The Pill Mentality

Over the past decade of teaching Creighton and serving couples throughout my diocese, I've noticed what I like to call "The Pill Mentality." While there are very clear connections to the birth control pill, it can be more expansively understood as a "Pharmaceutical Mentality." When I work with couples, I caution against this mentality which puts the family planning responsibility on the woman and simultaneously expects quick, effort-free results.

The birth control aspect of The Pill Mentality is when most (or all) of the family planning responsibilities fall on the woman. The birth control pill and the subsequent patch, shot, ring, implant, etc... whether consciously or not, moved conception from a shared experience of the couple to the sole responsibility of the woman. She became the one responsible for taking the pill, making the doctor's appointment for the shot or the implant, inserting the ring, applying the patch, or whatever else was needed. At the same time, the man stepped back and no longer shared in the responsibility - out of sight, out of mind. This resulted in a game of finger-pointing when an unintended pregnancy occurred. Instead of accepting joint responsibility for the pregnancy, the question was posed to the woman, "What did you do wrong? implying that she failed to take the pill properly or missed an injection, etc. I've seen this play out in my life when a woman using a contraceptive became pregnant and was blamed as if the conception of that little life was a solo event. I've also seen this play out with Natural Family Planning (NFP).

I cannot tell you how many times I've heard a man say, "she just tells me yes or no," and then turn around and complain that all he hears is "no" as if he's an innocent victim of NFP rather than a husband participating in a family planning method. I also cannot tell you how many times I've talked to a woman using NFP who feels isolated and confused because she feels the weight of carrying the family planning responsibility on her own. I've seen this in both infertility cases and in cases where the couple was avoiding pregnancy. I've also had the very sad experience of helping a couple troubleshoot their NFP chart after an unintended pregnancy and had the husband angrily blame the wife for using NFP incorrectly. This has happened more than once, and in every case, the husband was a non-participant in the NFP charting. Now I'm not saying every man does this because that is absolutely not true. Many men are very involved with charting, and they deserve to be recognized. But I've seen enough of The Pill Mentality applied to NFP to talk about it regularly. I encourage every man to participate in NFP. When I do, I tell them that I am not expecting the fiancé or husband to take the woman's temperature, check her cervical position (please don't do that), or stretch her cervical mucus (please don't do that either), but at a minimum, the couple should be talking about the chart regularly - where she is in her cycle and any observations she is unsure of or feels anxious about. Top-tier participation is when both the woman AND man attend the NFP introduction and follow-ups. Couples who do this tend to have the very best NFP experience.

The other form of The Pill Mentality (the Pharmaceutical Mentality) is expecting quick, effort-free results. Culturally, many people cannot or will not make life adjustments to improve their health. Instead, they want to take a medication or supplement, or use a product instead of making a lifestyle change. Think about the huge push for GLP-1 agonists like Ozempic for weight loss or Botox for wrinkles or contraceptives for preventing pregnancy. The underlying message of all of these is "take this pharmaceutical, and you will get quick results with little to no effort!" In many cases, a lifestyle change could be in order. For example, I have had a "watch spot" (whatever that means) on a tooth for 2 years. It hasn't changed, and my dentist usually doesn't say much about it. At my last visit, my dentist up and declared we would need to fill it like we do a cavity. I asked her if it had changed, and she said it had not. She was shocked when I told her I'd think about it and asked to take a picture of the ingredients she would use to fill the tooth. I went home and researched the ingredients. I discovered that several were endocrine disruptors. I did some further research and discovered that my preferred drink (carbonated water) can cause erosion of tooth enamel. I have decided to reduce the amount of carbonated water and use a remineralizing toothpaste and see what happens at my next appointment. Would it be easier to get the tooth filled? Yes. But it doesn't make it the most prudent choice at this moment. But the dentist's shock at my response to getting the watch spot filled highlights the pervasive pill mentality of our culture.

Now I'm not advocating that going 100% granola crunchy is the "right" way to do life because that extreme can be damaging too (maybe I'll write about that another day). I happen to be both very granola crunchy and a HUGE fan of progesterone, levothyroxine, and HRT! What I am highlighting is that many people choose the quick and easy route over lifestyle changes. Where NFP and this mentality butt heads is when someone tries to use NFP as if it is the birth control pill of IVF. I had someone abandon NFP to do IVF because "using NFP would take too long." I've seen this mentality applied when couples tell me that they shouldn't "have to" use yellow stamps, go to a doctor, or switch methods to avoid pregnancy because it is "too much work," as if NFP isn't a lifestyle choice. NFP is a lifestyle choice (that I hate using) just like eating well and exercising. It takes effort and experience to get good at it and enjoy the benefits. And like many lifestyle choices, having a coach can be the key to getting the most out of it and sticking with it. If you need NFP coaching and want to learn the Creighton Model FertilityCare System, then contact one of our Practitioners today!