The Problem With Ricki Lake’s ‘The Business of Birth Control’
About eight years ago, Ricki Lake and her producing partner Abby Epstein resolved to turn a critical eye on hormonal birth control. Their previous documentary, 2008’s The Business of Being Born, emphasized the risks and expense of giving birth in a hospital. This new project would apply that same medical skepticism to ongoing conversations around hormonal contraceptives. “In 1960 the birth control pill was all about progress, but does it still fit with our values today?” Lake and Epstein wondered in the project’s Kickstarter campaign. “Do we look to the tech sector to take on the challenge of providing women with alternatives to the pill?”
Like so much content that’s “just asking questions,” The Business of Birth Control seems to have a barely concealed agenda: to steer viewers away from hormonal contraception, and towards the tech-assisted “natural” methods the film ultimately endorses.
The documentary — which was released last month along with a $147 “Body Literacy Masterclass,” featuring many of the same doctors, authors, wellness gurus, and hormone coaches from the film — purports to be giving contraceptive users the information they need to make choices that serve them. But the film’s many questionable claims about hormonal birth control seem designed not to inform viewers, but to persuade them. Whether it’s alleging hormonal birth control risks that have no scientific backing, or making rare adverse events sound like common occurrences, the documentary’s message is clear: In the words of one of the film’s talking heads, “We’re saying kill the pill before it kills you.”
In a statement to Rolling Stone, Lake and Epstein defended the documentary’s intentions and material, as well as the integrity of the people who participated in the film. “We have one goal in making our documentaries: to empower people to make informed decisions about their health and the choices they have in front of them,” they wrote. “Our most recent film The Business of Birth Control presents well-documented and researched information that we believe people deserve to know. We stand behind the doctors, scientists, naturopaths, and hormonal health experts in our film who are highly regarded and have no financial ties to the documentary.”
Rolling Stone reached out to several OB-GYNs and medical researchers to ask their opinion of the information within the film; all acknowledged the proven risks of hormonal birth control, but took issue with the terrifying picture painted by Lake and Epstein. “I can definitively say birth control is an incredibly low risk medication,” says Dr. Danielle Jones, a board-certified OB-GYN. “By every argument that you can come up with from a science and data standpoint, birth control should be over the counter because it is as safe or safer than almost everything you can purchase at Walgreens.”
The doctors agreed that many of the the anti-hormonal birth control advocates featured in the film are spreading potentially harmful misinformation, which feels at odds with the filmmakers’ mission to inform and empower women. “I have no agenda or vested interest in convincing anybody to do any type of birth control,” says Dr. Rachel Flink, an OB-GYN in upstate New York. “But to villainize methods that are safe and effective and are beloved by many people feels more like a political agenda than actually caring about people and their decisions.”
The Business of Birth Control tries to argue that pharmaceutical companies are profiting off dangerous contraceptives. But the film undermines this argument by presenting its own slate of products, including apps and thermometers that can be used to track periods and monitor fertility. In fact, some of the companies that are featured in the film are also financial backers — a relationship that’s only revealed in the closing credits and separate promotional materials.( In a statement to Rolling Stone, Lake and Epstein said that their creative decisions are not influenced “by the individuals or organizations who support” their work. “Our documentary films have never been sponsored,” they wrote. “We include a list of Kickstarter contributors in the film credits, as do most documentaries that are crowdfunded. Our creative decisions are in no way influenced by the individuals or organizations who support our films.”)
One device that’s featured heavily in the film uses a person’s daily temperature to calculate if they are fertile. The system, called Daysy, markets itself as “the hormone-free solution for managing your fertility, cycles, and health.” Though it’s not clearly noted during the documentary, its promotional materials list Daysy’s parent company, Valley Electronics, as a “theatrical release sponsor” for the film. (It’s listed as a financial backer during the credits.) What’s more, the film’s producer and author of Sweetening the Pill, Holly Grigg-Spall, worked on “launching the Daysy fertility tracker in the U.S.,” according to her LinkedIn. As recently as 2020, she was described as a “brand ambassador” for the device. (Grigg-Spall did not immediately respond to a request for comment.)
