Sixty five percent of women globally are on a form of contraception, while only twelve point five percent of men are directly involved in family planning through the use of male contraceptive methods. This does not represent choice, liberation or autonomy, but a systemic gender inequality where women carry the burden of contraception and family planning while male contraceptives languish in labs, studies and clinical trials, beyond condoms and few vasectomies. It has been stated that access to contraception is empowering. It allows women to make reproductive choices, prioritize education and their careers, but how is it empowerment when it is a lopsided responsibility?
Women have a six day fertility window while men, a year round fertility. Yet women are the bearers of contraceptive interventions. Sperm only survives for five days, the ovum for one. Yet they are expected to consume pills throughout, have implants for years and even undergo some invasive procedures. Like something that needs fixing.
A lady on Twitter writes “Had an implant, bled for 4 months straight. My doctor put me on the pill my face broke out badly.” Another lady suggests she tries the IUD, and adds that she developed pulmonary embolism when she was on the pill. The IUD side effects include pain, cramping and period changes which subside. The complications, although rare include expulsion, infection, or uterine perforation. Beyond the common and less serious side effects of hormonal contraceptives are serious ones: Blood clots, stroke, liver damage and an increased risk of certain cancers. Their dismissal as rare is supposed to offer some comfort to the female consumers. Phoebe Asiyo, a Kenyan parliamentarian is alleged to have spoken against Depo Provera, drug which in lawsuits, has been associated with increased risks of meningioma, a brain tumor. This is the health, physical and emotional toll of contraception on women.
While women struggle with weight gain, mood swings, acne and so forth, male contraception research has stagnated. Beyond condoms and vasectomies (only 1.4%) there is little promising progress. A quick Google search, and there it is, a list of articles stuck on prospects and progress. With society’s assumption that family planning is a woman’s responsibility, we have a long way to go. Men’s reluctance to share the burden reinforced by patriarchal norms, further reinforces the unilateral responsibility by women.
The recent report by the African population and health research center (APHRC) on abortion has been reported as shocking, with about 800,000 abortions in the country, of which married, educated and Christian women top the list. Many on social media, concluded that the high abortion rates were just a consequence of promiscuity and infidelity among women. It would not be a shocking statistic if we could just step out of our moral bubble, and into the real world where it is not just about morality or religious beliefs. The high rate of abortions is a response to unplanned pregnancies which could be attributed to a number of factors: contraception failure; economic hardships; pursuit of career goals or lack of partner/spousal support. The report encouraged family planning and modern contraception, and an improved quality of post abortion care within health facilities. But why not, in addition, an appeal on awareness of male contraception and a laxity in abortion laws. To society abortion is amoral but to many of these women it is just survival. It should not be a scandal. Everlast in the song ‘What It’s Like’ sum up this inequity well, ‘They call her a killer, they call her a sinner, they call her a whore.’
If almost a quarter of all pregnancies end up in abortion, in addition to access to contraception, shouldn’t we be talking about safe abortions other than just focusing on improving the quality of post abortion care? The high abortion rates despite legal restrictions is just a symptom of a larger problem.
So who is responsible for this inequality and who needs to be addressed? Everyone. The men who think contraception weakens their masculine authority. The society which permits and has normalized this burden on women. The health institutions for only pushing women’s contraception and forgetting male contraception. Various institutions and governments for limited funding. And, big pharma for chaining women to the pharmacy.
I hope reproductive health organizations, on reproductive health events will address this inequality, and not just the usual myths and misconceptions of contraception.
