Our Bodies, Ourselves (44 page)

Sexual Health and Reproductive Choices

CHAPTER 9
Birth Control

O
ur ability to prevent or delay pregnancy is fundamental to our ability to choose how we live our lives. The advent of the Pill and other birth control methods has enabled women around the world to complete our educations, pursue our dreams, and create more egalitarian relationships.

Most of us want contraceptives that are effective and safe, are simple and unobtrusive to use, protect us against sexually transmitted infections–including HIV/AIDS–and can be used before having sex. Unfortunately, the perfect method does not exist. But advances in birth control technology have created more choices than ever before, making it more likely that a woman can find an option that meets her individual needs.

This chapter provides detailed, accurate, and up-to-date information on each method of birth control. It also addresses questions and concerns that many women share—such as how to choose a method of birth control, how to communicate about birth control with a partner, and barriers that keep us from protecting ourselves.

Shame about sex and negative attitudes toward pleasure and desire prevent people from seeking information about birth control. Laws, medical practices, and public school policies continue to prevent the distribution of accurate information and services—in spite of many studies showing that providing birth control information to teenagers does not make them more likely to have intercourse.

Many of us resist using birth control. Sometimes this is because of shame or fear, or social and political factors, such as poor sex education, a double standard concerning sex, or inequalities between women and men:

• We think that if we are using birth control we can't say no to sex. But using birth control does not mean we always want intercourse: No birth control method all by itself is an affirmative answer to sex. We need to be assertive about our desires and let our partners know that having sex should be a mutual decision, not an obligation.

• We are embarrassed by, ashamed of, or confused about our own sexuality. We cannot admit we might have or are having intercourse, because we feel (or someone told us) it is wrong.

• We are embarrassed by or ashamed of our own bodies or genitals, and feel uncomfortable talking about them in depth and candidly with a health-care provider. Body shame may also keep us from using some
methods that require us to touch our bodies in ways that we feel ashamed of or uncomfortable with.

• We are unrealistically romantic about sex: Sex has to be passionate and spontaneous, and birth control seems too premeditated, clinical, or messy.

• We hesitate to “inconvenience” our partner. This fear of displeasing him can be a measure of the inequality and our lack of control in the relationship.

• We think, It can't happen to me. I won't get pregnant.

• We hesitate to find a health-care provider, who may turn out to be hurried, impersonal, or even hostile. If we are young or unmarried, we may fear moralizing and disapproval. We may be afraid the provider will tell our parents.

• We don't recognize our deep dissatisfaction with the method we are using, so we begin to use it haphazardly.

• We feel tempted to become pregnant just to prove to ourselves that we are fertile, or to try to improve a shaky relationship, and therefore don't use birth control regularly.

© Nina Reimer

We can learn about the many methods of birth control and teach one another about the available methods. By speaking openly, and by carefully comparing experiences and knowledge, we can guide one another to workable methods and good health-care providers. We can recognize when a provider is not thorough enough and encourage one another to ask for the attention we need. By talking together, we can also gain an understanding of our more subtle resistance to using birth control. We can begin the process of
talking with our male partners about birth control, encouraging them to share the responsibility with us. We can join together across state and national boundaries to insist that legislatures, courts, high schools, churches, parents, doctors, research projects, clinics, and drug companies change their practices and attitudes so that we can enjoy our sexuality without becoming pregnant. We can create self-help clinics and other participatory health-care institutions where our need for information, discussion, and support in the complex and personal choice of birth control will be better met. We can use the good clinics that do exist. We can campaign for decent housing, jobs, and child care for all, so that we can choose birth control freely instead of being forced to use it by our circumstances. We can insist that birth control methods be available to meet the needs of all women, including women of color, women living in poverty, women with disabilities, and women in developing countries. Whatever we choose to do, we can act together.

At first I was afraid to talk about birth control with my partner. I didn't think he would be interested. As we discussed it, however, I realized that he wanted to prevent unplanned pregnancy just as much as I did. We talked about ways that he could participate in the birth control process, and afterward we both felt more confident in our mutual choices
.

Birth control is not just a woman's issue. Men benefit from the use of birth control in many ways, including being able to decide when and if they will father a child and being able to protect themselves and their partners from sexually transmitted infections. When a man leaves the decision about contraception up to the woman, he not only creates an unfair burden for her but also forfeits his ability to prevent an unplanned pregnancy. By failing to take responsibility for contraception, too many men become fathers before they are capable or willing. By sharing decisions about birth control, a man increases the likelihood that his partner will be protected; he also shows that he cares about her and about her future, and that he is a real partner in a sexual relationship, not just a bystander or beneficiary. Having a conversation with your partner about birth control is a good way to learn of his interest in participating in the process, which can also be an opportunity to assess if he is a good choice as a sexual partner.

Our culture and media rarely address male responsibility in the prevention of STIs and unplanned pregnancies. The prevailing societal
messages about contraception target women and often ignore the impact that unprotected sex can have on men. Using condoms is the easiest way for men to get involved in the birth control process, but they must be willing to do so. Some men are not interested in using condoms because they have received messages that say it is unmasculine, or they have a preconceived notion that sex is not as good with condoms. These attitudes reveal both a lack of education and a lack of respect for women; they also free men from taking responsibility for their actions.