Remember when the whole world started freaking out about the Oxford-AstraZeneca vaccine causing blood clots (one in 126,582 chances) while no one batted an eye at the National Blood Clot Alliance in the US, who estimated that one in 1,000 women per year who are taking birth control pills will develop a clot, putting the risk at 0.1 per cent?

Well, long story short, for years now, women have been taking this risk—knowingly for some, unknowingly for others—in order to live their lives the way they wish to; freely. Even if we forget about the whole blood clot controversy for a minute, different types of contraceptive pills are known to have some pretty worrying side effects. These can range from altering a woman’s body shape and causing metabolic issues to, in some cases, increasing the potential of suicidal behaviour.

But enough with the demoralising facts—at least for now—because I have good news for you! There’s a new contraceptive pill on the market (only approved in the US for the time being) that has the least side effects compared to all other oral birth control pills. Introducing Slynd, the first progestin-only pill (POP) with a 24-hour intake window and a 24+4 dosing regimen. Now let’s get into what that means exactly, and why this actually is good news.

Not every type of pill is a good fit for every woman—if you ask me, there is not a one-size (or pill) fits-all solution. That’s why you might have been offered different kinds of pills and changed from one to another. The first type of contraceptive pill you should know about are combination pills, which contain synthetic (meaning man-made) forms of the hormones estrogen and progestin. But that’s not the end of it: there are several types of combination pills, from monophasic pills and multiphasic pills to extended-cycle pills.

Progestin-only pills are different from combination pills because they contain progestin without estrogen, hence the name. POPs are also called ‘mini pills’. The success of progestin-only oral contraceptives in substantially decreasing, and controlling menstrual bleeding has led to the development of multiple progestin-only protocols for the sole purpose of bleeding control. In other words, POPs became the go-to pill for women suffering from heavy periods because it leads to either irregular monthly bleeding or none at all.

By taking it everyday without any break (unlike other oral contraceptives which use inactive pills during the last week of the cycle), period havers can ‘control’ when they bleed, among other things.

Okay, so what’s to say that this Slynd pill is so promising in comparison to other options? Well, according to a 2021 study conducted by Donna Shoupe, MD, Professor of Obstetrics & Gynecology at Keck School of Medicine, University of Southern California, Los Angeles, progestin-only contraceptives are the best form of hormonal contraception with the least side effects and only four days of bleeding. Sounds pretty dreamy.

First of all, older forms of contraceptives mixing estrogen and progestin, which are commonly used worldwide, cause widespread metabolic and inflammatory effects. If that isn’t enough, a 2020 study found that young women using oral contraceptives (both combination and progestin-only pills) may be at increased risk of suicidal behaviour, although it was noted that the risk declined with increased duration of use.

Last but not least, you’ve probably heard the rumour—and rumour is the key word here—that the pill can cause weight gain. While that isn’t exactly true, the BBC has confirmed that it can change body shape (and fat storage) in other surprising ways. Back in 2009, Steven Riechman, an exercise physiologist at Texas A&M University, discovered that when they worked out, women on a certain type of pill had less of the muscle-building hormone DHEA (and therefore less muscle gain) than those not on the pill.

“Another study found that women on pills with higher levels of oestrogen tended to have pear-shaped bodies and more subcutaneous fat, though not necessarily more fat overall,” added the BBC. Research also suggests that oestrogen can cause the body to retain more fluid, including the type used in the contraceptive pill, leading many women on the contraceptive pill to ‘bloat’.

Considering everything stated above, I completely understand why telling you that the Food and Drug Administration (FDA) has approved Slynd for use by women in the US is simply not enough. That being said, it does look like Slynd might be a lesser evil than all the other pills on the market.

Supplied in blister card packaging, each Slynd box holds 24 white tablets containing drospirenone 4 milligrams and 4 green inert tablets. These 4 inactive tablets represent the 4 days of period people on this contraceptive pill will be on.

In the ongoing evolution of contraception, the goal has always been to improve efficacy as well as minimising side effects. Estrogen dose reduction and shortening of hormone-free intervals have been helpful to meet these goals. “As a result, Slynd was developed with a 24/4 dose regimen, which provides a more stable hormonal timeframe compared to traditional 21/7 dose regimens, achieving greater pituitary and ovarian suppression,” writes Birth Control Pharmacist.

In simpler terms, Slynd’s 24/4 regimen has less hormone withdrawal effect and improves side effects such as pelvic pain, headaches, breast tenderness, and bloating symptoms that are reported during the hormone-free days with 21/7 regimens.

Furthermore, Slynd allows a 24-hour missed pill window (while other POPs tend to have very narrow windows), which improves reliability and bleeding profiles in the event of a missed dose. “One study compared two arms—one with four missed doses (four 24-hour delays) and the other with no missed dose during the cycle. Even with four missed doses in the cycle, there was adequate ovarian suppression and the same follicular size was observed in both arms,” continues Birth Control Pharmacist.

