The Pill – An Outstanding Business Model

You know what I haven’t talked about in a while?

Birth Control. Oh yes, it’s time for shameless plug on fertility awareness.

It is upsetting and embarrassing that in the 21st century, the average woman has absolutely no idea what goes on during their cycles. I say average woman, because I consider myself a somewhat average woman and up until about a year ago, I had no idea.

It is disconcerting that in 2012, we are told taking a pill to suppress a perhaps perfectly healthy body is the only “responsible and beneficial” thing to do*. And that your own body can’t be trusted. But the doctors say so, why wouldn’t we trust our knowledgeable, highly-educated, exceptionally salaried doctors? Let me be clear here, my goal is not to point out doctors as the bad guy, but rather illuminate a quandary in the medical profession and schooling.

I have spoken with a handful of people currently in medical school. My first question to anyone I discover is studying nursing or medicine is, “How do they paint the birth control pill in your classes? What sort of things do they say about it? Do they pose risks and complications?” And most importantly, “What do they say about fertility awareness methods?”

I have gotten a variety of answers. The biggest facepalm moment was when someone told me, “They really encourage both – I mean taking the pill and charting your cycles, that way you have double protection you know? You know when you’re ovulating on the pill so you can be extra careful.” To me, this was plain depressing. “You’re going to med school?” I thought to myself, “This is embarrassing for 21st century women. We don’t even know that the pill suppresses ovulation.” That’s right, for anyone who doesn’t know this – the pill’s primary contraceptive effect is suppressing ovulation, meaning that you DON’T. Therefore, you can not chart your cycles, because you aren’t actually having a cycle. (The same reason it doesn’t regulate your periods, because you’re not actually having a period.) Phew, okay now that that’s cleared up, we can move to other responses.

Someone else told me, “They paint it pretty well, I mean it really is the miracle drug. We have a responsibility to promote it for the health and well-being of all women. Anyone struggling with acne, irregular periods, cramps, etc.” Then I asked about fertility awareness, and she answered, “The rhythm method?” (Another facepalm.) I explain that the rhythm method and fertility awareness are two completely different things. She kind of muses for a second and says, “I don’t know there might have been a chapter on it somewhere, but we haven’t gotten to it.”

Lastly, someone else replied with, “The risks of the pill are so small in comparison to its benefits. Reduced risk of ovarian cancer and uterine cancer, clearer skin, it regulates your periods, it’s all worth it for a little bit of increased risk for blood clots and breast cancer, which the risks are already so small.” Hmm…I can agree that the risks may be ‘small’ (It all depends how you define small…) Then I asked about FAM, to which she responded, “Yea, I remember studying it for like a lecture. They present it kind of like, ‘It’s doable, but not practical.’ You know kind of like winning the olympics, it’s not easy.”

So before doctors are doctors, what are they? Med students of course. And what they are told in med school translates to what they tell their patients years down the road. And why would the pill be placed in such golden light in med school? I’ll give you 3 good guesses and the first two don’t count:

MONEY. The pill and LARC (long-acting-reversible contraception) are a multi-million dollar business. From an economic viewpoint, it’s a great business model – get a young girl on it at age 14 – then you’ve got solid business from them for the next decade, at least. That’s one pack of pills a month, 12 months a year, 10 years in a decade, well you do the math. (Insert, “But birth control is free now!” to which I respond NOTHING is free. No, not even lunch.)**

After initial costs of learning Fertility Awareness, which consists of a few classes, a thermometer perhaps, paper charts and/or a phone app (I got my phone app for free from a Catholic website, beat the system!), a copy of TCOYF if you so please, you need not invest another dollar. Knowledge is knowledge. Therefore FAM isn’t nearly as profitable, at least for an extended amount of time. If you will, a not-so-sustainable-business model.

The thought has cropped into my mind about how cool it would be to create some kind of nifty, designer charts, or technology such as the Ladycomp. (Think like an entrepreneur!) Maybe there’s a big business in something like Ova Ova (which is a beautifully designed online charting website), and these are all good and well. I mean isn’t the ringtone business a million dollar business? Or silly bands? If these things can be a viable enterprise, why can’t designer charts be?

The bottom line is that doctors can’t really sell FAM in a capitalist economy. (I’m all for capitalism, don’t get me wrong.) The drug companies can’t profit from it. The counter argument to this could be, “If the drug companies lose clients from birth control, then they would gain it in natal medicine.” But this still isn’t nearly as sustainable as birth control. Babies grow, children become teens, they won’t always need natal medicine. But a woman, as long as her fertile years are (Anywhere ranging from 20 years to 40), THAT’s a persistent consumer that Pfizer can count on.

**Now would be an appropriate time to bring up that birth control, while it rakes in profit annually, does ‘save’ money in the sense that a pack of pills is a hell of a lot cheaper than a human being. I am not ignoring this aspect of the issue, but Pfizer doesn’t profit from it, so it is not pertinent to this argument. If I was discussing why the government should or should not cover contraception, this matter now has a place.

In conclusion, the reason people aren’t very aware of Fertility Awareness Methods? Because it is painted as next to impossible in med school, and nobody gets richer off of it.

*One last footnote, for those in situations that are either unwilling or incapable of practicing FAM or in dire medical need of it, contraception is the most responsible action. Birth control, like everything else, has a time and place. I think contraception over abortion is preferred for all parties involved.

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