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Birth Control

I know a lot of pregnant women are shocked when asked about their post-baby birth control plans.  Birth control hasn’t been a part of your life in a long time (depending on how hard-won your baby is, possibly in a VERY long time).

However, there is a term for people who don’t have a game plan about post-baby birth control–parents of another kid.

Yes, breastfeeding CAN suppress ovulation.  Until six months or the FIRST time you go six hours between start of feed and start of feed.  That suppression is not effective in 100% of women.  You can’t rely on breastfeeding to be your birth control.  Even if you’d like another child-there are many reasons to wait 18-24 months before getting pregnant–another pregnancy so soon will be very difficult on your body and raises your chances of problems during pregnancy and pre-term birth.

If you’re on the fence about what method you want to use or are interested in a new option, may I strongly encourage you to check out Planned Parenthood’s website on birth control?

Personally, I’m getting another Mirena

I have tried many forms of birth control over the years, and this is the easiest by far.  Yes, it hurts to have it inserted, and it’s a good idea to plan to be home in bed that day (and possibly one more day).  BUT, once it is in, you are clear for sex without any secondary measures (like condoms) and you are pregnancy-free for five years before you need to get it re-moved and new one inserted.

I don’t plan to have more children, but if you want another (as I did after the LM), you can just get it removed and fertility returns immediately.  I got pregnant 2 months after my last Mirena was removed.

I am not being paid to shill for Mirena–this is a product I’ve used and that I like.  I suck at the take a birth control pill every day, much less every day at the exact same time.  The shot can cause issues with bone density. I didn’t like the ring.  The patch irritated my skin and gave me a rash.  Condoms are too easily forgotten in the heat of the moment.  The copper IUD isn’t recommended for women who have bleeding disorders (as I do).  Hence, Mirena is really my best option.

If we were in the US, I would likely be getting the Essure female sterilization procedure done, but no one in my current home country is licensed to perform it, so back to Mirena I go.

I had a C section-Why can’t I use tampons?

Here’s something I learned only a few weeks ago.

I’d been thinking about my c section and comparing it to the LM’s vaginal delivery.  Obviously the two experiences are, overall, quite different, but one thing remained consistent–NO TAMPONS during the lochia bleeding post-delivery.

I understood what the risks were with tampons and vaginal delivery-the cervix had been opened, and there was an open wound where the placenta had been attached to the uterine wall-creating potential for infection.  I also had torn during my delivery and had stitches in my vaginal wall, creating another spot vulnerable to infection.

But why couldn’t I use them now?  Hadn’t I gotten cut open, completely bypassing that whole “cervix opened” issue?

I asked my OB, and it turns out that during the c-section, they open your cervix anyway, to help aid with the passing of the lochia.  Internet research says that not all doctors do this, so it may be okay’ed your individual physician.  However, it’s worth noting that you still have an open wound at the spot where your placenta connected to the uterus, and that it remains at high risk for an infection.

So, inconvenient, messy, and just kind of gross or not…best to use a pad after delivery for the few weeks that you’ll bleed.  Once you’ve stopped and your “normal” period returns (which can take up to six months if you breastfeed), you’re welcome to return to other methods of blood collection like tampons/diva cups/what have you.

For the record, I’m not being paid to recommend these, but with this birth I used the loquaciously named “Always Extra Heavy Overnight Maxi Pads with Wings“  and found that unlike after E where I put two pads (one front, one back, kind of overlapping in the middle) on, I had very little staining and only had to throw out one pair of panties.  They’re easily found in the US, but I had to bring them back as I couldn’t find a product with equivalent coverage here in Singapore.

The A Word–review

The A Word–a film by Lindsay Ellis

“The A Word” is not an easy film to watch.  It is a 30 minute look at how the experience of abortion affects women who have had abortions…including the film-maker, Lindsay.

The uncomfortable truth that had me squirming as I watched the movie, is that both sides of the abortion debate are so focused on the fetus that we don’t really spend enough time on the women who’ve gone through the procedure.

We meet the head of a post-abortion counseling hotline, Aspen says it best when she says that

The pro-choice/pro-life debate in the US hurts a lot of things.  And it certainly hurts women who’ve had abortions.  The goals of either side is  to keep the arguments as simple as possible, and to shut down anything else that sort of doesn’t align with that message.

What happens is that all the yelling at each other keeps the voices of women who’ve actually experienced abortions from being a part of that discussion in any way.

As a pro-choice woman, perhaps especially because I’ve volunteered with Planned Parenthood…I’m guilty of this, too.  I want to cheer in triumph when reports come out saying things like Abortion Study no long term ill-effects on emotional well-being, and if I’m being totally honest, shove it into pro-life demonstrator’s faces.  My gut instinct when I see things like the moment in Ellis’ film where she interviews a pro-life woman who had four abortions and she holds up a sign saying “I regret my abortion” and says that all the women who attend the rally will hold that sign…is to doubt the veracity that every woman who’ll be holding the sign actually had an abortion…because I don’t want to believe that so many women do.  I want the side of the debate that helps justify the hours of my life I’ve spent with Planned Parenthood, the letter writing campaigns, the hatred I feel for protestors who harass women coming in and out of the clinics.

It’s not easy to have a documentary teach you a lesson you may not want to learn.

Growing up, the idea of going through an abortion didn’t seem like a big deal to me. It was distant, impersonal, uncommon and more just something people debated about during election seasons. But my circumstances changed.  And with a change in circumstance comes a change in perspective.

