How MAHA Seized Hold of the Birth Control Conversation

In 2010, the birth control pill turned 50 years old. Amid a swell of celebratory headlines and historical retrospectives, Salon chose to mark the occasion in a different manner, publishing Glamour editor Geraldine Sealey’s pithily titled personal essay “Why I Hate the Pill.”

Over the course of several thousand words, Sealey walked readers through a contraceptive tale of woe. About a year after first going on the birth control pill in her mid-20s, she noticed a marked decline in her libido. Switching to a different pill didn’t help (and yes, she tried several). Neither did her brief stint with the NuvaRing, which — despite its lower and localized hormonal dosage — still managed to leave her feeling anhedonic.

At this point, Sealey concluded that hormonal birth control was the culprit, and that meant not just pills and vaginal rings, but also shots, implants, and even some IUDs were totally off the table for her. Copper IUDs — the primary long-acting, reversible method still available to her — proved no better. “Within 24 hours, the 1 3/8-inch long device started poking out of my cervix, which my boyfriend discovered to his horror during sex,” Sealey wrote. A visit to the gynecologist revealed that her uterus was slightly too petite to comfortably accommodate the sole copper IUD available in the U.S. Prescription birth control, Sealey concluded, was simply not made for her.

At the time of its publication, Sealey’s essay was positioned as a bold feminist provocation, a rare voice speaking truth to power about the ways that prescription birth control — most of which relied on the same general cocktail of hormones, just distributed in different forms — had failed a significant number of people. But now, stories like Sealey’s feel impossible to avoid. On TikTok and Instagram, a significant number of posts — and especially posts from high-profile influencers — share birth control horror stories. Hormonal methods, influencers insist, lead to weight gain, loss of libido, mood swings, and even, in some of the more extreme claims, cancer and infertility. IUDs are positioned as torture devices forced on patients by sadistic doctors. The problems Sealey broke consensus to speak out about are now, in their own way, becoming a new consensus — at least among large sections of the online commentariat.

But there’s something very different about the current swell of birth control hatred. While Sealey’s essay was arguing for more and different birth control options — perhaps a smaller version of the copper IUD, like the one approved for use in the U.S. earlier this year, or the lower dose of mifepristone currently being investigated for birth control use in the Netherlands — today’s birth control skeptics are advocating for something else entirely: a return to “natural” contraceptive methods like the fertility awareness method (FAM), dressed up for the modern era with high-tech flourishes like the Natural Cycles app and Oura ring. Much in the way that left-wing hippie vaccine skepticism has given way to a massive right-wing movement, feminist critiques of the ways that Big Pharma has been underwhelming when it comes to contraceptive innovation have been co-opted by a right-wing anti-birth control messaging machine. (Call it the MAHA-ification of birth control.)

Even at the time of Sealey’s essay, there were obvious signs that bad actors might take her legitimate critiques out of context to fuel a more nefarious movement. Just a week after Salon first ran her essay, it had already been picked up by the Pro-Life Action League blog, where a writer positioned Sealey’s distress as a sign that contraception itself was a bad idea. But the real pivot point was almost certainly Ricki Lake and Abby Epstein’s anti-hormonal contraception documentary The Business of Birth Control, which offered a proving ground for many of the arguments we see online today.

First released in 2021 as a follow up to Lake and Epstein’s The Business of Being Born, The Business of Birth Control positions itself squarely on the left, describing itself as an exploration of “the feminist movement to investigate and expose the Pill’s risks alongside the racist legacy of hormonal contraception and its ongoing weaponization against communities of color.” Lake and Epstein describe their work as offering education and options to “women, non-binary, and trans folks [who] are seeking body literacy and empowering forms of healthcare.” A laudatory quote from Jameela Jamil appears on the film’s website.

And yet, as multiple reviews of the film noted, Lake and Epstein’s critique goes far beyond arguments like Sealey’s — which, notably, recognized that many people happily use hormonal birth control with minimal or even no negative effects. In the world of The Business of Birth Control, hormonal contraceptives aren’t a useful, if imperfect, medication with a somewhat shady R&D history; they’re a plot to destroy women’s lives. Moreover, the solution isn’t further research and innovation that might yield more favorable methods for people like Sealey or the film’s subjects. It’s a return to, you guessed it, the same “natural” methods being promoted by today’s social media influencers — methods which, at best, require rigorous monitoring and a willingness to abstain from sex or use barrier methods on fertile days, and which, at worst, offer inaccurate assessments that set people up for failure.

But under its pseudofeminist framing, The Business of Birth Control presents FAM as “real” liberation; a way of managing fertility by getting back in tune with one’s body rather than using medication to disconnect from it; an argument we now see again and again on TikTok and Instagram. Who needs medication when you can be in tune with your body? Never mind that these very medications were created because “naturally” managing fertility was ineffective for many people. If hormonal birth control isn’t perfect, it’s a sign it must be rejected.

A decade and a half after Sealey’s essay, it’s easy to see how genuine feminist critiques of birth control helped pave the path to where we are now. Birth control, like all feminist accomplishments, is far from perfect. It hasn’t fixed things for everyone, and quite a few people feel failed by it, and, yes, there’s racism and exploitation baked into its history. It’s dishonest to pretend that birth control is perfect — and yet at the same time, it’s far too easy for honest, thoughtful criticism of our feminist accomplishments to feed into reactionary calls to roll back all progress entirely. Walking the tightrope between silencing all criticism and laying the groundwork for antifeminists is a challenge, to be sure. But as the MAHA birth control movement grows ever louder, figuring out how to do that feels more important than ever.

Perhaps instead of focusing on birth control’s failures, we can highlight its successes while also recognizing the work that needs to be done to make full reproductive control accessible to all. Hormonal birth control hasn’t “failed” anyone — it’s simply that it’s unrealistic to expect that one mode of pregnancy prevention will ever fit everyone’s needs. Hormonal birth control is a crucial part of universal reproductive freedom. But so, too, are more innovative non-hormonal IUDs, antiprogestins, better barrier methods, and “male” contraceptive methods. It’s not a question of picking one or the other. It’s a matter of enthusiastically fighting to have it all.