Of course, it would be daft to claim premature victory before we know the impact that this new option has on women in the long term, but what can be said after reading a variety of research on the matter is that Slynd has strong potential to change the oral contraceptive market for the better.

Meet Katie Vigos, nurse and founder of Empowered Birth Project, an online-based project and Instagram movement that promotes education on childbirth and motherhood. Since launching the project, Vigos managed to terminate Facebook and Instagram’s censorship on birth content. We spoke with Vigos about why she started Empowered Birth Project, technology’s impact on birth and motherhood, and how she’s advocating for women’s rights one Instagram post at a time.

1. What pushed you to start Empowered Birth Project, and in which ways did your experiences, as both a nurse and a mother, influence this decision?

I started Empowered Birth Project in 2014 because, during the beginning of my childbearing years, it was still difficult to find accessible online resources for people seeking to know and understand more about birth. I realised very quickly how important community and support is during pregnancy, postpartum, and parenthood, and I realised that social media could allow me to create that. My platform was originally intended to document the birth of my third and last child, who was born very dramatically via emergency cesarean at 43 weeks gestation. I processed my healing and recovery very publicly, and a wonderful, supportive community grew around me during that time. The platform eventually evolved to include stories from people of all walks of life, as well as information and education about birth in general. As a nurse, I use my background as a healthcare professional to inform my writing and critical thinking. Additionally, working on the other end of the life spectrum as a critical care nurse has actually taught me a great deal about birth. They can be understood, honoured, and celebrated in very similar ways.

https://www.instagram.com/p/B1mTCPdJM7q/

2. Throughout the years you’ve managed to build an impressive online community. In which ways is this community taking place outside the internet?

Empowered Birth Project is still primarily an online initiative, though I have started hosting and speaking at events. I’m working on a lot of exciting things that will launch within the next year.

3. You’ve been battling with web giants to take down censorship on birth images and videos. What has been the hardest challenge you faced since you started this campaign?

Ironically, the greatest difficulties have come after the policy changes within Facebook and Instagram to allow uncensored birth content. The initial petition actually won pretty quickly, and since then, while we’ve been able to share so many wonderful uncensored images of birth, Facebook and Instagram still manage to find ways to limit the birth community. Accounts and photos still get taken down occasionally due to error, their filters and ‘safety features’ make birth accounts more difficult to find and/or prevent various hashtags from working properly, and so forth. Furthermore, their ad policies are much more restrictive, so businesses posting birth-related images on their landing pages often have difficulties publishing advertising and reaching other social media users. So, we won a major victory, but we are still fighting for visibility in many ways.

https://www.instagram.com/p/B3AYBVypqXT/

4. What are the biggest lies that are still sold to women about giving birth and how can we challenge them?

I think the biggest lies sold to women and birthing people is that they cannot trust their intuition or their bodies. They are told to give their power to an external figure, such as a healthcare provider or the medical institution as a whole. Birth should always be centred around the birthing person and their comfort, safety, and well being. Their voice should always be the most important and respected in the room.

5. What are the upcoming objectives for Empowered birth Project?

I’d like to expand my initiative across more social platforms, as well as continue to use my voice for advocacy and social change. I want to see policy changes happening on a grander scale—such as state and federal governments—to make birth safer and better for everyone.

6. Despite the many fights for women’s reproductive rights, today’s scenario looks threatening. How is the Empowered Birth Project addressing this issue and how dangerous are the pro-life movements for women’s rights?

I will continue to address this issue by speaking out about the importance of reproductive choice and freedom. Restricting access to medical procedures such as abortion actually leads to worse maternal and neonatal outcomes. In my opinion, the pro-life movement is really just anti-choice and anti-abortion. In order to truly protect the lives of birthing people, we need to ensure they have medically accurate information, access to healthcare, and support in their decision-making process. We certainly have a very long way to go in this regard. It’s only been recently that I’ve spoken out about this, because for many years I have been processing and healing from the shame and secrecy of my own abortion experience. I no longer feel any need to remain silent about it and I’m very excited to continue this conversation on my platform.

7. From assisted reproductive technology (ART) to the controversy of CRISPR baby, and potentially artificial wombs, the future of childbirth is going to be massively impacted by technology. What’s your view on reproductive technology and when do you think, if at all, should these developments be restrained?

I actually hadn’t heard of the CRISPR baby! I guess despite the fact I’m a huge birth nerd, some current events still manage to escape me. But as for assisted reproductive technology, I think it’s ‘natural’ for humans to evolve in ways that give us more tools and capabilities to reproduce and advance our species. As long as participants are giving fully informed consent and are aware of the risks, like anything else, I personally think it’s a remarkable way to offer the experience of childbearing to those who previously could not experience it. Like all areas of medicine, it’s an experiment and always evolving through the scientific process. I don’t think it’s morally inferior or problematic; it’s just different. And we need to make sure people participating in ART are supported and respected just as much as people who conceive without the assistance of technology.