Lindsay is struggling with her decision to have had an abortion.  She doesn’t fit neatly into any of the little boxes that the pro-choice or pro-life lobbies would like her to be in.

We see her talk with her mother, who has far less ambivalence than Lindsay does about her own choice to have an abortion following a rape, and Lindsay’s choice to have one.  She talks with the baby’s father, who comes across largely as frustrated that they’re still talking about this, with one exception when he asks her if she’d named the baby.  In taping a pro-life rally, Lindsay is moved to speak to step from behind the camera to the front and speaks to the crowd… about how isolating the experience is.

One of the key things that comes up is that with very few exceptions, there is almost no support for women who’ve had abortions.  The post-abortion counseling that does exist is largely Christian and conducted by pro-life groups.  Which is not necessarily helpful for many women…as they will have expectations for you to feel guilt in the same way that my compatriots expect you to feel good about your decision.  There doesn’t seem to be a lot of room for ambivalence, and ambivalence is Ellis’ primary emotion.

It is actively painful at time to watch.  I was moved to tears more than once. I knew Ellis was good–I’ve been a fan of hers for over a year.  But I had no idea that her potential was this great.  This is a movie that deserves, NEEDS to be seen…and if you’d like to see it to, read about how you can obtain a screening copy and help fund submitting the movie to various film festivals here.

Is it a perfect movie? No.

My first wish is that it be longer.  I think the subject is so meaty and that Ellis is such a strong film-maker that a 60 or 90 minute documentary could have been even more powerful.  However, having read her blog, I know she struggled with funding the documentary as it is, so that may be a key reason that it isn’t longer.

My second is that I wish Ellis had given a little more time to pro-choice groups.  We see a pro-life woman say some things that are inaccurate (that there’s documented prof that abortion causes emotional damage and that it has physical consequences…there is no such documented proof).  I’m worried that perhaps there aren’t enough pro-choice organizations thinking about aftercare.

Lindsay–if you ever read this…I just want to say thank you.  Thank you for sharing your story.  Thank you for saying an uncomfortable truth.  I promise to actively try to open my mind and legitimize opinions that aren’t my own, and to not shove you or women who have gone through what you have in the box I’d prefer that you/they fit into.

My Mirena Story

I hesitate to tell my story about my experiences with Mirena.  I hear so much vitriol hurled in their direction that I don’t want to serve as further ammunition.  I genuinely feel that while I had a negative experience, that my story is a rare one, and that Mirena is one of the better contraceptive options available today.

I chose to use Mirena after the birth of my daughter in 2008.  My obstetrician at the time advised a 10 week wait time before insertion to give the uterus time to return to normal as well as the cervix.  I found the insertion process to be painful, but within a day or two I was fine.  I had the occasional break-through bleed for 1-2 days at various points throughout the two years that I used it.

I did find it odd that I had a long (5-7) day bleed in November, but didn’t really think anything of it.

In early December, having arrived at the decision that my partner and I were ready to move forward and have a second child, I chose to have the Mirena removed.

Two days after removal, I had began to bleed.  The first day was a light to moderate bleed, and nothing that seemed out of the norm for me.  Day two was a heavier flow with some clots, but again…nothing out of the realm of “normal.”  It wasn’t until day three when things began to worsen, rather than improve or stay stable that I began to feel concern.  By day five, I was soaking through a pad about every two hours and each time I sat down, large clots (alarmingly large…easily the length and width of my index and middle finger held together) were passing.

I had called my gyn (not the same doctor that inserted it…I was living in the US during insertion and now live in Singapore) to report my bleeding and express concern.  I was metaphorically patted on the head and told that I was imagining/exaggerating the extent of my bleeding.  This just isn’t how Mirena works, or what women experience after removal, I was told.  I fired him.

I searched for, and found another gyn, and was able to get an emergency appointment.  She too, at first, thought I was exaggerating, but did a pelvic exam and seemed quite concerned about the clots she had to clear just to visualize my cervix.  I was sent for an ultrasound, which showed I had grown a very thick endometrial layer within my uterus and had several large potential polyps present (in the analysis done later, it was shown that they were merely large clots).  An emergency D&C (dilation and curettage) was scheduled for the morning.  This was reassuring, as I was officially hemorraghing by this point…I was soaking through a pad an hour, passing large clots, and was beginning to feel the strain from all the bleeding.

I’d had a D&C in 2007, related to a miscarriage, so I knew what to expect (which is good because no one felt the need to review the procedure with me, unlike in the US where they went over it at least 3 times).  I did not expect to have to beg and scream and cry for painkillers, which led to more than an hour wait before the pain was treated such that I didn’t want to pass out.  This is the opposite of the vicodin I had poured down my throat once I regained consciousness in the US.

Within two or three days I felt fine, and my uterus has returned to normal.

What I find disturbing is the lack of information that Mirena provides on this as a potential reaction.  I do not doubt that it’s rare..rare enough that the gyn here said she wouldn’t hesitate to put me back on it after a second child’s birth, which I was surprised by.  But I do think that even if it’s a 1 in 10,000 reaction, that there should be some admission by Mirena to that effect.  I’ve certainly found enough anectdotes online to indicate that it’s hardly as rare as 1 in 10,000 (a number I’m just making up.).

I have had some truly frightening experiences in my life, so I would not rate this as “the scariest,” but my partner and I were genuinely frightened by the hemorraghe.

In the service of educating others about contraception and their pluses and minuses, I feel it only right to share my story.

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