Oct 25, 2023 - Health

What's driving more women to quit birth control

Illustration of a sheet of birth control pills with the "no" symbol crossing each pill out.

Illustration: Annelise Capossela/Axios

At the same time the fall of Roe v. Wade has fueled an interest in expanding contraception access, OB-GYNs say they have seen a wave of patients quitting hormonal birth control for more "natural" options.

Why it matters: The turn against effective forms of birth control raises concern about increased risks for unplanned pregnancies when abortion is being severely limited or banned across much of the U.S.

  • Experts say that while this shift remains small for now, it reflects both the growing power of online influencers — who in some cases may be providing inaccurate information to their predominately younger audiences — as well as a changing conversation around women's health.
  • "Women's health is generally top of mind in the public discourse in a way that it hadn't been before," said Neel Shah, chief medical officer for women's health company Maven.

Between the lines: Polls have found increased interest in taking birth control since Roe was overturned in Dobbs v. Jackson, and the first over-the-counter birth control pill is expected to become available early next year.

  • Anecdotally, however, reproductive health experts say more patients are asking critical questions about hormonal contraception such as pills, patches and implants.
  • TheSkimm, a media company focused on Gen Z and millennial women, in a recent Instagram poll found a third of women who were not on birth control said they'd stopped taking it within the last year.
  • Reproductive health experts say the skepticism is tied to the heightened political debate around birth control, as well as an increase in social media and other content — like the 2021 documentary "The Business of Birth Control" — raising concerns about the risks of hormonal contraception.

Doctors say they welcome patients' questions and more nuanced discussions about the benefits and potential side effects and health risks of hormonal contraception, such as a small but statistically significant increase in risks for stroke and breast cancer.

  • They also acknowledged this discussion is complicated because some women — particularly women of color — have found their concerns about side effects they've experienced dismissed by their doctors.

The American College of Obstetricians and Gynecologists, in clinical guidance updated last year, said the benefits of contraception are "widely recognized" and that a "lack of knowledge, misperceptions, and exaggerated concerns about the safety of contraceptive methods are major barriers" to its use.

  • The problem starts when patients put undue weight on cherry-picked studies, misinterpreted information, or flat-out disinformation, said Suzanne Gilberg-Lenz, an OB-GYN in Beverly Hills.
  • She pointed to claims making the rounds online that the pill interferes with women's pheromones, affecting their attraction to their romantic partners once they stop taking it.
  • While intriguing, those claims have been based on small studies and are often exaggerated, she said.
  • "The difference is the rise of health influencers who literally have no idea what they're talking about, no legitimate claim to educate the public," she said. "It's hard for the public to distinguish who's who."

Zoom in: A surge of investment in the business of delivering women's health care, driven by Roe's reversal, may also be amplifying unreliable information, Maven's Shah said.

  • "It's almost like a gold rush," Shah said. "That is good in the sense that we're finally getting the investment in women's health, but it's also creating a lot of noise."
  • "That makes it harder for people to sift through what's credible and trustworthy and what isn't."

The intrigue: Broader questions around contraception for women may be driving an increased interest in men's role in preventing unplanned pregnancies, said Khaled Kteily, founder of male fertility company Legacy.

  • The company saw a 50% increase in men choosing to freeze their sperm and get proactive vasectomies after Roe was overturned, he told Axios.
  • "That was part of a broader trend of men wanting to rebalance responsibilities around family planning," he said.

The bottom line: Disinformation is an existential issue in women's health, Shah said.

  • "What you're seeing in contraception is one manifestation of it, but I'm seeing versions of it in maternal health and fertility and menopause," he said.
  • "And I do think that it's going to get an order of magnitude worse, over the next year, going into the general election."
Go deeper