Pregnancy

The New Moms Who Have Had Enough Of Birth Control

“My body has been through the wringer. I have done my part.”

by Melissa Dahl

In retrospect, the butter incident may have been a sign. Eight weeks after giving birth to her daughter, Kylee Tingstrom of Jacksonville, Florida, got an IUD, and didn’t think much of it; she and her new little family of three went on with their lives. One morning, her husband made breakfast for the two of them, but afterward he failed to put the butter back in the fridge — and Tingstrom felt like she would explode with rage.

“I was just like, ‘Why are you doing this? Why can't you put this back in the refrigerator?’ I was so, so frustrated — like, ridiculously frustrated,” she said. It was a zero-to-60 kind of anger that, as she realized later, felt a bit… familiar. “The only thing I can equate it to was when I was pregnant, and the pregnancy hormones and just how crazy you feel all the time,” Tingstrom said. “That is exactly how I felt with the birth control.”

Less than a year after getting the IUD inserted, Tingstrom had it removed; she now uses the fertility awareness method, carefully tracking her cycle to avoid having unprotected sex on the days she might be ovulating. “Sometimes it gets really tricky,” she said, especially compared to something low-maintenance like the IUD. “But I was just tired of feeling like I had to have something foreign in my body.” So many things look different after going through pregnancy and delivery, and for Tingstrom, returning to hormonal birth control was one of them.

In the past five years or so, it’s become something of a burgeoning wellness trend for women of reproductive age to question, or even outright quit, hormonal birth control. It’s unclear as of yet how many women really are abandoning the pill or other forms of hormonal contraception — to the contrary, there is some evidence that interest in contraception has increased since Roe was overturned in 2022 — but a recent poll from TheSkimm, conducted via Instagram, found that about a third of women who responded that they were not currently on birth control had quit it within the past year. Online, the anecdotal evidence abounds: On TikTok, young women are making their boyfriends read the side effects, or they're unfolding the information sheet and marveling at its sheer size (you could make a dress out of it, they say, or perhaps use it as a blanket). For some, the skepticism is borne out of a concern for their mental health; for others, it’s a desire for something more “natural,” or at least an increasing distaste for filling their bodies with synthetic hormones.

“This is not the first time that we've seen this,” said Dr. Mary Rosser, M.D., an OB-GYN at Columbia University, referring to what appears to be a wave of distrust in conventional gynecological advice. To Rosser, it’s not unlike the so-called Dalkon-Shield disaster of the 1970s, when it was discovered that women who’d had that particular IUD inserted developed twice the risk of developing pelvic inflammatory disease, a painful infection of the reproductive organs that can result in ectopic pregnancy or infertility. Soon afterward, she said, “More women were using the diaphragm, for side effect purposes — they didn't want to worry about the side effects, so they would use something more natural.” Likewise, many women today are drawn to “natural” options like fertility awareness, often with the assistance of apps like Natural Cycles. (In 2018, the Food and Drug Administration allowed Natural Cycles to market itself as a method of contraception.)

Women’s health experts are worried about the spread of misinformation online, and want to remind the public that hormonal contraception is generally safe — in 2022, the American College of Obstetrics and Gynecologists reaffirmed its clinical guidance on contraception, noting that “lack of knowledge, misperceptions, and exaggerated concerns about the safety of contraceptive methods are major barriers to contraceptive use.”

But new moms come to this decision with their own particular set of concerns: After dealing with the intense body-and-brain-hijacking hormonal changes that can occur during pregnancy and the postpartum period, the last thing many new mothers want is to introduce yet another variable into the mix. So much of the perinatal period is spent questioning your own mental and physical reactions: Are they hormone-driven, or are they “real”? And just because they may be hormone-driven, does that necessarily mean they’re not “real”? Much of the aversion to hormonal birth control by new moms is a desire to simplify those questions — another way of saying they want to feel like themselves again.

“Your body is just this soup of hormones when you're pregnant,” said Patty Belew, a mom of two young boys who lives in Manhattan. She’s not wrong. In pregnancy, hormonal changes happen almost immediately: think human chorionic gonadotropin, or HCG, the pregnancy test hormone, which can be detected in the blood as early as 10 days after conception. Progesterone and estrogen increase over the course of pregnancy; relaxin peaks at the end of the first trimester before dipping and then increasing again at the time of delivery; oxytocin increases slowly over the course of pregnancy and surges during labor. After birth, the “dramatic drop” in hormones, particularly in progesterone, is thought to play a role in postpartum depression.

