It was a Saturday night and I was having dinner in a downtown Manhattan restaurant with a group of girlfriends when I started venting about having to get off the pill because it was giving me lots of side effects. Desperate to find a new one, I asked the girls what they recommended. The majority answered that they were not on any sort of birth control, yet they were all sexually active in relationships. My jaw dropped. I was completely shocked.
“I don’t use birth control pills. Never tried it and probably never will. It’s so unnatural, and I’m scared of gaining weight and developing health issues,” a friend said. Another in the group went on about how she believes there’s a connection between birth control and the infertility epidemic that seems to be occurring. Wow, I thought, so many Latinas basically fear birth control.
What was even crazier to me was that the same friends who said they weren’t on the pill said they weren’t using condoms either. So what are they using to prevent pregnancy? The pull-out method.
I soon came to find out these aren’t the only twentysomethings Latinas out there relying on the pull-out method. In fact, they’re calling it the “pull-out generation.” A Duke University survey reported that one in three women between the ages of 15 to 24 uses the pulling-out method as her primary form of birth control. I’ve noticed this to especially be the case among my Latin friends.
Overall, 56 percent of pregnancies among Latinas are unintended, and nearly 4 in 10 of these pregnancies end in abortion. Still while teen pregnancy rates are at a historic low, Latinas are still giving birth more than twice as much as white non-Latina teens.
So why us? Cultural factors still play a huge role in our sexual health, according to several doctors and social workers I spoke to. “Latinas tell me their mothers track their periods, probably because they already suspect or fear their daughters are sexually active,” says Dr. Paula Castaño, assistant clinical professor of obstetrics and gynecology at Columbia University Medical Center.
Although, younger Latinas seem to be more open to the pill, says Melanie Tran, a licensed school social worker at Central Islip School District in Suffolk County who has worked with many different age groups and races as well. “When I worked with middle and high school students in a school-based mental health clinic in the city, the Latina girls were very interested in finding out more information about birth control, how to properly use condoms, and be safe. They, however, did not want their parents to find out.”
Guilt or shame haunts a lot of Latinas when it comes to sexual health, which could stem from more religious and Catholic upbringings, according to several sources. “Our family of origin is our primary teacher of what life is and what we need to make of the world,” says Vicky Barrios, a psychotherapist at Western Queens Consultation Center and a life and relationship coach. “Those messages stay with us even as adults.”
A Nicaraguan friend I spoke with told me that the first time she whipped out her birth control pills in front of her father, her aunt told her to quickly put them away because “he won’t be happy if he sees that.” In reality she wasn’t even sexually active at the time but had gotten the pills to get rid of hormonal acne. She still hasn’t forgotten that incident.
“For many of us, our parents are where our first set of values come from. Oftentimes they are our first introduction to our culture,” says Larissa Vasquez, a health educator who has worked with Latinas at New York Presbyterian Hospital. “We listen to our parents’ opinions and experiences and take into consideration the wisdom they impart. This relationship can sometimes steer us toward one option and away from others.”
Aside from culturally instated biases, there are a lot of fears about birth control pills themselves, even though it is now considered one of the most studied types of drugs available. “The birth control of our parents’ time has evolved and it’s one of the safest, most researched medications on the market, but many don’t know that,” Vasquez adds.
Despite the wealth of information out there, fear of infertility persists. A Puerto Rican girlfriend of mine, for example, told me her grandmother still brings up the Puerto Rican pill trials that took place in the mid-1950s and caused major side effects like depression, fatal strokes, and blood clotting. But the difference is those prescriptions were packed with three times as much hormones as the pills of today.
“Common fears today are about fertility and weight gain,” says Vazquez. But most of the birth control options now contain low doses of hormones.
“[There are a lot of] fears of side effects, particularly menstrual changes and weight gain, and fear of contraception affecting their fertility,” Dr. Castaño adds. “While menstrual changes and weight gain can sometimes happen, we can tailor a woman’s choices to optimize her desires around these side effects.”
Experts agree that overall the biggest barrier to birth control is lack of awareness. From progestin-only pills to extended-cycle pills to combination pills to diaphragms to an IUD to the female condom, condoms to the patch to vaginal rings and more more, women have lots and lots of options nowadays.
“There are options that can fit your preferences and lifestyle that many are not aware of. Not every method is hormonal, or expensive, and what worked for a friend may not be what works for you,” Vasquez adds. “Taking care of your sexual and reproductive health can be very powerful.”