The invention of ‘the pill’ gifted women with the ability to reliably prevent pregnancy and provide for themselves and their families by enabling them to sustain a stable career.  While the historical and societal significance of oral contraception need not be underestimated, the potential negative impact on women deserves scrutiny. These side effects are universal, but specific aspects are even more challenging for Orthodox brides and their spouses.  From my experience as a kallah teacher,  I have seen the pill cause women to fall into depression, suffer from anxiety, turn into crying, moody messes during an already stressful time in their life, suffer from hormonally caused sexual pain, and try and grapple with the myriad changes they encounter on their path to marriage and intimacy while feeling emotionally compromised. The havoc created by oral contraception deeply impacts both members of the couple.

Although many more young women today are self aware and well informed about their bodies, they can still underestimate the influence of birth control pills.  They assume that their blues or discontent is due to moving cities, living with a new partner, or their new hair covering. I had mild anxiety as a teen that is being revived by the stress of marriage.  My doctor didn’t tell me that this could happen, so it must be something else.  Women tend to blame themselves for their increased emotionality rather than their oral contraception, which can lead to loneliness and confusion. .  This issue is further complicated for Orthodox brides who are sometimes ill-informed about other forms of permissible contraception, like the diaphragm and various forms of spermicide.  No method is perfect, but once a woman has felt mismanaged on the pill, her dedication to barrier methods is often greatly increased.

Many women are prescribed hormonal contraception– with little to no instruction about how to take them, and with no mention about the emotional and physical stress it may cause.  Discussing the pill’s side effects is not a self-fulfilling prophecy. Hormones control every aspect of the human body and ingesting artificial hormones causes great changes. Oral contraception has its time and place, but lack of preparation and proper forewarning never do.

How can we create significant change in society’s nearly blind acceptance of the pill and its side effects?  A woman’s choice of method is often influenced by a number of people, all of whom can potentially minimize her suffering and help her make a more educated decision:

Physicians: While the 10-15 minute treatment slot awarded to patients here in Israel does not create an ideal setting for proper medical care, at a bare minimum every woman prescribed oral contraception should receive a user-friendly hand out with explanations and illustrations.  While the internet may seem accessible, many women will struggle to apply even the most accurate online information when treading on such unfamiliar ground. Some women choose physicians because they are simply available, but most seek integrity—especially in their gynecologist—and willingly wait an hour in a waiting room if they know that on the other side of the door is a kind, caring, and informative physician.  Give them an email address to contact with questions and follow up concerns, because making another appointment can take months of waiting during which the woman and her marriage may suffer tremendously. For many women you may be the only person they can talk with about this topic. If you don’t help them, in many cases no one will.

Kallah teachers: The instruction a woman receives before her wedding is an opportune window to review the biology of her monthly cycle and explain how different contraceptive methods work.  Discussing healthy sexuality with brides must include at least a theoretical conversation about contraception, even if she does not plan to use it immediately. Organize the material in a digestible way for the kallah.  Gather samples of contraceptive methods and make the lesson illustrative. Put the information in a halakhic framework in order to understand the principles governing its use.  If a bride does choose to use oral contraception in the months before her wedding, follow up after her wedding and ask how she is feeling. Keep your ears open for any oddities that may be traced back to the pill.  Many women experience breakthrough bleeding from their oral contraception. Therefore proper instruction in the laws of staining is invaluable so that they don’t elongate the niddah period unnecessarily or assume they are niddah, when in fact, they are not.  

Additionally, by joining packs together and eliminating the placebo week, couples can gain a respite from the on-off system of halakhic intimate life. While physicians once deterred women from doing this, today many support these manipulations.  This is one of the greatest advantages of oral contraception for both new and veteran Orthodox couples. While this phenomenon deserves its own article—as it underscores how challenging the observance of niddah laws are for many couples—a specific point regarding kallah teachers is relevant here: A kallah teacher should not find herself endorsing pills so that a bride can avoid niddah status on a regular basis.  It puts the young women in an unfair position wherein she potentially sacrifices her own well-being in order to alleviate the couple’s halakhic reality.  Relief for couples who feel overwhelmingly challenged by the observance of these laws must come from somewhere else.     

Husbands:  If you see that your bride or wife is suffering after beginning to take oral contraception, do not hesitate to kindly bring this to her attention.  As it is, she likely feels overwhelmed by her new responsibilities in the halakhic and biological realms of Jewish marriage.  Your concern and support for whatever she decides to do is of monumental importance.  

Parents :  Daughters need to be taught the biology of their monthly cycle and the basic principles of fertility.  Never learned this yourself? Order Taking Charge of your Fertility by Tony Weschler and read it with your daughter. , Alternatively, you can sponsor her enrollment in a workshop that teaches these fundamentals when she is ready to learn them.   She may still choose hormonal contraception or a number of other methods in the future, but she will know that knowledge of her fertility belongs to no one but herself. Teach your sons these basic principles as well.  It will make him a more empathic and aware spouse.

Last but not least, the women:   The blanket acceptance society has given oral contraception has caused emotional and physical damage to many women, but those who suffer can become the most effective and impassioned advocates of change.  Share your experiences with friends. You will be surprised to hear you are not alone and they will be comforted to know the same. Contact your physician and ask to change pills or switch methods altogether.  This information is often best facilitated by professionals trained in public health and family planning advisement who can offer you more time, support, and information while you deliberate your chosen method.  Don’t accept the status quo if it compromises your daily functioning. You know yourself and your body better than anyone else. No pill can ever take that away.

 

Dr. Yosefa Wruble holds a doctorate in Bible from Bar-Ilan University and teaches Bible to women of all ages.  She also teaches private courses for new brides and married women. She lives in the south of Israel with her husband and three daughters.