Anyone with a womb knows that navigating healthcare can be a thorny thicket. From contraception to HPV vaccines to the politics of pain relief in childbirth, much of what many of us “know” comes from old wives’ tales, fleeting appointments with GPs or advice from tipsy aunts. For every enlightened pal who lets you know some side-effects your doctor didn’t mention, there is an equally ill-informed Twitter account broadcasting that the morning-after pill leaves you infertile or the pill increases the chances of your child having ADHD.
With such sophistry and illusion around the facts, there’s ample space for terrible “wellness” advice, such as blaming cramps on Mercury being in retrograde or Gwyneth Paltrow selling jade eggs to insert into your vagina to “balance hormones”. Snake oil and other potentially harmful alternative treatments can get more traction when the side-effects of progesterone are ill-researched, black women are four times more likely to die during childbirth than their white counterparts and waiting lists for Mirena coils are, as this programme tells us, up to a year long.
I remember sitting in the same room as another young mother, each doing our postpartum health centre visits, and hearing the copper coil and the Mirena coil explained to her as exactly the same. As a long-term Mirena coil user, who at one point had periods so agonising my vision would blur, I wanted to scream to her: “One will probably make your periods lighter or disappear and the other will likely make them heavier and more painful!” There are reasons to go with a copper coil, but there are significant differences that are outlined in detail by one of the nurses interviewed by Davina McCall in this documentary. Unlike her, I kept this information to myself and said nothing to the stranger. Now, years later, I can’t help but imagine how justifiably angry she would feel watching Davina McCall’s Pill Revolution.
It’s a one-off documentary looking at the current state of contraception in the UK. McCall had a terrible time on the pill herself as a teenager, and having seen one daughter go through something similar while her other daughter was absolutely fine, she investigates just what choices are available to us, why the information about them is so unreliable and why accessing the best options for our physical and mental health is a minefield.
McCall talks to medical experts, politicians, researchers and regular people about the consequences of contraception. Even though many of them give hugely helpful information, and McCall goes so far as to be filmed having her own Mirena coil replaced on camera – talking us through the experience including the brief moments of discomfort – there are still glaring holes in the research that she cannot compensate for.
McCall’s doctor explains that there is only limited research on the side-effects for some contraceptives – from weight gain to loss of libido to volatile mood swings – as they are regarded as acceptable consequences for women to endure for birth control. The documentary features some heartbreaking testimony from those who started the pill only to be overcome by depression, leaving their relationships and careers in disarray. Others who couldn’t bear it any longer resorted to unreliable fertility tracking apps, which led to unwanted pregnancies. In the middle of a mental health crisis, it’s shocking to hear how little we know about the ramifications of these medications on depression and anxiety when these people can testify to these drugs causing a seismic shift in their mental state.
Unlike in Europe, the doctor explains that women in the UK have to work the system if they want to be prescribed anything other than the cheapest contraception (the combined pill microgynon) and to get an alternative, such as a coil, an implant or simply a different pill. While NHS doctors can prescribe the Mirena coil as a treatment for painful periods, this doctor tells McCall that she isn’t commissioned to do it simply because a patient wants effective contraception.
These hard-to-swallow truths are ones that Pill Revolution tries to present in as palatable a way as possible. McCall is as charming and smiley as ever, at one point donning a sparkly red gown to create a camp, miniature gameshow within the programme. There are “true or false” rounds about popular contraception myths and a spinning roulette wheel where literal guinea pigs get to “win” the many possible symptoms from taking the pill.
But McCall also demonstrates her skill as an interviewer capable of shifting into a more serious mode. When she meets Maria Caulfield, the minister for women’s health strategy, she holds her to account. The minister comes off as defensive and keen to spin the appearance into a showcase of her plan to fund women’s health hubs – where contraception advice and treatments will be available – and assure McCall that £25m has been allocated to make this a reality. McCall responds firmly: “That sounds like a lot of money, but when you’ve cut a billion pounds from health, and lots of that would have been used for sexual and reproductive health, putting £25m back in, it feels like a drop in the ocean.” As she leaves the interview, McCall is noticeably deflated. “It’s one step forward after many steps backwards.”
There are some glaring gaps in the narrative. Class, race and disability aren’t really broached when it comes to access and care. Nor does the programme dive into the fact that some of the issues around contraception access are rooted in a desire to suppress women’s sexual freedom. But it is still a powerful documentary that will leave many viewers making more informed decisions about their bodies, saving them from pain – and potentially saving lives as well. And if the woman from the health centre is reading this, I’m sorry I didn’t yell.
• Davina McCall’s Pill Revolution was on Channel 4 and is available on More4
• This article was amended on 9 June 2023 to clarify that it was one doctor’s comment on prescribing the Mirena coil and not NHS guidelines.
