Let’s talk about birth control.

About three years ago, I chose to go off of hormonal birth control. I hadn’t had a long story with it – I never used it in college; I relied on condoms. After college, I went on the pill and then switched over to Depo Provera shots for two years. During that same period of time, I gained about thirty pounds, also went on depression medication, and experienced a massive autoimmune crash. I subsequently decided to remove anything from my system that I felt could be contributing to the steady decline of my health. In a relationship at the time, we switched over to condoms and carefully paying attention to where I was in my cycle to make sure we stayed #TeamNoBabies.

I’m 30 now. I’m not in a stable long-term relationship and the way my finances and life goals are set up, I don’t want to have a kid right now. But I do know that I’m in a much better mental state, far healthier, and stable *enough* that were I to get pregnant, I would choose to go ahead and have the kid, and that’s not a life-experience I want to accidentally put myself through right now.

I never really had the sex talk. When I was 16, I vaguely remember my mom asking me if I needed birth control and my response being something along the lines of “OH MY GOD, NO MOM.” As I talked about in a previous post, I didn’t have sex until after high school, but there was a very short period of time between starting to have sex and – what is the inevitable when someone hasn’t had sex education since 5th grade – getting pregnant.

I was on Christmas break my freshman year in college when, flying to Seattle to visit my older brother for the holidays, I threw up during take off. I’m not a generally queasy person, but I didn’t think much of it – it was a rough take off. I also didn’t think much of it when EVERY smell made me nauseated, or when my period didn’t come. I was 17. I wasn’t particularly aware of my body or my health at that point.

When we got back to Chapel Hill, North Carolina, where my mom was living at the time, I started to realize something was off. I started counting weeks. I thought, “there’s no way it’s that” but made an appointment at the local Planned Parenthood just to check. I didn’t know where else to turn and I certainly didn’t want to walk into a local store to get a pregnancy test. How would they look at me, basically a kid? I was ill equipped, immature, and I didn’t want to deal with it.

I swung by the clinic after a dentist appointment, thinking it would be a quick in and out, “nope, you’re not pregnant!” visit. Instead it was a crying-for-an-hour-in-my-car-by-myself visit, then going home to figure out how I was going to tell my mom.

I steeled myself, walked in the front door, saw my mom, and burst into tears. I explained what had happened. How I had only recently lost my virginity. How I didn’t think something like this could happen so quickly. I was a kid. I had never had a conversation about this. I didn’t think this kind of stuff would happen to me. I just didn’t think.

My mom, in her ever-present grace, remained calm on the surface. She said she already had a feeling about it; moms always know. She sat there, quietly, as I talked through what I wanted to do next. I knew I didn’t want to carry through the pregnancy.

I had just started college in Miami, I hadn’t the slightest idea how or wish to take care of a kid and, above that, my type 1 diabetes (T1D) was not well controlled enough to make it a safe situation for me or the child. I told my mom when my clinic appointment was and she went with me, providing a well-calculated mix of lecture to make sure nothing like this ever happened again and support as I was scared out of my mind. Unbeknownst to me at the time but necessarily, she contacted my endocrinologist to run everything by him, make sure there wouldn’t be any diabetes-related complications to look out for, and make sure I had proper healthcare and diabetes support when I got back to Miami for the Spring semester.

Abortion is a painful procedure. Below the level of pain of breaking my ankle in three places a few years ago, but above the pain of getting an IV in one of my jugular veins when I was diagnosed with T1D at 10. But I was surprised at how normal it seemed, at how normal the small group of women with me in the recovery room looked.

In 2008, one in three women had gotten an abortion by the age of 45. In 1992, it had been almost half of women. The rate is expected to have continued to decline, in large part due to increased sexual education and access to birth control, young women continuing to spearhead important conversations amongst each other in person and on the internet, the Affordable Care Act providing free or low cost birth control (thanks, Obama), and more birth control options in general coming on the market.

The normalcy doesn’t mean it’s always an easy decision. No one wants to be in a place to get an abortion, but it is a necessary decision for many women. I know a lot of people have strong feelings about this, and that for some of you, reading this account will feel like a punch in the gut. I won’t try to argue your beliefs, for I know you have them for a reason. For me, the decision was a clear one and it is not one I have ever felt any guilt over, nor will I ever. It was the right decision for me and I stand by it.

I believe that anyone who decides they need or want an abortion should have access to safe medical care and proper, medically-based information. But I also know that we can avoid that entirely if we all talk to each other in smarter ways about sex, reproduction, and birth control without shame or judgement.

Women have long been shamed for any aspect of our physical selves – our bodies, sexuality, periods, reproductive systems are all expected to be spoken about only behind closed doors, only with our doctors (because all of this is clinical, right?), and only ever if for the reason of having a planned child.

When we cannot even speak about these experiences we go through without being hushed, how can we ever change the narrative? How can we possibly continue to lower the rate of women who turn to abortions, increase the amount of healthy information our young women are getting from trustworthy sources, and pull men into the conversation too if every time women and sex are mentioned in the same sentence, it’s considered taboo?

Enter, a renewed conversation about birth control. I remain ever-grateful for the wealth of information at our fingertips these days, and at how normalized social media has made so many previously unheard of conversations. I think that we, as a society, have become much better about having necessary conversations and we must keep moving in that direction.

Through the Clue app, where I track my period and fertility, I found out about Nurx, an easy, safe, and secure way to get mail-order birth control within a matter of days without having to physically go to a doctor. I had contemplated getting a non-hormonal copper IUD, but my body already rejects nearly everything and I’m scared of infections or other complications (although they aren’t common). My auto-immune illnesses mean that my immune system regularly rejects anything it sees as foreign.

I had wanted to go the non-hormonal route because of how delicate my system tends to be, and because of my experience with weight gain while on hormonal birth control in the past. However, every few months, I do have issues with severe depression during PMS and I’m often nauseated and fatigued in the days leading up to my period. After lots of research and a conversation with my endocrinologist, who oversees my type 1 diabetes care, I decided to give hormonal birth control another shot.

It hasn’t been long so I don’t have updates on the health front yet (other than an irritating amount of nausea – thanks estrogen), but I am exceedingly grateful that this process has become so easy. I am so incredibly thankful for resources like Planned Parenthood, my health insurance that does cover birth control at 100%, smart solutions like Nurx and Clue, and a true plethora of educational platforms to help me make these decisions. I don’t know where I would be without these resources, but I do know that I would have a kid turning 13 this Fall.

Being able to have these conversations is important. Normalizing, reducing stigma, and being able to be honest – when we choose to share information on our own terms – is vital. Particularly in a time when our healthcare is being overhauled and when women’s and reproductive rights are constantly put into shaky territory, I will continue to use my voice to fight for what I know is necessary. This is the only way we can ensure that we can be healthy, that abortions become less and less necessary, and that women can retain our right to safe and effective health care. We cannot go backward.

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