reported that only 8% of women aged 15-49 do not use any method of contraception. Originally presented as a “choice”, gradually becoming standardized, this issue is now being challenged by the third generation of women.
Birth control pills: dissatisfaction and mistrust
The pill has become the most widely used means of contraception. Although thrombotic risks had been reported since 1995, it was only after complaints filed by women with severe thrombotic attacks with these 3rd and 4th generation pills in 2012-2013, that the pill’s reimbursement was cancelled. Consequently there seems to be increasing dissatisfaction with the pill according to the 2016 Health Barometer. While 45% of women took the pill in 2010, reported usage fell to 36.5 % in 2016. Although the majority of adolescent girls (60.4% of 15-19 years old) continue to take the pill, its’ usage is losing ground in other age groups. An article in Le Monde pointed out: “anxiety over taking hormones, refusing to suffer the side effects of migraine, nausea, and/or weight gain, and a greater ecological awareness explain the emergence of this post-pill generation “. The pill has been substituted by IUD’s (25.6%) or by condoms (15.5%), with an increased usage in recent years.
Serious warnings with other contraceptives
On December 7, 2017 the New England Journal of Medicine published results from a Danish study which reported a slightly higher risk of breast cancer among women using hormonal contraceptives (pill, IUD or implants).
In With Mirena, the hormonal IUD, the National Agency for Drug Safety received 2,700 reports of adverse effects between May 15 and August 4, 2017. The Agency concluded that some symptoms were already well-known: “including headaches, depression, hair loss, acne, abdominal pain, decreased libido, hot flashes and weight gain (…). Other adverse effects, which have not previously been recorded, will now be mentioned in the leaflet, including asthenia (physical fatigue, weakening of the body) and seborrhea (excessively oily skin),” according to an article in Le Figaro. At the beginning of 2017, the association Vigilance Hormonal IUD was founded to support victims and denounce the silence regarding the device’s side effects which severely impact some women’s lives.
September 2017, Bayer pulled the Essure sterilization implant off the European market after a heated controversy. The Resist association fought to have the product labeled as being dangerous (debilitating fatigue, ENT symptoms, bleeding, depression …). In France, neither male nor female sterilization is very popular due to its irreversibility, in comparison with other countries. For example in the United States 43% of women have recourse to sterilization, 20% in Spain and 39% in China.
In an article published December 7, 2017, on the medically referenced website “Medisite” the potential consequences of taking the morning-after pill were highlighted. “With a progesterone dose 40 times more than a normal contraceptive pill, the potential side effects are not negligible. For women who have used this emergency contraception, indeed common symptoms include menstrual cycle irregularities, migraines, nausea … But more serious side effects are also reported such cardiac blood clots, especially for women with cardiovascular disease.”
Increasing requests to reconsider excessive medicalization and women’s role in contraception
In its analysis covering the 50 years since contraception was legalized in France, the National Institute for Demographic Studies (“INED”) asks: “Should women be exclusively responsible for contraception, including the undesirable side effects inherent with some methods? Although women have had an advantage of better fertility planning, men’s role in contraception appears to have been completely overlooked, as if they were not concerned, and with few choices available to them. (…) Contraception has become a women’s affair. In conclusion the analysis states: “As we mark the 50th anniversary of the Neuwirth Act, which led to widespread use of contraceptives, there is an increasing request to reconsider excessive medicalization and women’s role.”
This controversy was addressed by journalist Sandrine Debusquat in her book “I Stopped Taking the Pill” published in September 2017. She investigated why women are relinquishing the pill. Her book addresses new perspectives for this generation, which show respect for women’s bodies without automatically relying on chemical contraception. She emphasizes that more natural methods are available which respect the temporal rhythms of the female body, which foster dialogue and give the couple a more balanced responsibility. On September 19, 2017 an article published in Le Monde asks “Why women are abandoning the pill?” To cite a few extracts: Little by little, the truth about “minor” side effects is being revealed. For a long time either masked or endured without discussion, in exchange for sexual freedom and peace of mind, today they are no longer tolerated. Nowadays in 2017, it is considered unacceptable to suffer the nausea, weight gain, mood swings or low libido attributed to taking hormones. “
Misconceptions to be clarified between men and women
Besides challenging the issue of some contraceptive products, it is worth recalling the paradoxical coexistence of a high contraceptive rate as well as a high number of abortions in France: 72% of women who resorted to abortion were on contraception when they became pregnant. There are many reasons for that: forgetting the pill, misuse of condoms, becoming pregnant despite IUD’s…. The same phenomenon is observed in other countries with varying degrees.
In 2016, there were 211,900 abortions in France, compared to 785,000 births. According to INED, it is estimated that 33% of all French women will have an abortion at some point during their lives. According to INED, “The propensity to resort to abortion for unplanned pregnancy appears to have increased although controlling fertility had improved. As the norm of the programmed child gained ground, unplanned pregnancy appeared as a mistake and became increasingly unacceptable.”Can an unexpected child be accepted? This is a recurrent issue, causing conflict for couples, and as often observed by Alliance VITA and its SOS Baby telephone counseling service, with men applying pressure to abort.
This observation led Alliance VITA to launch an informational campaign at the end of 2016 especially for men, to clarify misunderstandings between men and women on issues of sexuality, maternity and paternity, and especially to highlight misconceptions about contraception.
At a time when sustainable development and preserving the planet have become top priorities, women are calling for ecological changes for themselves.