Why I never started the pill

A story about choosing differently, and being okay with that.

For a long time it felt like there were only two kinds of women: the ones on birth control, and the ones who hadn't figured their lives out yet. I got the raised eyebrows. The "wait, seriously?" The assumption that I just hadn't gotten around to it, or that I was naive, or that I was one bad night away from learning my lesson.

I wasn't naive. I made a decision and I've stuck with it for years, and I'm tired of explaining myself like it's a phase I'm going through.

So here's the actual explanation, once, in full.

Why I said no

I never took hormonal birth control. Not the pill, not the patch, not an IUD. It wasn't because nobody offered, my doctor brought it up more than once, the way doctors do, almost as a default question on the intake form. Every time, I said no thanks, and every time I had reasons.

I didn't want to gain weight. I know that's not universal, plenty of women take the pill and never notice a difference on the scale. But weight change is a documented possible side effect, and I know my own body well enough to not want to gamble on it. I'd watched it happen to people close to me. That was enough for me to steer clear.

I didn't want a surprise pregnancy. This is the part people don't expect, because the assumption is always that birth control prevents that outcome and skipping it invites it. But I watched several of my closest friends get pregnant while on the pill, missed doses, antibiotic interactions, bad timing, or just plain bad luck, because no method is 100 percent. I have the godchildren to prove it. Beautiful kids, every one of them, and I love them fiercely. But watching my friends navigate pregnancies they hadn't planned for, at stages of life they hadn't chosen, taught me that "I'm on the pill" isn't the guarantee it gets sold as. I wanted a method I trusted completely, and for me that wasn't a pill I could forget to take, or take wrong, or have knocked out by something else in my system.

IUDs made me nervous for a different reason. I looked into them seriously, they're effective, they're low-maintenance, they check a lot of boxes on paper. But IUDs can shift position, and in rare cases migrate or perforate the uterine wall. The odds are low. Low odds of something happening inside my body without me knowing about it were still not odds I wanted to carry around. Call it squeamish. I call it knowing myself.

My method of choice was abstinence and condoms. Not glamorous, not what shows up in birth control ads, but it worked for me. Abstinence when it made sense, condoms when it didn't, used correctly and consistently every time, that part matters more than people think. My doctor once told me that used correctly, condoms are far more effective than most people give them credit for. That was the reassurance I needed to feel confident in the choice instead of anxious about it.

The silence and assumptions

When you choose not to take birth control, a few things happen.

People assume you're uninformed, or that you just haven't had "the conversation" with a doctor yet. In my case it was the opposite, I ended up doing more research into methods, failure rates, and side effects than most of my friends who were on the pill ever needed to, because I was the one who had to justify my choice at every turn.

People also assume that skipping hormonal birth control means skipping precaution altogether, like the pill is the only thing that counts as "doing something about it." There's a difference between not being on birth control and not doing anything. I was doing plenty. I just wasn't doing it with hormones.

And there's a quieter assumption underneath all of it, that if you're not on the pill, you must be either reckless or repressed, with nothing in between. Nobody ever asked if I'd actually thought it through. They just assumed I hadn't.

My friends' experiences, the surprise pregnancies, weren't failures of judgment on their part. They were proof that no method is bulletproof, hormonal or not, and that everyone's body and risk tolerance are different. Some of my friends have been on the pill for a decade with zero issues. Good for them. That math just didn't add up the same way for me.

My actual stance on birth control

I'm not writing this to convince anyone to ditch their prescription. I'm not anti-pill, anti-IUD, or anti-anything. If hormonal birth control works for you, manages your symptoms, fits your life, you feel good on it, that's genuinely great, and you shouldn't second-guess it because of a blog post.

My stance is simple: choose what's best for you. Everyone's body, health history, risk tolerance, and life circumstances are different. What worked for my friends didn't work for me, and what worked for me won't be right for everyone reading this either. There isn't one correct method here, just the one that fits your body and your life.

Talk to your doctor. Ask the uncomfortable questions. Ask about side effects, about failure rates, about what happens if something goes wrong. Don't let anyone, including me, tell you there's only one responsible choice. The responsible choice is the informed one, whatever it ends up being.

I went with abstinence and condoms because that's what let me sleep at night. Your answer might look completely different, and that's exactly how it should be.

If you've made a birth control choice that didn't look like everyone else's, I'd love to hear about it in the comments.