The World of Female Contraceptives Just Got a Little Brighter

By: Madelyn Walthall

“Oh my God. Oh, no, what do I do?”

Emma McHugh, 21 at the time, frantically called her mom after a sharp pain notified her that her copper IUD, an intrauterine device, had shifted out of place. Scared and in pain, she waited as her mom called to notify her Colorado-based doctor.

Moments later, McHugh received a call from her doctor saying that she needed to get to an urgent care or doctor immediately. The repercussions? Her body would begin to involuntarily push the IUD out itself, causing the uterine wall to be scraped to infertility. 

Her first thought was to drive to a Planned Parenthood, but it was a Sunday evening, and this clinic was closed. Crying and rocking back and forth on the floor is how her friend found her that afternoon. Together, they drove to the nearest urgent care and told them of the dire situation. They were told that that office did not have stirrups nor the necessary tools to do this procedure. They drove to the next urgent care and were met with the same problem. In a crunch against time and immense pain, McHugh and her friend began calling different urgent cares and private practices all over San Diego. Her mom found one doctor in La Jolla that said he could do the emergency IUD removal. So up the coast, they went.

McHugh lay on the table with her feet in the stirrups, sobbing from the pain and laughing from the nerves. With some persuasion, her friend was allowed to join her in the room to try and calm her down. 

Her friend was instructed to ask the Alexa in the room to play classical music. Loud, aggressive piano music began to play. The female nurse cradled McHugh’s head, as Dr. Mann, the male doctor — the first male doctor that she has ever been a patient of — continued to order her to scoot down and relax. 

“As I’m laying down, the woman nurse is like, petting my head, the doctor’s telling me to stop crying because I’m being too dramatic,” McHugh recalls. “He keeps saying like, ‘I know, it doesn’t hurt that bad. Don’t be dramatic, it’s not gonna hurt that bad.’”

Panicked, on the verge of throwing up and in severe pain, McHugh remembered that her mom told her to cough when the IUD was about to be removed to help ease the process.

Coughing, crying and laughing at her friend hurriedly commanding that Alexa play calming music instead, the doctor managed to take it out, and the pain instantly subsided. 

“It was terrifying,” McHugh said. 

***

This one makes me gain weight, this one causes me anxiety, this one gives me migraines. 

It was in true Goldilocks fashion that fourth-year political science major and women studies minor Annalise Welsh tried out different birth control methods. From the Depo-Provera shot to oral birth control pills to the NuvaRing, Welsh found herself at the end of the contraceptive road. 

At age 17 she first began the process of the Depo shot. After talking with her parents and her primary care physician, Welsh decided to undergo a quarterly birth control shot due to its convenience and 99% effective rate. 

Within a few months, Welsh began noticing a few changes within her body. She was gaining weight and was constantly on edge. So she stopped. 

Still wanting to be on some form of birth control, she switched over to taking daily oral pills. Again what followed was not a positive experience. For over a year, Welsh tried to train her body to accept these pills, but instead, she was met with severe anxiety levels, causing her to end her prescription.

In college now, Welsh contacted the Point Loma Nazarene University Wellness Center to discuss other potential contraceptive methods. It was here she was prescribed the NuvaRing, a birth control ring that goes inside the body and is changed following each monthly cycle. Aura headaches and depressive episodes followed shortly after she began her NuvaRing journey, bringing it to a halt.

Now, after various failed trials, Welsh is no longer on birth control. 

“It’s not like a one-size-fits-all sort of thing,” Welsh said. “It’s kind of hard because everybody’s bodies are different. I have plenty of friends who have been on birth control for years and have no side effects at all and have had nothing but great experiences. So I think just trying things and talking to a healthcare professional and someone who knows what your health situation already is, and can kind of say like, ‘You already have this going on, so you should try this.’”