“You don't realize how much hormones affect everything!” Belew said. “And it’s not just your mental well-being. It's also like, ‘Oh, I'm really sweaty. Why?’ And then you Google it, and it’s — ‘Oh, that's a hormone thing.’” At one point during her pregnancy, she developed an allergy to Band-Aids. “As in, the glue,” she said. “I couldn’t put a Band-Aid on without having to itch it off.”

After dealing with the intense body-and-brain-hijacking hormonal changes that can occur during pregnancy and the postpartum period, the last thing many new mothers want is to introduce yet another variable into the mix.

The Band-Aid thing was, obviously, a minor irritant. More concerning to Belew were the postpartum hormonal changes she knew were coming — and the fact that, in the past, she’d suspected that the hormonal changes associated with the Pill had done a number on her mental health. She worked with a psychiatrist to minimize her postpartum depression and anxiety, and by the time her baby was 6 months old, she felt OK. Warily, she scheduled an appointment with her OB-GYN to discuss birth control.

“I felt better, but you can still have postpartum [depression and anxiety] for a very long time after having a child — so I was very nervous that I was somehow going to accidentally kick it back up again,” she said. “I thought, ‘What if I take this pill and the hormones start doing their thing and I get anxious and depressed again?” Her mental health was a big concern, but she’d also read that certain hormonal methods of contraception could diminish milk supply, and she really wanted to keep breastfeeding. But also: she really didn’t want to get pregnant again so soon.

The doctor she saw prescribed the Nuvaring, and soon after, Belew’s milk production did indeed diminish (a known risk of this type of contraception); on the advice of a different doctor, she quickly switched to a low-dose version of the pill, but it was too late — her ability to breastfeed didn't return. “I was so worried about the mental health aspect,” she said, “but, ironically, losing the ability to breastfeed made me really sad.”

And sometime in that window of swapping from one birth control method to another, at eight months postpartum, “that's how Georgie came to be,” she said, referring to her second son.

Years later, she is in love with Georgie, and her family feels complete with his arrival. But she’s still frustrated and disappointed by her experience. On the one hand, she wonders if she didn’t advocate for herself enough — and on the other hand she feels like she did, but she wasn’t heard.

Many new moms, like Belew, feel dismissed by their doctors when they bring up concerns about hormonal birth control. Katie Galvin, who lives in Northern California, visited her OB-GYN when her period still hadn’t returned at six months postpartum. Without much of a conversation, her doctor recommended hormonal birth control to regulate her cycle. “It felt like, ‘Let’s address your symptoms, but not address the reason for why you’re having symptoms,’” she said.

Are you feeling lousy because of your hormones — or because you aren’t sleeping, or socializing, or showering? Are you feeling a little crazy because of that sharp drop in progesterone — or because you’re deep into the discovery that our culture does a terrible job of supporting mothers?

The concerns new mothers have about hormonal contraception are part of a larger conversation that’s happening around postpartum care and why so much is still unknown about women’s health in general. Take, for example, the standard postpartum checkup. It occurs six weeks after delivery — a period of time that, to Rosser, has always seemed somewhat arbitrary. (Years ago at a conference, she and her colleagues gossiped about whether it came from the Bible.) “No one really knows where that came from,” Rosser said. “And what we have learned in the last 20 years is that the postpartum period is not just six weeks — that it is actually up to one year.”

While it is confounding that so many women are candidly expressing skepticism toward contraception even as reproductive rights are being rolled back across the country, perhaps the timing makes a certain amount of sense? Maybe that legislative attack on women’s health has helped highlight how little attention is paid, in terms of empirical evidence, to women’s health — and maybe all of that put together has caused some women to experience a deepening lack of faith in our health care system, prompting them to instead turn to each other for advice. It can sometimes feel like the ladies of Reddit take more time to address your health concerns than your doctor.

