Amanda Black, Professor of Obstetrics and Gynecology at the University of Ottawa, outside the King Edward Hotel in Downtown Toronto on March 21.EDUARDO LIMA/The Globe and Mail
Look up #naturalbirthcontrol on Instagram and TikTok and you’ll find thousands of posts produced by young influencers encouraging women to ditch the pill and use other methods to avoid pregnancy – mainly by tracking their cycles on their cellphones.
In one TikTok video with 1.1 million views, a young woman describes taking her temperature each morning to determine whether she needs to use contraception that day: A red light on her oral fertility thermometer means yes, while a green light means she doesn’t need to.
Other posts encourage women to avoid pregnancy through “fertility awareness,” which involves tracking bodily changes as a way to determine if they are fertile or not.
Some of the central arguments, which are not supported by science, include that hormonal contraception is unsafe and toxic.
Canadian gynecologists say these social media videos, often misleading and created by individuals with large followings and no medical credentials, are reshaping conversations in their clinics, largely among twentysomethings.
The physicians who specialize in reproductive health worry the content is connected to a shift in perspectives about effective, safe and long-standing contraceptive methods that have given generations of women and gender-diverse people agency over their reproductive health. There is also concern that this will result in unwanted pregnancies.
The Society of Obstetricians and Gynaecologists of Canada issued a statement last fall outlining its concerns about social media influencers promoting fertility tracking apps as substitutes for hormonal contraception.
The technology has been criticized by medical professionals who say it is not reliable to avoid pregnancy because menstrual cycles are unpredictable. Some are 28 days while others are shorter or longer. Stressors can also throw off timing.
The SOGC said social-media content is being used to undermine trust in health care providers and treatment options and is creating confusion for patients. It has called mis- and disinformation on women’s health a “growing threat.”
Dr. Black says one of the challenges for health care providers is to ensure they address misperceptions that are circulating so patients can make informed decisions based on the best available science.EDUARDO LIMA/The Globe and Mail
Earlier this month, the Center for Intimacy Justice released a report that found tech platforms including Meta, Amazon, Google and TikTok are “systematically suppressing sexual and reproductive health information for women and people of diverse genders.”
The change in attitudes about tried and true contraceptive methods is taking place at a sensitive time in the reproductive rights movement, including while 19 U.S. states have abortion bans or restrictions in place. In 2022, the U.S. Supreme Court overturned Roe v. Wade, a decision that made abortion a constitutionally protected right for almost half a century.
In Canada, abortion has not been a criminal offence since 1988 but there are barriers to access, particularly in rural and remote communities.
Contraception was decriminalized in the Criminal Code in 1969. At the outset of its availability, the pill was subject to backlash, primarily among religious groups who believed it should either be banned or restricted to married women who wanted to limit the number of children they had.
But the medication has been lauded for decades by reproductive rights advocates who say it affords bodily autonomy to women and gender-diverse people who want to have intercourse but don’t want to get pregnant.
Sexual health professionals fear an uptick of non-scientific information shared on social media, particularly among young people, could result in unwanted pregnancies.
Jen Gunter, a Canadian-born obstetrician-gynecologist and New York Times bestselling author, is concerned women’s health is being targeted with medical misinformation.
In a social-media video last year, Dr. Gunter challenged individuals who talk about “post-birth control pill syndrome” online and make unproven claims that symptoms such as headaches and acne can arise approximately between four and six months after individuals stop taking the pill.
Dr. Gunter said this is not described in medical literature, yet supplements, books and courses are being developed about it, which she calls alarming.
The topic has been a focus for author and naturopathic endocrinologist Jolene Brighten. Her 2019 book, entitled Beyond the Pill, describes the pill as a quick-fix solution used for a variety of women’s health conditions but claims that its use can result in other health consequences, including inflammation and depletion of nutrients in the body.
She has acquired a significant following online, including among young women. In one video, she describes how the pill “pretty much wrecks your body.”
However, Amanda Black, a professor of obstetrics and gynecology at the University of Ottawa and a past president of the SOGC, said hormonal birth control is supported by science, both in terms of its safety and benefits.
In recent years, she has watched a shift unfold in attitudes and opinions on the use of contraception. Often, she said, perspectives are influenced by non-scientific claims made on social media.
Dr. Black said one of the challenges for health care providers is to ensure they address misperceptions that are circulating so patients can make informed decisions based on the best available science. It is important to communicate in a way that builds trust, she added. She does not want patients to wonder if there is an “ulterior motive” of which there is none.
Health care providers are working to support patients who need safe and effective contraception, Dr. Black said.
She has now distilled her response to misperceptions into about 15 seconds. Dr. Black debunks myths including that the pill makes people infertile. She knows it is important to counsel patients because if concerns are left unaddressed, individuals may not want to fill prescriptions, even if they leave the clinic with them in hand.
Dr. Black said Canadians are fortunate to have access to birth control options and reproductive health care because in some countries, contraceptive choice is not available.
She has written in the Journal of Obstetrics and Gynaecology Canada about how Canadian women of reproductive age have largely grown up with available contraception. Many, she wrote, do not realize that more than 50 years ago, selling or advertising of birth control was not legal.
“Today, they have many contraceptive options,” Dr. Black wrote.