Valley Electronics has been accused of peddling misinformation in the past. Chelsea Polis, an independent research consultant in sexual and reproductive health, has consistently challenged the company on its claims. Beginning around 2017, Polis says, she became concerned that Valley Electronics was marketing the Daysy device as a contraceptive method — even though it was not FDA-approved as such—and claiming it was as effective as an IUD. In 2018, Valley Electronics published a study on its product’s supposed effectiveness. Polis successfully called on the journal that published the study to retract it, arguing that its “unreliable” estimates of contraceptive effectiveness “could leave consumers more vulnerable to the risk of unintended pregnancy.” When Polis subsequently described Valley Electronics as “unethical” and their study as “junk science,” the company responded with a million-dollar defamation suit, which has since been dismissed. “This is a very clear example of a company trying to silence a scientist for speaking out truthfully and in evidence-based ways in their area of expertise,” she says. Valley Electronics did not respond to Rolling Stone’s request for comment.
As more and more products flood the market, Polis emphasizes the need for better oversight and clear marketing. “If you were using a pill, you would want know that it had been studied for effectiveness and for safety, and you would want to know that there had been some regulatory oversight of whatever claims were being made. And I think that the same should hold true for people who are interested in using apps or devices.”
There’s no such thing as a good moment to spread misinformation, but The Business of Birth Control is particularly ill-timed. With Roe v. Wade at the brink of repeal, abortions will most likely become even more inaccessible in this country. Enter a documentary that’s stacked with “experts” trying to convince those in need of birth control that these safe and effective drugs are actually massive threats to their wellbeing, and that they’d be better served by returning to “natural” methods.
“The whole sum of this drives patients away from birth control altogether,” says Dr. Kate White, a practicing gynecologist, the Vice-Chair of Academics and the director of the Fellowship in Family Planning at Boston Medical Center, and the author of Your Sexual Health. “Everything gets lumped together as, ‘It’s all dangerous. It’s all a scam. I don’t want to use any of it.’ And if people are okay getting pregnant, that’s totally fine. But for some people, unintended pregnancy is absolutely catastrophic.”
There’s a clear risk of patients rejecting hormonal birth control and embracing less effective methods, only to experience an unplanned pregnancy that they are then unable to terminate. Fertility awareness methods like the ones highlighted in the film involve monitoring signs and interpreting them accurately. Many people, from those with irregular periods to those whose work schedule or lifestyle won’t allow them to execute the method perfectly, won’t be prime candidates. Dr. Flink balked at “the idea of telling the average 22-year-old to throw out the thing that we know is 99 percent effective at preventing pregnancy and use this thing that requires a lot of work and has a huge range of effectiveness instead.”
“My biggest concern with this kind of movement and the time it’s occurring is that there’s going to be a downtrend in contraception that works the most effectively,” Dr. Selina Sandoval, a board-certified OB-GYN and fellow with Physicians for Reproductive Health, tells Rolling Stone. “At the same time that we have the lowest access to abortion.”
Beyond individual outcomes, doctors are afraid that this brand of anti-birth control rhetoric could be weaponized by the right. “I really worry that as we are entering a time that abortion’s going to become illegal in half the country, that conservatives who genuinely don’t believe in women having the right to control their own reproduction are going to come after birth control next,” Dr. White tells Rolling Stone. “And they can point to these headlines and stories and say, ‘See, women are being harmed by these things, so we need to ban them.’”
“As feminists,” Lake and Epstein said in a statement to Rolling Stone, “we believe in unfettered access to all forms of birth control and abortion.” The filmmakers argued that failing to discuss the side effects of birth control actually benefits anti-choice advocates by allowing them to “control the narrative.” In light of current attacks on reproductive freedom, Epstein and Lake continued, “we believe that body literacy is more important than ever, and we are actively supporting women and GNC people in having greater control over their fertility and well-being.”
The Business of Birth Control boldly bills itself as “redefining the meaning of reproductive justice,” a movement founded by Black women to expand the conversation around reproductive rights. The film shines an important light on abhorrent histories of forced sterilization and exploitative drug trials, particularly in communities of color. But these legacies seem to be invoked with the aim of placing current hormonal birth control methods on this timeline of atrocities — the latest in a long line of horrors unleashed on black and brown patients. Dr. White calls this argument a “perversion” of the movement it references. “If we start to take away methods of contraception, it is absolutely people of color and economically disadvantaged patients who are going to suffer the most,” she says. “The people who reproductive justice is trying to lift up and elevate to begin with.”
Acknowledging the racist history of the development of birth control does not mean that “the current medications available are bad,” Dr. Jones tells Rolling Stone. “And it gets even more concerning when you look at who is behind these things, because it’s very rarely going to be a marginalized person of color. It’s almost always going to be a very wealthy person who is white. So how are we using this historical information? Are we using it to make sure that we move forward in a way that is anti-racist and avoids these things happening again in the future, or are we using it to further marginalize people of color and achieve our goals of making a bunch of money from a documentary?”