I have been on and off the pill since I was sixteen. The combined pill, for those who know the difference. For years, every morning, at about seven thirty, with my breakfast – which for a long while consisted of a cup of coffee and two toasted hot cross buns – I would pop out a small round pill from beneath its foil casing and place it carefully on the centre of my tongue. There we are, I’d think. No baby. Another day unburdened by the threat of early motherhood. One tiny white pill, gone in seconds, and I had reasserted control over the trajectory of my life.
When it was announced earlier this year that young people were to be offered the Pfizer COVID-19 vaccine rather than the Astra-Zeneca version over fears about the risk of blood clots, I was among the women nationwide exasperated. A review by the Medicines and Healthcare products Regulatory Agency revealed that, as of the end of March, 79 people had suffered rare blood clots after having the AstraZeneca vaccination in the UK, 19 of whom had died. This was out of 20 million administered doses, making the risk of a blood clot about one in 250,000. The risk of a blood clot caused by the pill, on the other hand, is one in 1,000 women each year. Considering that 100 million women worldwide are currently on the pill, it seemed odd that such a fuss was being made about the vaccine when such little is said about the pill.
What troubled me more, however, were the related claims that women shouldn’t complain, because they had chosen to take birth control knowing the risks involved. Blood clots, along with other possible health threats, had been in the terms and conditions from the start. In my case, this was true to some extent. I had continued on the pill knowing it was causing headaches and weight gain. I had weighed up the risk of accidental pregnancy with the side effects of putting artificial hormones in my body and decided that it would be worth it. I wasn’t ready to be a mother, and I was sure that the guys I was involved with were nowhere near nappy changing or child support.
“It takes two for pregnancy to happen in the first place, so why are we the ones who have to accept the emotional, social, economic and physical burdens of contraception?”
However, my free choice was not as black and white as it seemed. A key reason that the scales are tipped in a way that encourages women to take the pill is the lack of male contraception options available. We mess with our hormones because we don’t want to fall pregnant, and while of course we are the ones that have to carry a baby if sex does result in pregnancy, it takes two for that to happen in the first place. So why are we the ones who have to accept the emotional, social, economic and physical burdens of contraception? Why am I the one who has an alarm set every morning to stop me from forgetting to take my daily pill?
There are fifteen methods of contraception, of which only two can be used by men. Male condoms, probably the most popular method on the list, are effective when used perfectly. However, the NHS reports that with typical use condoms are actually around 82% effective. This means around 18 in 100 women will get pregnant in a year. If all the female students in Cambridge woke up one day and stopped using hormonal contraception, imagine how many babies there might be in nine months’ time. Evidently hormonal contraceptives are needed too, and since only women have this option, the choice of whether we do so or not is skewed from the outset.
“Even condoms, despite being a male birth control method, very frequently become the responsibility of women”
A woman who doesn’t want to get pregnant can, among other things, take a pill, stick on a patch, have hormonal implants pushed into her arm or into her uterus, get a copper IUD, sign up for a shot, fit a diaphragm, or if all else fails, take the morning-after pill, or even have an abortion. In each case, the site of the birth control is her body, and she alone will experience the results, both intended and unintended. Even condoms, despite being a male birth control method, very frequently become the responsibility of women. Sex might feel better without, we concede to our partners, who have historically used this as an excuse to escape their already limited contraceptive responsibilities, but the difference is not stark enough to warrant giving up the next nine months, or eighteen years, of our lives.
In some ways, a primary virtue of many of the female birth control methods available is exactly this: that they are woman-controlled and do not require much in the way of male participation in order to be used effectively. It is one of the few things over which we have control. However, that the costs, side-effects and responsibility can only be the woman’s when it takes two people to make a baby? That seems unfair.
A YouGov survey reveals that a third of sexually active British men would consider using hormonal contraception, such as a pill or an implant. However, while there have been a number of successful trials of hormonal male contraceptives, with both pills and injections proving effective in preventing pregnancy, pharmaceutical companies show little interest in developing or marketing them. They ignore studies which show the potential audience for such a product and claim that they aren’t marketable, simply because men aren’t willing to put up with the acne, mood swings, and pain that women have become used to.
Access to birth control has liberated women. I feel lucky to have it as an option, as a way to take control of when I have children, letting me postpone motherhood in favour of other avenues like higher education, a successful career, and the chance to try on different kinds of people for size before I pick just one. However, women shouldn’t have to be the only ones responsible for preventing pregnancy. This is an unjust burden. There needs to be more conversation, and more research, around the current state of contraception and what can be done to involve men in the process. It’s time to make birth control everyone’s responsibility.
