Ease spoke to 10 women about what it was like getting birth control in Singapore and found some recurring themes that surfaced across all their stories. We hope that you’ll feel a sense of community as you read through their raw and honest experiences.
Most of these women decided to embark on their birth control journey because they felt a desire to have more control over their bodies - either to quell their fear of pregnancy or to regulate their period on their own terms. That being said, birth control can be used to treat or manage any hormone-related issues, and is not necessarily tied to sexual activity. Another common thread amongst these stories are barriers to access - be it cost, lack of information or stigma. Overall, these women emphasised that they had to go through everything alone. Navigating clinics, information and cost all on their own, with little or no support.
Taking control of your sexuality
Many women shared the sentiment that their decision to take birth control was a result of the “paranoia” they experienced while having sex. The fear of pregnancy was preventing them from fully enjoying intimacy with their partners (be it long-term or casual), and they wanted a way to get peace of mind. While condoms are the most accessible way of practising safe sex, some of the women we spoke to expressed worry that it “wasn’t fully effective.” This is because, although with perfect use, condoms can be up to 98% effective, most people don't use them perfectly, meaning they are only around 85% effective in practice.
V, 23 and working in a tech start-up, talked to us about how she wasn’t comfortable “taking that risk because the few months that (she) wasn’t on the pill, (she) was just always so paranoid about whether (her) period would come.”
After a bad sexual experience with her previous partner, A, a 21 year-old student, described her relationship with sex as “bad.” She would get “massive panic attacks” and “was very worried about the consequences.” Currently in a healthy relationship, she “wanted to have more control over the situation and do more to make sure nothing was going to happen.”
D, a 25 year-old actress and educator, echoed this sentiment - deciding to get on “the lowest dosage of oestrogen to get (her) period cycle on track and to lessen (her) anxiety towards an unwanted pregnancy.”
Beyond mere pregnancy prevention, birth control enables women to take ownership of their sexual and reproductive health and most importantly, reduce the stress or anxiety they feel, which in turn allows them to experience better sexual intimacy with their partners.
Birth control beyond birth control
While many of the women we spoke to used birth control as a means to gain control of their sexuality, some women talked about other reasons for getting birth control. It’s a common misconception that birth control pills are taken solely for pregnancy prevention. Many use birth control to treat acne, manage hormone related health issues, or to simply regulate their period.
O, a 25 year-old lawyer, spoke to us about how her period cramps “were getting in the way of my career and other aspects of life.” In seeking out a solution, her friends recommended that she get on the pill. K, a 23 year-old interior designer, said she uses the pill to “control when (she’ll) get (her) period.”
Despite having specific health-related reasons for taking birth control, these women still face the stigma that comes with anything related to sexual health. K elaborated that some of her close friends perceive her as “more 'hoe'-like simply because (she’s) on the pill.”
Bearing the cost
While there’s no doubt that accessing birth control in Singapore can be expensive, one thing that is often overlooked is the emotional cost of accessing birth control. Whether you’re getting emergency contraception or it’s your first time considering birth control pills, the time, effort and (most importantly) the emotions that go into acting on that decision can be a lot to bear. In a conservative society like Singapore, sexual health doesn’t make for typical coffee shop talk and less so, dinner table conversation with your parents. What happens as a result, is sneaking around and harbouring secrets from your parents - you went to the clinic because you “had the flu” or the pills they found in your bag are “just hormone pills”.
D, who is 24 and working in the creative field shared with us that although she tried to keep her birth control pills a secret from her parents, they “accidentally found out and it was a pretty rough night.”
It isn’t so much the pills themselves that these young women are worried about, but the association of birth control with sexual activity. A, who is a 21-year old university student, told us that when she decided to start on birth control to quell her paranoia of pregnancy, she “knew (she) had to do it secretly because (her) parents would literally kick (her) out of the house if they found out that (she) had sex.”
For some parents, despite having a less vehement attitude towards birth control, there is still a tacit agreement that it is not a topic to be discussed. F, a 23-year old fresh graduate shared that when her parents found out and she played it off by “just refer(ing) to it as hormone pills,” she had a feeling that her mom “sort of knew.”
On doctor visits, nerves and lack of information
While the 10 women we interviewed had different reasons for taking birth control, one thing that resonated throughout all their experiences was unpleasant visits to clinics.
D, a 24 year-old student and visual artist was prescribed birth control for hormonal imbalance issues and recounted that “the same doctor shamed (her) for it because ‘it wasn't good for young girls.’” For V, a 23 year-old working in a tech startup, her doctor blatantly spread misinformation by telling her that “if (she) was on the pill, (she) won't be able to have kids in the future” - putting her on the spot and making her feel as if had to “choose between having safe sex now or having kids in the future.”
A, a 21-year old student was taken aback when the doctor that was prescribing her the pill curtly said to her “yeah just take, but there’s still a possibility that you’ll get pregnant.” A’s experience was made even more unpleasant when the doctor used a speculum on her without warning - “she didn’t tell me anything, she just shoved it inside of me.”
The women we spoke to also talked about how it was difficult to ask their doctors more questions about birth control. For some of them, it was their first time on the pill and they were brimming with concerns about side effects and wanted more information on the different brands of BCP. “They didn’t tell me much about the side effects and I had to google the pill by myself. And do my own research on the pill I was taking,” said A.
D, a 24-year old creative spoke about how little information she was given during her consultation with the doctor. “Initially, I wasn't told how much it would cost. I wasn't told there were other brands available for prescription, I didn't know there were different types with varying hormone levels and prices. I just accepted what the doctor wrote as the only type available. I only found out when other friends asked about BC and we realised there was a variety and we all took different types.”
A desire for care
Ultimately, what these women needed during their first journey getting birth control was care, support, and sensitivity. F, a 23 year-old fresh grad commented on a whole that “doctors in Singapore, they’re so medical and there’s no emotion.” Sensitive healthcare as a category differs from other "traditional" categories of healthcare, and has its own distinct set of priorities and concerns. It is in the name itself - “sensitivity”.
Sensitive healthcare as a special category of healthcare has gone unrecognised for too long in Singapore. From these stories and all the countless messages we get at Ease, it is evident that this service needs to not only be readily available, but also properly managed. The human and emotional aspect cannot be ignored when it comes to sensitive healthcare, and this can make all the difference to a patient’s well-being.