Birth Control Opinions in North America

By Kaylee Chou

What comes to your mind when you hear the term, ‘birth control?’ Do you think of choice, freedom and opportunity? Maybe you think of stigma, misunderstanding and inequality? Or perhaps, you don’t know what to think. Well, around the world, birth control opinions around the world are widely varied, so don’t be too worried if you can’t place yourself in one of the above categories.

To start off, birth control is used for a variety of reasons. Most commonly, it is used for preventing unwanted pregnancy. However, it’s important to remember that it has many other usages.

According to the Cleveland Clinic, birth control can also be used to:

“Regulate or lighten menstruation.
Prevent anemia by making periods lighter or shorter.
Lessen menstrual cramps (dysmenorrhea).
Manage premenstrual syndrome (PMS) and premenstrual dysmorphic disorder (PMDD).
Treat polycystic ovary syndrome (PCOS).
Treat endometriosis or uterine fibroids.
Lower the risk of ovarian cancer, uterine cancer and colon cancer.
Improve acne.
Stop unwanted hair growth.
Reduce migraines.
Control hot flashes during the transition into menopause.”

Despite these various reasons, people tend to fixate on birth control as a contraceptive. This has led to a wide range of opinions, debates and controversy over the usage of birth control and who should be held accountable in the case that a person becomes pregnant unintentionally. Across the world, factors like culture, religion and societal views affect the overall outlook on birth control and can either create or destroy barriers when it comes to the access and education around it.

CANADA

In Canada, there are various options including:

HORMONAL:

The pill
The patch
The ring
Injection
Hormonal IUDS

NON-HORMONAL:

Copper IUDS
Vaginal contraceptive film
Sponges
Diaphragms
Withdrawal

To gain access to whichever method is preferred, a prescription can be given at various sexual health clinics, walk-in clinics or an online doctor’s visit if one does not have a family doctor. A parent or guardian’s permission is not required for a prescription as well, allowing youth to feel more comfortable if they need/want a prescription.

In British Columbia (BC), a province in Canada, birth control was recently made free.

This monumental move not only helps those who use birth control save up to $10,000 in their lifetime, but opens the door for inclusivity as men, including trans men, also have access to it. Being that the pill is one of the most common forms of birth control, the province’s decision to provide it free of charge allows those who need it, more opportunity to take control and care of their health. Since BC is the first province in Canada to have done this, it has prompted other provinces and territories to start more discussions around birth control usage and accessibility.

However it’s crucial to remember that while birth control in BC is free, fears and trauma still exist. For instance, Indigenous people in Canada have faced a harrowing history associated with unwanted sterilization forced upon them by the government. In the past, since at least the 1930’s, forced sterilizations have occurred in Canada. Some women were misled into believing that forms of birth control such as, getting one’s tubes tied, would be a reversible procedure. Others were forced to sign while they were in a vulnerable state, including being in labor. According to the University of Alberta, many government policies permitted these sterilizations to happen, one of which includes Alberta’s Sexual Sterilization Act. It was practiced from 1928 until 1972; and as reported by the University of Alberta, “Indigenous people represented about 2.5% of the population but made up 25% of those who were sterilized.”

As a result of the Alberta Sexual Sterilization Act, approximately 3000 women were sterilized.

Sadly, those with intellectual disabilities & lower IQ test scores were main targets of the program, as they were looked at as less than when it came to being a parent. In fact, Indigenous women became targets later on when more women gained access to health care.

Fast forward to modern day, health care disparities are still prevalent, particularly for Indigenous communities.

Oftentimes, women living in Northern Canada have a much longer journey to travel for birth control. While this has been an issue for a long time, issues with effective & quality maternal care as well as infant care, still need to improve. Along with that, family planning services need to be more accessible and properly trained to understand & work through the trauma Indigenous people may have.

U.S.A.

