Book Review: In Our Control: The Complete Guide to Contraceptive Choices for Women

By Cynthia Pearson

Fifty years after the approval of the first birth control pill, over 80 percent of U.S. women old enough to have needed it have taken it, at one point or another in their reproductive years.  At the same time, studies have found that nearly one third of all women who start taking the Pill stop using it within a year or two, and many women, whether or not they’ve used the Pill, report being dissatisfied with the contraceptive choices available to them. 

If the Pill is so ubiquitous, why isn’t it enough? Contrary to Margaret Sanger’s hopes that a contraceptive pill would be a magic bullet – a family planning technology that works every time, for every person – oral contraceptives aren’t ever right for some women and aren’t always right for many women. If a woman believes oral contraceptives aren’t the right choice for her, where can she get useful information?  These are the questions that prompted Laura Eldridge to write her new book, In Our Control.

There’s a real need for books like Eldridge’s, which builds on Our Bodies, Ourselves’ tradition of women-focused health empowerment. While many women are well-served by caring and respectful clinicians, corporate marketing efforts can complicate these relationships. Too many clinicians prescribe the most expensive and newest brand of oral contraceptives when their patients could use an equally effective and much cheaper generic version — or might do better using a different contraceptive altogether. And, unfortunately, even after decades of efforts to break down barriers that kept women and people of color out of medical school and to foster providers’ cultural competency, some professionals don’t believe they have a responsibility to treat all women with respect or offer complete information about the pros and cons of all available methods.

So, it’s no surprise that there’s a real need for books like Eldridge’s. It’s subtitle is The Complete Guide to Contraceptive Choices for Women, and that’s certainly truth in advertising. In Our Control is an extremely in-depth presentation of every approach to contraception a woman could choose. In fact, it’s so in-depth it even includes a chapter on the pill for men. But, unlike similar in-depth guides written for clinicians, In Our Control isn’t just a good source of solid, factual information. It’s that and a lot more. 

Eldridge’s 300 pages are fun to read – starting with her clever organization of material into sections that make sense from the perspective of a curious consumer. In particular, “Hidden in Plain Sight: Non-hormonal Contraceptive Options” and “Spotless: Questions and Controversies with New Menstrual Suppression Drugs” are two chapters likely to interest most readers, even if they aren’t currently considering a diaphragm or the new year-round oral contraceptives. In her chapter on newer hormonal methods, “By Any Other Name,” Eldridge does a superb job explaining how patches, rings, implants and hormone-releasing IUDs evolved from oral contraceptives. Eldridge’s clear explanation of this complicated material will help women who might want a method that doesn’t require remembering to take a pill every day, but don’t want to expose themselves to the newest versions of hormones — some of which may be slightly more risky than versions used in other methods.

No consumer guide to contraception should avoid discussing the safety of various methods, and here, too, Eldridge acquits herself well. She presents the facts in an understandable manner, and humanizes the decisions women have to make about balancing risks with convenience and effectiveness by presenting well-chosen anecdotes from real women. 

Women who pick up this book hoping to find useful information to support their personal decision will find that, and more – In Our Control includes chapters on menstruation, HPV vaccines, and the international struggle over women’s right to contraception. One of the final chapters, “Going Green: The Environmental Burden of Contraception,” is a thought-provoking examination of exactly what happens when we’ve finished using a contraceptive. It’s not just flushing the toilet that affects the environment, as Eldridge explains in sections devoted to how best to dispose of used vaginal rings and contraceptive patches.  

Laura Eldridge has worked with the legendary Barbara Seaman, one of NWHN’s co-founders, and Barbara would be proud of this book. Eldridge continues the best tradition of providing clear and accurate information to women so they can make choices that are best for them. The book is well worth reading and it’s wonderful that Eldridge ably continues Barbara’s commitment to putting patients before profit, and empowering women to take health issues into their own hands.

In Our Control:  The Complete Guide to Contraceptive Choices for Women, by Laura Eldridge, 352 pages, $21.95, Seven Stories Press, New York; www.sevenstories.com.

Cynthia Pearson is the NHWN Executive Director