Sunday, 17 August 2008

Whose responsibility is contraception?

Macdoctor has responded to a story in the Herald about a shortage of Depo-Provera a contraceptive injection. I'm not going to rant about this, other than to say Pharmac and Pfizer need to have better systems in place to ensure that one rejected shipment doesn't result in a 2 weeks of no product. But I do want to pull out one quote from his post which I think discussing:
Pregnancy most assuredly has a “fault” side to it. Pregnancy has consequences for both men and women. Should the woman be allowed to have an abortion if she has been intentionally reckless? Should the man have to pay child support if the woman doesn’t tell him she may not be protected against pregnancy? These are ethical questions that arise purely because of the issue of responsibility.
His comments seem to be based on basic premise that medication and responsibility for fertility isn’t a male responsibility, it’s the women's, and you’d best not forget that. Yes in the end women are the ones that end up getting pregnant and have the 'luck' of determining whether their pregnancy continues or not. But unless they are carrying the son of god, their eggs didn't fertilize themselves. And given how many men resist paying child support for their progeny, you'd think that men would be just as keen to take responsibility for minimizing risk of an unplanned pregnancy through the simple act of using a condom.

But in my experience that is not the case. Although my sample size is not huge (and I'm not revealing the magic number on the internet), there is a sizable chunk of straight male population who would prefer not to use a condom if they can avoid it. The most common reason seems to be a diminished sensation whilst doing the deed and having stop in the middle of getting hot and heavy and put one on was also a common reason to avoid their use.

During my 'asian years' the situation was even worse. I was surprised how many men I slept with in Korea assumed that I must be a slut because I carried and *shock* knew how to use a condom. My fellow male expats also had a similar bizarre situation where their partners would be offended if they suggested a condom because that must mean they are 'dirty' girls. Then throw in one large global misinformation campaign on condoms effectiveness and it is little wonder that condoms have a bad wrap amongst large sections of the population.

But surely male forms of chemical contraception are on the way right? Umm no. Over the past few years the big pharmaceutical companies have halted their studies of this. Why? Too expensive and apparently big pharma thinks guys don't want it. But if even a small percentage of sexually active men agreed to try a new method of birth control, that would represent a huge number of potential consumers and I'm pretty sure that someone somewhere could come up with an effective way to market 'have plenty o' sex and no babies' to men. So why we are in a bizarre position of having a major industry deciding that men - millions of whom manage to do things every day which require more effort and less potential reward than birth control - are simply uninterested and incapable of swallowing a tiny pill on a daily basis or go in for shots every month or so?

One the of the reasons for the hold-ups for drug development in this case is actually legitimate: a significant number of men don’t actually respond to hormonal birth control, leaving it fully effective in the majority of cases where it does work, and completely ineffective in the ones where it doesn’t. But even when fully effective male chemical birth control becomes available, based on big pharma's attitude and that around condom useage there’s still significant male resistance to the idea.

Any form of male birth control is going to involve doing something to a man’s sperm—stopping ejaculation completely (but not orgasm) or causing no sperm to be made or released, or keeping them from maturing. And I think that on a deeper level many men would be uncomfortable with chemicals messing with their swimmers because they think that their virility and therefore their masculinity would be compromised if they weren't just a few strokes away from producing a baby.

On the otherhand, women are expected to just accept chemical interference with their reproductive systems as a matter of course. We all know that motherhood and pregnancy and fecundity are strongly linked to our ideas of womanhood just as much as they are for men yet female chemical birth control (or was that period control) is one of the more popular forms of birth control. However the male version still seems to be years away and not many people think that they would take it.

Which leads me back to my original question: whose responsbility is contraception?



Hugh said...

I'd say contraception is the responsibility of both partners collectively. If they're both willing to accept a higher risk of pregnancy in exchange for more enjoyable sex (I actually know some women who prefer it if their partner doesn't wear a condom), then good for them. If they can't agree on that, then having sex is probably not the best idea.

And I'd just add that personally I would leap at the availability of a male chemical contraceptive, although I'd probably still wear a condom, just to be sure.

weka said...

While I agree that contraception is a shared responsiblity, I'd never risk my fertility by trusting male contraception (i.e. I wouldn't trust something so important to someone else for whom the consequences are quite different). This is why as far as I'm concerned abortion is solely the pregnant woman's choice. We ultimately take the risk and the responsibility for both contraception and pregnancy.

Should the woman be allowed to have an abortion if she has been intentionally reckless? Should the man have to pay child support if the woman doesn’t tell him she may not be protected against pregnancy?