On the other side of the border in America, birth control options also vary largely, with one’s choice of method dependent on price, age and cultural & religious values. Institutions like Planned Parenthood are in place to educate and spread awareness to the public about different methods of birth control, as well as the variety of options one has if they have an unintended pregnancy. Organizations like this are crucial, especially being that according to Guttmacher Institute, in 2018, “65% of women aged 15-49 were using a contraceptive method.” Similar to Canada, in America, the pill is the most common form of birth control. Following that, is female sterilization.

While the United States supplies many forms of birth control to the population, the matter of whether it’s accessible is a major issue. As pictured above, there are many contraceptive deserts in the U.S, which affect approximately nineteen million women. Contraceptive deserts are where people have to drive more than thirty minutes to access a health clinic. This distance puts people at a disadvantage because on top of what the cost of their birth control may be, they have to factor in transportation costs and time. In fact, according to WebMD, in 2010, “1 in 4 women in the U.S. went for birth control services at publicly funded family planning clinics. More than half of the 37 million women in the U.S. who needed contraceptive services depended on publicly funded planning clinics to get their birth control. That’s because either their income was 250% below the poverty line or they were younger than 20 years old.” Unfortunately, along with this, comes the issue of healthcare disparities and systematic racism; people of color still face many gaps in healthcare and the access to it.

Past and present traumas still exist, such as doctors not taking people of color as seriously when it comes to their health concerns. With problems like this glooming over the world, let alone this country, birth control access remains a prevalent matter.

To add to this already complicated manner, Roe v. Wade was overturned in June of 2022. This means individual states now have the power to govern their own abortion laws. To see the widespreadness of contraceptive deserts factored in with this, is shocking and upsetting. Yes, America does have places that spread the importance of sex education and provide a variety of birth control forms, but the sad reality of it all, is that it has many limitations and this unfortunately means that those who can’t, simply won’t.

MEXICO

In Mexico, birth control is available over the counter without a prescription. This is due to their national family planning program. Some of the more common forms of birth control include the pill, like in Canada & the U.S, and the intrauterine device, IUD, surgical sterilization, and injectable hormones. However, just as there is in Canada and the U.S., barriers lie in many people’s way. In Mexico, stigma, prejudice and misunderstanding largely impact the usage of birth control.

In an article by Direct Relief, Mariana Alarón-Cassius, the Program Director of Reproductive Health at CASA, a center for sexual & reproductive health care in San Miguel de Allende, Mexico, explains that, “It’s viewed badly to use contraception.” This makes it harder for those who need access to birth control as they face judgment or societal & familial disapproval.

According to the article, a study conducted by Dr. Jean Marie Place, found that some healthcare providers would even withhold information from the patients. The study had recruited women to act as patients at health care facilities in Mexico City. The study questioned a healthcare provider's ability to answer questions/concerns about long term contraceptives that require more than an over the counter visit.

According to Dr. Jean Marie Place, as a result of that study, “In some cases, providers didn’t want to provide information, but they weren’t direct about saying so. They would come up with excuses, such as telling women, who ranged in age from 15-24, they were too young to be using contraception or they needed a parent present. Many women .. said to me, ‘I’ll never go back to that clinic, they were so disrespectful’ or ‘I felt so judged’ or ‘I felt so rushed that I’ll never go back to that clinic.’”

A lot of this stigma and lying also stems from religion. This is an issue that exists in many parts of the world, however, according to Dr. Place, “It’s a heavily religious country with a predominantly Catholic faith, and so the faith may have played into some of those providers’ perspectives of not wanting to provide contraception.” This can then further affect a person’s choice to get birth control as they now feel an increased sense of dishonor, guilt and fear.

SUMMARY

While these countries in North America are fortunate to have access to a wide variety of birth control, there are still many unfortunate barriers standing in the way. It is not just a matter of having birth control be more accessible, rather, it’s about destroying misconception and building awareness. Unfortunately, factors like cultural and societal stigma are large influences in this controversial topic of discussion. However, the fact remains that birth control is needed far and wide across the world so no matter how difficult the conversations may be, they are certainly conversations worth having.