Over a month back I learnt of an incident in my field area that caught my attention. An Auxillary Nurse Mid-wife (ANM) employed in the Primary Health Centre (PHC) under the Government Health Services reported of her success on a Whatsapp group I am part of. She was elated to have successfully counselled a man, the only man in the households under the purview of her responsibility, for a Vasectomy. This irreversible birth control procedure for males can be performed in under 20 minutes right in the doctor’s office. If everything goes well you can walk in and out without any assistance. A car was booked by the PHC team to transport the brave man to the centre. The ANM received recognition from the members of the Whatsapp group and the local health officials and would be congratulated among her peers in the up-coming Block level meet.
In the 23 years of my life this was just the second man that I directly heard of in my personal and professional spheres who opted for this procedure. Let’s face it, how many men would voluntarily choose to have a scalpel touch their sex organs so their wives, partners would not conceive? None I can think of! This was an even bigger cause for celebration in the context where the PHC is located in the remote tribal belts of south Rajasthan. Here, the lack of comprehensive sex education, access to affordable modern contraceptives and gender inequities are higher in comparison to urban, semi-urban, and other rural set-ups. And hence, for a man to take the responsibility of fertility in his relationship is commendable. But, I know of numerous women who have gone through Tubectomy (the female equivalent of Vasectomy), diligently inject themselves with hormones every three months, and even others who have incorporated the consumption of the oral pill in their daily routines for close to a decade. They have made it their silent duty to take control of their fertility. Yet there is no car, or congratulatory speeches for their sacrifice. When did the responsibility of birth control of a couple, comprising of both man and woman, fall solely on the shoulders of women?
For centuries women had little or no control on their fertility. Education and accessibility to birth control was non-existent. In fact, only in the past century has it become widely accessible. Birth control innovations have had a remarkable impact on modern societies.
Carl Djerassi is the scientist who led the team who first synthesized a hormone instrumental to the creation of the oral contraceptive as we know it. However, Margaret Sanger, an American activist played a significant role in legalizing contraceptives and making them available for women. The advent of the oral pill enhanced women’s opportunities to control childbearing and their careers, increased their participation in the labour market and their earnings, and increased their prospects of a healthy and long life.
Prior to this women were bound by gender specific roles designated by society and their male partner’s permission. It was at such a time that Sanger began her fight. She was of the opinion that birth control was purely a women’s responsibility. Giving women responsibility at that time also meant giving them power, which was essential in her era and still is today. There are numerous Indian communities that still stigmatize the use of contraceptive methods. Women are frowned upon for wanting to control a “gift” that nature has bestowed upon her. We much ask do the contraceptive means available at present really empower women like we think it does?
A little research revealed that men have five options of birth control as compared to women who have 13! Out of the five – one is permanent, two involve not having intercourse, and one is withdrawal which has a proven lower success rate. By method alone the responsibility of preventing pregnancies is placed heavily on women. They also face a host of negative side effects from prolonged use of IUDs, hormonal injections, pills, and patches – like nausea, increased risk of thrombosis, higher risk of developing depression and breast cancer, degeneration of bones to name a few. It has been spoken off time and again about the gender inequities that persist in drug trials for male birth control. Numerous trials have gone south at the first indication of side effects.
Is it bad that women have so many birth control options? Absolutely not! If at all it showcases how much progress we have made while providing agency and power for women. But always placing weight on women for preventing pregnancies lessens the responsibility for men.
* Featured image from creative commons.