Natural Medicine Clinic Publications

Contraception: Birth Control is a Decision of Body-Mind-Spirit

By Nancy Aagenes, ND

With some humility I remember that only in the last 40 or 50 years of human history has control over fertility been easily, safely and consistently available. Prior generations of women did have some ways of enhancing and avoiding conception, but the history of women's lack of safe contraception is sometimes shocking and brutal .

Also let's recognize at the outset that some religious and spiritual paths still do not condone conscious contraception. Spiritual consideration is a right part of every contraceptive decision. Given that its use is so recent and its societal change so great it is good to be respectful to the traditions of others. I want us not just to be respectful, but also to open to the influences and considerations of those who might think differently.

As a naturopathic physician, what do I recommend to my patients for prevention of unwanted pregnancies? The answer is simple because my policy and practice is to respect the wishes of an individual woman. My commitment to patient choice is rock solid. The answer is to the contraceptive puzzle is complex because there are many unique and personal considerations with each option.

Hormonal contraception, birth control pills, are the first choice of many women. My own bias has been to advise away from this. Hormones are delicately interrelated and have many effects besides the one intended. Recently with study at the Women's Institute in Portland, I have been forced reexamine my own prejudices ( Don't you hate that?! ) about hormonal contraception.

The intersection between a woman's personal choice and the increased medical knowledge gained by four plus decades of use of birth control pills is helping even naturopathic doctors find right application. If a woman makes a strong choice for this kind of contraception, and if it is not otherwise contraindicated, I will prescribe it.

Latex condoms are still the method of choice if prevention of sexually transmitted disease is a consideration. We do fit diaphragms and cervical caps at our clinic, but these barriers do not block STD transmission.

The form of birth control most effortless for women in committed long-term monogamous relationships is an intrauterine device. The IUD got a very bad wrap in this country when women had multiple problems with one brand some years ago. It remains a preferred method of birth control in Europe. And it has an ancient use. Historical anecdotes record Chinese midwives inserting sterile stones into the uterus after birthing of the last wanted child.

We can now also prescribe emergency contraception. If the condom breaks, or you discover a tiny hole in your diaphragm at the wrong time of the month, and if a woman is treated within 72-hours it is possible to avoid conception. When fitting my patients with cervical caps or diaphragms I am also providing them with a prescription for emergency contraception.

Again, I want to acknowledge that these choices are personal and sacred. How we handle our reproductive decisions is a certain overlap between parts that are spiritual and hormonal and intellectual. These decisions illustrate well the lack of separation between body-mind-spirit.

Find a doctor you trust, one with who makes you comfortable in frank discussion of your sexual life and preferences and who is current in medical literature on all these options. Decisions about contraception and fertility are important ones. Good wishes for your health.