An Emergency Birth Control Guide For the Rapidly Crumbling South
A Table of Contents and Explanation
In 2019, Alabama banned virtually all abortions the same month I graduated high school. Doctors who performed an abortion after heartbeat detection could face life in prison, and there were no exceptions for rape or incest.
The bill passed three weeks after my 18th birthday. When I heard the female governor had signed it into law, I felt immediately, violently nauseous, and I wasn’t alone. My sister, in medical school, trying to figure out if she could practice medicine in a state that criminalized basic healthcare. My friends, desperately trying to get secret IUDs from one of the two Planned Parenthood in the state. And myself, as an advocate, bracing for Alabama to become even more guilt-ridden, frightening, and hostile to people with internal reproductive organs.1
The “Human Life Protection Act” still hasn’t gone into effect in Alabama, as it was immediately challenged in court over its direct disagreement with Roe v. Wade. In contrast, Texas’s nationally criticized Senate Bill 8 has been allowed to go forward, due to the legal fact that Senate Bill 8 allows everyday people to sue other people they suspect of having an abortion, rather than having the state punish people seeking abortions. I started writing this in response to Dobbs v. Jackson Women's Health Organization, a case the Supreme Court is currently considering that will directly address whether Roe will stand. Currently, most judicial analysts believe that the court will allow Roe to be overturned, throwing the nation’s abortion protections into chaos. When I started this guide, I didn’t yet know that Senate Bill 8 would change the lives of 7 million child-bearing aged women in Texas. Now that it has, I feel even more pressure and urgency to present this guide to those who need it.
Growing up with a uterus in the American South is harrowing, and I truly believe it will continue to get worse. I think access will begin to be a problem in states with long records of reproductive access. And most of all, as the President of Planned Parenthood at Duke University, I think that conception control is a human right, and if abortions are hard to access where you live, then you should have all the information possible to help you avoid needing an abortion. In an ideal world, this guide would be unnecessary, because everything listed is a basic, non-shameful healthcare tool.2 Until we reach that world, this guide exists to help you make the best decisions possible in whatever situation you are in.
The following guide can be read in any order; I recommend looking at the following table of contents to find the general section you’re interested in and then specifically searching for whatever you are currently panicking about. If you choose to read it from oldest to newest, you will (hopefully) receive a comprehensive understanding of the best way you personally can protect yourself from unwanted pregnancies and other reproductive health issues.
How Pregnancy Happens + Rhythm Method
“Pulling Out” and if Pre-Cum Gets You Pregnant
Condoms: Overall, Your Best Friend
The Morning-After Pill (AKA Plan B)
The Birth Control Pill: What it is and How to Get a Secret Prescription
The Birth Control Pill: Paying for it and Refilling it (Without Parental Knowledge)
Starting the Pill Correctly: Combination Pills + Mini Pills
The Birth Control Pill: Taking it Correctly (Combination Pills)
The Birth Control Pill: Taking it Correctly (Mini Pills)
If you choose to read it from oldest to newest (or top to bottom), you will (hopefully) receive a comprehensive understanding of the best way you personally can protect yourself from unwanted pregnancies, STDs, and other reproductive health issues.
And most of all, remember that this guide should be read with your individual circumstances in mind. For a lot of reasons, some people aren’t that scared of getting pregnant. Maybe they have access to transportation and live in a state with excellent abortion rights. Those people might read this guide and focus on convenience; if Plan B costs 45$ and they have unprotected sex on day two of their period, they might choose not to take the Plan B because they personally are more bothered by the hassle of getting Plan B than the relatively small chance of getting pregnant.
For a lot of reasons, some people are really scared of getting pregnant. Maybe they live in a state that requires parental consent for under-18 abortions, and they feel unsafe informing their parents. Those people might read this guide and focus on getting their chances of pregnancy as close to zero as possible; if they’re having sex and the condom breaks before anyone ejaculates (or cums), they still might take a Plan B, because they personally are more bothered by the very small chance of pregnancy than the cost of Plan B.
This guide will give you a lot of information, including the costs of various contraceptive methods and the chances of certain sexual activities leading to pregnancy. It is up to you to balance this information with your personal context. If you learn that condoms are 98% effective, but you absolutely cannot get pregnant, then you should use multiple birth control methods. If you don’t have much money but can access abortions very easily, then there are some cases where you should take a pregnancy test and potentially get an abortion rather than spending money you shouldn’t spend on Plan B. I can’t tell you in every instance what you should do, because I don’t know what your individual priorities are. You should absolutely read this guide with those individual priorities in mind.3
Throughout this guide I use terms like “partner” and “internal reproductive organs” and “people with periods.” This is because the terms “girl” and “boy” don’t fully encompass all the people who I’m referring to, given the number of boys who get periods and girls with external reproductive organs. I want to be as inclusive as possible, but at times I do default to boy and girl when I am discussing gendered social reactions (such as the tendency for girls to feel pressured in a sexual relationship, rather than boys).
This guide is intended for people who are consensually choosing to have sex. If you feel pressured into sex, or don’t feel comfortable enough with your partner to discuss conception, please know that you deserve to feel safe and enthusiastic about any sexual activity. For help, call 1-866-331-9474 to get connected to Love is Respect, which can help you 24/7 if you’re experiencing sexual pressure in a relationship. You can also call 1-800-656-HOPE to get access to RAINN, the Rape Abuse Incest National Network
The medical advice listed in this guide is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this guide. In addition, this guide is not sponsored by Planned Parenthood or Duke University