Permanent birth control choices redefine my identity as a woman

By: Rose Hansen

Posted: 10/7/08

If you paid attention during sex ed in middle school, you'd know about the plethora of birth control options out there - abstinence, condoms, spermicide, withdrawal, ovulation timing, the patch, the shot, the pill, the ring, vaginal contraceptive film, IUD's, and sterilization.

I've tried several methods, but eventually chose Implanon - a small rod inserted on the inner part of your arm just underneath the skin. It stops your body from ovulating for up to three years. They give you a shot to numb the area, punch a tiny hole (the pen mark for the insertion is larger than the actual puncture), and slide it in. The process literally takes about one minute. And the best part? Thanks to the Family Planning Project at the Student Health Center, the consultation and cost are covered.

Just how effective is Implanon? The failure rates are between 0.05 and 0.1 percent. That's better than sterilization, which is 0.2 percent. And if you were wondering, condoms average 85 percent and the pill 95-97 percent effectiveness.

Well, if you're anything like me, you don't use condoms and pills correctly every time because life gets in the way. You didn't bring a condom, it breaks, you left your pills in your purse, you partied too hard and threw up, or you just plain forgot. I was on oral contraceptives for the majority of my sex history and didn't always do it right. Although I never had a serious pregnancy scare, I reached a point where I either needed to be more responsible about the pill or change my birth control.

In the days leading up to my Implanon insertion, I was looking forward to a lot of positive changes in my life. I was ready to say goodbye to worrying about pills, plan B, and pregnancy.

Now, I'm a few weeks past getting Implanon, and only recently did it hit me: I won't have a baby for the next three years. I've got a higher chance of dying, contracting an STD, and developing skin cancer. But basically, I'm infertile until I take Implanon out.

This should be a good thing, right? I'm young. I'm in college. There are still places to see, people to meet, things to do, food to taste and sex to be had. Besides, having complete control over when I have children is the new American way. In our country, many women have evolved past having babies in our teens and twenties, when our bodies are ready for it. Now, we have them in our thirties and sometimes forties, when our incomes are ready for it.

But still, it's weird. Since ancient times, having children is universally linked with womanhood. Fertility is so celebrated in history and culture that it seems strange to purposefully shut it off. I never questioned birth control while I was taking oral contraceptives, but I think my growing discomfort with Implanon is because its effectiveness is so absolute.

I don't even know if I ever want children, and I've never had sex with the intention of getting pregnant. But in the back of my head, I always assumed that if I did get pregnant, that would be my baby. I had taken the steps to prevent pregnancy, but if it happened, it would be the baby I was supposed to have.

My temporary inability to bear children is jarring my self-perception. Is a woman who shaves her head less feminine? What about a man with long hair? Are you still a woman after you lose your breasts to cancer? A man without testicles? And for those who can't bear children, are their personal identities forever altered?

In perspective, questioning my identity is probably better than the irreversible life changes that result from accidentally having children - especially without the income to support it. For now, I've got three years to wonder.