***

The very first over-the-counter birth control pill, Opill, has hit the shelves in drug stores around the country and on online platforms such as Amazon as of March. Approved by the Food and Drug Administration (FDA) in July 2023, this progestin-only pill is now available with no age restrictions and no prescriptions necessary. 

So, what does this mean for women who are considering their contraceptive options? There is no doctor visit required, no medical examinations, copays or visitation fees and no insurance needed. The only thing standing between you and a month’s supply of Opill is $19.99. 

Jen King, the executive director of the Wellness Center says that it is unlikely that Opill will be brought to campus; however, she affirms the accessibility that this pill provides. 

“There’s a lot of nuances in oral contraception and in all contraceptive methods, and they really should be tailored to the individual for health, related to risk, related to sexual practices, there’s just a lot of things that need to be considered,” said King. “There’s no screening process with Opill, so my bias against it is that there should be more screening and education, although I’m very supportive of access.”

Health Promotion Specialist, certified family planning health worker and 2021 PLNU alumna Kaitlin Sorgea explained that one demographic that may take a special interest in this over-the-counter pill is college-age women. 

“Think about how many people go to Point Loma that are from a different state and their primary care provider is in a different state, their insurance doesn’t apply to places here,” said Sorgea. “So, you know, that kind of cuts off that barrier of trying to find a prescriber here — which, they could get prescribed at the Wellness Center, but if that’s not something that they wanted to do, then they can go over the counter. And that applies, you know, to college-age students everywhere, whose PCPs (primary care physicians) are potentially in a different state.”

***

When considering the most common options for contraceptives that don’t require surgery, women are faced with extremely high prices. The most expensive is the birth control implant which costs up to $2,200 and can last up to five years. What follows is an IUD that can last up to a year at $1,300, a vaginal ring at $500 a month, a birth control shot at $130 quarterly and prescription birth control pills averaging $50 a month, all according to Planned Parenthood. 

When men need to consider their non-surgical contraceptive options, they only have one; condoms which typically sell for less than $2 a condom. While their choices are limited, they are affordable. 

“I think there’s this underlying [idea that] it’s okay for boys to have sex and it’s not okay for girls to have sex,” McHugh said.

McHugh, who graduated from PLNU in 2023 with a degree in international development, said that since her emergency IUD removal procedure, she has not taken on any new contraceptive methods or prescriptions. Having a five-year-long history with birth control pills, she said she knows that she no longer wants to put her body through more hormones, nor does she plan on getting a new IUD inserted. 

She does, however, see the importance of having over-the-counter contraceptive options available, especially for young women who may not have a healthy relationship with their parents regarding sexual health, she said. 

“I have a lot of friends who, even now, are full grown adults, and they live on their own and financially support themselves, but they are on their parents’ health insurance,” McHugh said. “And they won’t go get birth control. They’re scared to because of their parents still.”

Welsh shared a similar sentiment, explaining why she believes that not needing a prescription will be liberating for young women.

“I think a lot of reasons why young women end up pregnant that don’t necessarily want to be pregnant is because they’re scared to talk to their parents about it because their parents are strict, or are against it or have religious beliefs,” Welsh said. “So I think that the fact that it’s more accessible is a really good thing.”

While Opill is a step in the right direction in terms of accessibility and equality in the contraceptive world, there are still many factors that young women should consider before ingesting this pill, said Sorgea. Because it is a progestin-only pill, it has lower health risks when compared to the combination pill that has progestin and estrogen, but it is “touchy,” she said. With progestin-only pills, they need to be taken within a three-hour window every day. Not doing so causes the pill to be ineffective. 

For students who are considering taking Opill as a daily contraceptive, King and Sorgea encourage them to make an appointment with their doctor or on campus at the Wellness Center so their individual health needs can be assessed. 

“We understand that that can be maybe a tough thing to bring up, especially if it’s your first time talking about it,” Sorgea said. “And we’re here to meet you where you’re at. Whether you’re abstaining from sex, [or] whether you are not.”