For the most part, the responsibility for avoiding pregnancy still falls to the person with the ability to get pregnant. While women might expect male sexual partners to carry condoms, the overwhelming majority of UK women over the age of 20 do not use condoms as their main form of contraception – relying instead on other methods including the pill, the coil and surgical sterilisation.
These methods can have a significant physical impact on women. But according to new research, trying not to get pregnant doesn’t just take its toll on our bodies; it can be a substantial mental and emotional burden, too. What’s more, there is an assumption – reinforced by the medical professionals who advise us on our contraceptive options – that it is a burden for women to shoulder alone.
A study published in The Journal of Sex Research analysed the conversations between 52 women who did not want children, and contraceptive clinicians at medical centres in the US.
They found that medical staff habitually portrayed not getting pregnant as the woman’s ‘job’ – offering an example of “how gender inequality is (re)produced through clinical encounters”.
The clinicians, most of whom were women, spoke to the women about the potential physical impacts of various different forms of contraception. However, the study reports that they did not directly acknowledge the “fundamentally mental and emotional” nature of avoiding pregnancy – nor “question that these responsibilities were assigned to women”.
The study argues that trying not to get pregnant constitutes a form of unpaid emotional and mental labour, something which the sociologist Andrea M. Bertotti has termed “fertility work”.
“Fertility work encompasses not only the physical burdens of contraception, including side effects, but also the associated time, attention, and stress,” says Dr Katrina Kimport, who conducted the research.
On the surface, it might seem like simple common sense for women to take on most of the responsibility for not getting pregnant. For a start, most effective methods of contraception, such as the pill and the hormonal implant, work only in the female body (and men are apparently still reluctant to try anything similar themselves).
However, Dr Kimport tells ELLE.com that “it’s not just about having the medication in your body” – because female contraception carries with it all kinds of other pressures that are separate from its bodily impact, from remembering to take the pill to carving out time to pick up prescriptions and worrying about side effects.
Dr Kimport argues that both women and the medical professionals advising them have come to see these worries and responsibilities as part-and-parcel of female contraception. She points to the fact that a study for a ‘male pill’ was recently halted after the men in the trial experienced unwanted side-effects (which were remarkably similar to those experienced by women in initial studies for hormonal birth control).
“That is definitely a manifestation of our social belief,” she says, “that it's important enough to women to prevent pregnancy that they would have a higher threshold of acceptability for some of the side effects.”
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In an ideal world, says Dr Kimport, men would become more engaged in decisions and discussions about contraceptives – whether they are using them directly or not.
By this, she doesn’t mean that men should have control over a woman’s contraceptive methods; simply that at the moment, we rarely consider how men could help take on some of the emotional and mental pressure of avoiding pregnancy.
She suggests making the pill available over the counter so that men can collect them for their female partners, doctors talking to men more about contraception, and more research into male birth control options.
“If the structure can be more welcoming, that’s a systematic way of encouraging a shared burden for fertility work,” she says.