An Easy Pill to Swallow: Birth control options for women over 30

by Sherri Kolade

Birth control has come a long way and Black women are taking advantage of the latest and greatest (and tried and true methods) to keep babies at bay for now, later or forever.

From 16th century BCE Egyptian and Mesopotamian women mixing unripe acacia fruit with honey and ground dates to use as a spermicide to the pill becoming approved by the Food and Drug Administration in 1960 – women have many choices today. But which one is the right one? Local doctors share what’s what. But, not so fast.

According to the Centers for Disease Control and Prevention, nearly two-thirds of U.S. women use contraception; Detroit resident Tikoya Lanier-Nwabuisi, 39, is one of those women.

Lanier-Nwabuisi wants kids in the future but recently became a new bonus mom to a five-year-old and an eight-year-old.

She said that she’s used oral birth control in the past and it didn’t work for her; now an IUD is more to her liking.

“Birth control is used to treat reproductive health issues as well as preventing pregnancy and even with this you have options,” she said, adding that when she was first given oral birth control it made her sick and caused her to have blackouts and fainting spells.

Lanier-Nwabuisi said that she’s learned through the years how to be an advocate for her own health and to “speak up when something doesn’t feel or seem right.”

“Personal research and talking to doctors directly have been the modes that have worked best for me,” Lanier-Nwabuisi said. “I ask questions until I feel satisfied with the answers then I pray about the rest and make a decision.”

Dr. Earlexia M. Norwood, service chief of Family Medicine at Henry Ford West Bloomfield Hospital, said that there are multiple forms of contraceptives available so women “actually have a choice.”

“Historically, women have had only limited choices for options … the first place to start for women 30 or over, or younger, is to think about what they want long-term,” Norwood said, adding that the primary question is, are the women searching for birth control options interested in having more children, or not.

Dr. Earlexia M. Norwood of Henry Ford West Bloomfield Hospital, wants women to learn what birth control options work best for their bodies. Photo provided by the Henry Ford Health System

She added that she provides women with long-term and short-term contraception choices, and discusses the health risks associated with them.

Some permanent birth control procedures include getting a tubal ligation where a woman’s fallopian tubes are blocked.

“This little tube is inserted on both sides of the fallopian tubes to cause scarring so eggs are not released,” she said.

She added that this surgery is more costly than a vasectomy, which is cheaper and less invasive and can be done in an out-patient procedure.

“Most men don’t want to do that,” she said, adding that birth control, no matter the route, is not 100 percent effective.

For women over 30 who are healthy, looking to have more children and want something long-term, they can consider taking a birth control pill.

“If you are over 30 and you are a smoker, birth control pills are no longer recommended,” she said. “We know that it increases your risks of heart attacks or strokes.”

Norwood said IUDs (used by mothers and grandmothers generations ago) are placed in the uterus and are a bit different today. There is still a copper IUD also for emergency contraception for women who have sex without protection but don’t want to get pregnant.

“The copper IUD … has changed a bit and lasts for 10 years and there are no hormones in it,” she said of the IUD she described as “one of the great saving graces” that can give women longer contraception if they don’t know if they want to have kids or not, but don’t want to take something every day.

Norwood added that the one of the most popular birth control forms is the Mirena IUD which lasts for about five years. It is a hormonal IUD that women like because it can help decrease the likelihood of them getting their cycle.

IUDs are placed by the physician during an office procedure and are checked occasionally during a pap smear to ensure the IUD is still in place.

“I think the IUDs are a great way to have long-term contraception for women who are looking to not conceive because they’re trying to finish their career, school,” and the like she said. “I think we’re seeing a lot more women using that form of contraception as opposed to taking birth control pills every day.”

From injections every three months (certain ones can increase weight) to tiny arm implants and vaginal rings (inserted into the vaginal canal) and kept in for about three weeks and removed during menstruation and replaced with a new one, Norwood added that hormonal birth controls continue to be popular. Non-hormonal barrier methods are popular, too.

Some include male and female condoms, a diaphragm, a cervical cap, vaginal sponges, and the rhythm method, which she said is not reliable.

“If you are looking for contraception and protection against an STD use a barrier method,” Norwood said. “I don’t care what you’re using, if you are not in a committed one-on-one relationship use a barrier method to decrease your risk.”

Beaumont Dr. Shari Maxwell, program director of the Obstetrics & Gynecology Residency Program, helps women with birth control options, and said that some patients have very strong desires to not have hormonal birth control options, while other patients don’t mind either way.

Beaumont’s Dr. Shari Maxwell helps women with birth control options. Photo provided by Beaumont Health

“When I’m trying to counsel patients or educate them [I] let them know the two types of birth control: some are associated with hormones and some that are not.”

Maxwell added that she gets a feel for where they are on their journey and see what possible concerns and hesitations they might have.

She added that she knows the disparity in care Black women have received from doctors who might have given them limited birth control options instead of the full spectrum.

“It is really important for the physician to make sure that the patient understands what their options are and get a feel for how involved the patient wants to be in taking or using a particular form of birth control,” she said.

“If a person is forgetful, pills may not be the best method,” she said, adding that abstinence is the best contraception, but if that is not in the game plan, choosing the best birth control is the next best thing. “I have to find out what your goals are.”

Maxwell has young and older patients who come to her Dearborn office in different phases of their lives and birth control journey. She said some patients come to her with planned pregnancies and a lot of unplanned pregnancies, especially for her older patients.

“Older women come in saying, ‘I wasn’t expecting to get pregnant again,” she said adding that some of her patients who don’t use birth control (only the rhythm method) never get pregnant. “I say they’re more lucky than not.

“Certainly, as an African American female patient make sure your doctor is taking the time to discuss those options with you and not just pushing something on you because it is the easy thing to do,” she said. “I even tell my patients when I put them on pills if this doesn’t work for you, I’ve got all kinds of pills because everything doesn’t work for everybody.”

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