Likewise, if a man seriously doesn't want to risk getting a woman pregnant there are things he can do irrespective of what the woman does or does not do. But of course the consequences for men are quite different than for woman, hence the stupidity of Macdotor's questions.

Anonymous said...

My partner and I practice a form of Natural Fertility, as a contraceptive, supported by Natural Fertility NZ. While I was extremely sceptical about it at first, I now recognise that dispensing with any form of chemical and condoms has been one of the most empowering things I have done in my life. While I do not wish to speak for my partner, I am sure she would have similar thoughts.

Now we rely on a greater understanding of our bodies, natural fertility cycles and more intangible things involving psychology, hormones etc to avoid pregnancy.

We took on this challenge together because we wanted to share all the responsibilities that come with being intimate with someone. That started with acknowledging that we wouldnt be together unless we were prepared to accept the possibility of having children together.

Then we acknowledged that pills, injections, condoms ad all that stuff is not really taking responsiility for your body and its reproductive power. All you're doin is shifting ultimate responsibility to a scientist/pharma company/latex company.

Also an important factor is that condoms, pills and injections are not good for our bodies, and more importantly not good for the environment. They are not sustainable choices, so Natural Fertility is in line with so core values I hold - katiakitanga in particular.

There were also some factors at play that revolved around me being Maori and the implications of birth control and abortions for me at a wairua/mauri level, which I won't bore this blog's audience with.

A lot of people, mostly men, in our lives have scoffed at our committment to Natural Fertility, but its been quite some time and we haven't had children yet.

What we have had is the pleasure of an ever deepening understanding of our own and each others bodies, cycles and the rest. I am still somewhat disappointed that even Natural Fertility is weighted towards female responsibility, and very little is known about male reproductive cycles, but its certainly better than one or both of us poisoning ourselves and our whenua with pills, condoms and injections.

It was really difficult at first to understand and accept that we couldnt just do what we wanted when we wanted - and we also realised how little control people have over their bodies! But over a period as short as 4 months we got used to the cycle, and now living by this cycle is something I enjoy.

As an aside we tried using a condom not that long ago, and neither of us could 'do it' so to speak. We both couldnt stop think about how each condom is tested mechanically 3 times before its lubed up and wrapped in its very own peice of non-biodegradeable/non recyclable foil. Thats not sexy.

It got us to wondering - if a post-oil world doesn't have the ability to produce cheap and plentiful chemical/latex birth control...

I got a whole lot more I could say on this subject, but this is a bigger story than I originally intended so...


Ari said...

Actually, I'm going to have to differ slightly here with some of you and take Weka's line to a degree. I don't think the responsibility of contraception is shared. I think you have individual responsibility for contraception yourself if you don't want to be raising children, and I think partners should ideally BOTH be using different types of contraception if they both agree they don't want children.

Maybe I'm just paranoid and individualistic though. ;)

Likewise, if a man seriously doesn't want to risk getting a woman pregnant there are things he can do irrespective of what the woman does or does not do. But of course the consequences for men are quite different than for woman, hence the stupidity of Macdotor's questions.

While I don't disagree with you, I think it's worth pointing out that a man's far more limited contraceptive choices make it a bit harder to make an independent decision, as they're mostly things your partner will know about. We can always insist, but still, it'd be nice to have some truly "invisible" contraception for men.

Depo-Provera Side Effects said...

My name is Janet Smith and i would like to show you my personal experience with Depo-Provera.

I am 38 years old. I have been taking Depo-Provera for 8 years. This drug may not be the answer for everyone but for me without it my life is not pleasant. Bleeding in my shoes for days each month, terrible to the floor cramping and pain. First shot, period gone, have gone off it, takes months for it to come back but when it does it is just as bad. My mood changes when I am due to have my shot, I can feel it happening, and I will admit that I depend on it to keep me more level. I can feel the PMS when my 12 weeks is up, during the 12 weeks I have no side effects. My mom has some bone density issues and my doctor has suggested that perhaps I go off, not going to happen, it is monthly miracle, and although I understand the effects are different for everyone I say sometimes to have a more normal cycle you need to not have one.

I have experienced some of these side effects-
possibly weight gain, had been gaining weight before, mood swings when I need to get my shot, none that I get complaints about when I am on it, decreased sex drive

I hope this information will be useful to others,
Janet Smith

Depo-Provera Side Effects

Will said...

Contraception for men has already been trialled successfully but not rolled out. It has been proven to be fully effective, last nearly a decade and the single injection costs less than the syringe cost.

I believe that contraception should be an equal duty and men need more choice, that is why I urge everyone to please sign this petition:​en-GB/petitions/​nhs-government-allow-male-c​ontraceptives-equal-respon​sibility-for-both-genders