But there’s a razor-thin line between advocating for yourself and “doing your own research,” the latter phrase, of course, a red flag for seeking out misinformation. It’s possible that some people end up in that fringe health territory because they’re chasing a certainty that just doesn’t exist. In particular, the focus on hormones is, perhaps, borne from wanting one concrete thing on which to pin the blame for all manner of inexplicable postpartum symptoms, said Dr. Randi Epstein, M.D., M.P.H., the author of Aroused: The History of Hormones and How They Control Just About Everything and Get Me Out: A History of Childbirth. And while it’s true that pregnancy and the postpartum period are a wild ride of hormonal changes, it’s also possible we are giving too much credit to hormones here.

“I wrote the book — ‘everything is your hormones!’” Epstein said. But she wonders if “we don’t give ourselves enough self-compassion to be like, ‘This is also the most major change anyone can ever go through in their entire life.’” Are you feeling lousy because of your hormones — or because you aren’t sleeping, or socializing, or showering? Are you feeling a little crazy because of that sharp drop in progesterone — or because you’re deep into the discovery that our culture does a terrible job of supporting mothers?

Still, one might argue, if you’re skeptical about hormonal birth control, why not get an IUD? The modern version emits a low dosage of hormones, and has been shown to be safe and reliable; plus, there’s always the copper IUD, a nonhormonal option. It’s even possible to get an IUD inserted immediately after childbirth, which may be a less painful experience because the cervix is already open. And yet: not everyone wants something shoved up their cervix shortly after giving birth. For many new moms, much of the hesitation around hormonal birth control is emotionally complex, and is often complicated by strong sense memories of pregnancy, labor, and delivery.

Emily, a mother of two young children who lives in New York City, recalls her induction using Cervidil, which is delivered in suppository form. “It looks like a giant tampon, and they stick it up through your cervix,” she said. It was a jarring, painful experience, which for Emily led to uterine hyperstimulation, an induction complication defined as five or more contractions in a 10-minute period. “I basically went from not being in labor at all, which is why they induced me, to having 36 contractions an hour — so it was pretty much nonstop contractions,” she said. “I had those for 14 hours and then I still had another 14 hours of labor.” All in all, she said, the Cervidil “was the most scary thing I've ever experienced in life. And the idea of an IUD going up that way, too — I’m like, no. Hard, hard no.”

“My whole reaction to it is how dare you ask me to do anything else?”

To be sure, not every new mom feels so strongly about contraception. Some women might be a little lax about birth control simply because with a newborn and another little kid or two around, they’re just not having sex that often. Some may be practicing a kind of family planning that boils down to, “If I got pregnant again, would that be the worst thing in the world…?” But for others, particularly those in relationships with men, the issue taps into something that had been percolating for a long time: a dawning realization that they have spent years — decades, even — taking on the bulk of the reproductive responsibility. And they are being asked to do it yet again after their bodies — and brains — have been through one of the biggest changes a person can possibly experience.

When Emily looks back now, it’s the aftermath of the delivery that makes her still, five years later, unwilling to further mess with her body. “I remember laying in the delivery room afterward, and there was just blood everywhere,” she said. “There was blood on the bed. There was blood on the walls — the pushing had splattered blood on the walls. It looked like a horror movie.” She’d had an epidural, she wasn’t in pain, and she was happily holding her newborn son. “But I remember looking around the room and thinking, ‘Oh my God. This is a violent act.’”

Pre-pregnancy, she’d been on birth control for 15 years, starting when she was a teenager. But after pregnancy, labor, and delivery — plus a rocky postpartum period with her second son, during which she dealt with postpartum depression — something snapped. She was done.

For Emily, and for many new moms, whether birth control is “good” or “bad” is largely beside the point. The deeper frustration may be toward a partner who is unwilling to do their part: Tubal ligations outnumber vasectomies 3 to 1 in the United States, even though vasectomies are considered the safer and simpler procedure. One recent study even found a decline in vasectomies performed from 2002 to 2017.

“My whole reaction to it is how dare you ask me to do anything else?” said Emily, whose husband has so far declined to get a vasectomy. “I took the pill to keep us from getting pregnant when we didn’t want to get pregnant. When we wanted to get pregnant, I created and birthed and nursed our children.”

“My body has been through the wringer,” she added. “I have done my part.”

Melissa Dahl is a health journalist covering psychology, fitness, women's health, and more. Previously, she was the executive lifestyle and wellness director for Bustle Digital Group. Before that, she held a range of titles at The Cut, including executive editor. She is also the author of Cringeworthy: A Theory of Awkwardness, published by Penguin Random House.