MSI UK Advocacy and Public Affairs Advisor Louise McCudden reflects on the ways in which contraception – and sexual and reproductive health more generally – is a feminist issue.
The advent of the contraceptive pill in the 1960s revolutionised sexual and social relationships, allowing women to defer pregnancy, enter the work force and make life choices their mothers could not. And today, there are more contraceptive options than ever before, with a slew of potential benefits, from better skin to lighter periods, but we should not forget that contraception* can also be hard work.
In fact, sociologist Professor Andrea M. Bertotti produced a whole piece of research arguing that ‘fertility work’ ought to be discussed alongside other types of gendered labour divisions, such as housework, emotional labour, and childcare.
Research like Bertotti’s has found that women tend to take more responsibility for the work involved in choosing contraception, such as comparing side effects and lifestyle compatibility. Women are also more likely than men to be actively involved in other aspects of organising contraception, whether that’s remembering to take the pill, having coils fitted and removed and refitted again, managing complicated side effects, and, in many cases reminding men to get their own health check-ups sorted too.
This is not universally true, of course. Many, perhaps even most men nowadays are keen to be equal partners in these decisions. But studies, surveys and personal stories do show up an uncomfortable pattern: that it is still women, on average, who do the overwhelming share of the work associated with sexual and reproductive health.
Why do women do the overwhelming share of the work associated with sexual reproductive health?
So why? Is it simply because women are more likely to face longer-term consequences, like pregnancy? Certainly, that may be part of it. But this dynamic isn’t exclusive to contraception; it mirrors a labour divide we see repeat itself between men and women in other areas of work. It also speaks to a wider problem. Women are constantly expected to take responsibility for men’s sexuality, in all sorts of contexts. Why would contraception be any different?
We still live in a world where women are not only judged for how much sex we have, but a world where women can be redefined as a different category of person if we have the wrong amount. We have special, dehumanising words for women who have sex too much or too soon. We don’t have those words for men, because men are not expected to be the ones responsible for resisting temptation or upholding conventional ideals. (Of course, we also have special dehumanising words for women who don’t have enough sex, because misogyny is a confusing mess). Men are not held responsible for the consequences of sex in the ways that women are. It makes sense, then, if women end up more likely to take on this ‘fertility work.’
A history of contraception
When the first oral contraceptive was made available on the NHS in 1961, it was only, officially, for married women until 1967. There were fears that the pill would dramatically change sexual power dynamics. And not only from people who were hostile to women’s equality. Some feminists were worried that easy contraception meant easier sex for men, while women would still take on the work, the stigma, and the consequences – perhaps more so than ever.
In 1984, when the so-called “morning-after pill” was made available in Britain, there was predictable panic about that, too. This panic and stigma never wholly left us. As recently as 2017, a major pharmacy chain claimed that women would “misuse or overuse” the after-sex pill if it was more affordable. (They have, rightly, apologised since for saying something so unpardonably daft. But these were not words from another generation. The chain made this comment in 2017.)
Too often, we see people respond to this discomfort with women’s sexual choices by assuaging fears rather than challenging the underlying premise. It’s tempting to respond to moral panic by saying: no, don’t worry; this pill won’t be used by feckless irresponsible women who have sex with different men just for the fun of it. It’s designed for respectable women, who have sex only with their own husbands, and either have children already, or want to have them at some point. It is not unheard of for people to insinuate that Long-Acting Reversible Contraception (LARC) is for the nice sorts of women, while the morning after pill must be handed out with great caution, because that is for, well, the other kinds of women. The ones we have special words for.
The importance of choice
We mustn’t allow this narrative. Everybody deserves to choose a method of contraception based on their own preferences, and that includes lifestyle preferences as well as clinical. Not every method is equally effective or clinically suitable for every person. It’s important that whichever method people choose, they know how to safely use it. The role of the clinical sector is to support contraceptive choices, giving all the information about whatever matters most to you; which side effects you’re willing to experience, what type of schedule you can stick to, and many other factors that we weigh up when choosing contraception. We must then trust people to make the right decision for themselves.
Because despite the fears some people had, greater contraceptive choice did change sexual power dynamics, for the better. Women were able to avoid pregnancy while having sex for pleasure, for amusement, out of boredom, for money, or for any other reason which wasn’t procreation. It’s a cause for celebration, not panic, that there are so many choices to make about different types of contraception – including options like vasectomy, and, hopefully one day, the so-called ‘male pill.’ These choices mean that now is as good a time as any to consider ways that men can play a bigger role in choosing, researching, and taking responsibility for contraception.
At MSI Reproductive Choices, we are proud of providing accurate, clear information in a non-judgmental way, never insisting that one notion of “best” must the same for everyone. At the heart of our approach is the understanding that people are different, and that difference is to be celebrated. Everybody who has sex does so for different reasons. And none of those reasons are morally better than the others. No matter what your life looks like, there is a contraceptive choice that is right for you. We trust you to make it.
Our new digital contraception counsellor is here
At MSI Reproductive Choices UK, we know that learning about contraception makes people better equipped to have healthier, safer and more enjoyable sex lives, so we have launched a personalised contraceptive counsellor, which provides information on the main contraceptives available.
Check out our Contraception Counsellor online tool here.
*We recently launched contraception-only clinics in:
- London (for clients in Camden, Islington, Lambeth, Southwark and Lewisham)
- West Yorkshire
If you live or are registered with a GP in these areas, contact us on our dedicated phoneline 03453002350 for your contraception counselling appointment. The line is available Monday to Friday, 8AM to 4PM.
Aside from these three clinics, MSI UK can only offer you contraception counselling as part of your abortion treatment. If you would like to access contraception counselling but are not having abortion treatment with MSI UK, ask your GP or local sexual health clinic about services in your area.