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Birth Control

Introduction to Birth Control

Our 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.

Some Obstacles to Getting Birth Control and Using It Well

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.

What Can We Do?

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.

A Brief History: Birth Control and Reproductive Rights

Understanding the history of the struggle for birth control and reproductive rights can help us advocate for our rights today. Over the past 150 years, there have been three significant periods of birth control activism. Each period was followed by a conservative backlash.

  • In the 1870s, the first major defense of birth control—called voluntary motherhood—emphasized the dignity of motherhood and women’s right to refuse sexual activity. Branding birth control “race suicide,” conservative opposition succeeded in criminalizing abortion and categorizing birth control as obscene.

  • In the 1930s, Margaret Sanger inspired a resurgence of interest in birth control, fighting to make information and services available to every woman. At the same time, a broad-based feminist movement for legalization of birth control defended the separation of sex from reproduction and supported women’s sexual freedom. By midcentury, the “birth control movement” had again died down, and a general conservative trend following World War II put women back into the home and fostered the baby boom.

  • By the 1960s, the new rise in feminism had defined birth control as a reproductive right and motherhood as a choice, leading the way to expanded access to contraception and the legalization of abortion. Since then, conservative forces have worked to deny access to reproductive health information and services and to recriminalize abortion. By defining both birth control and abortion as against religious teachings, they have further eroded women’s access to reproductive health care.

Conservative forces continue to resist efforts to make safe, reliable birth control and information about birth control freely available to all women, and our rights continue to be at risk. For more information on the fight to keep birth control and abortion safe, legal, and accessible to all women, see “History of Abortion in the United States,” p. 337. A good source for news coverage and analysis is RH Reality Check.

Excerpted from the 2011 edition of Our Bodies, Ourselves. © 2011, Boston Women's Health Book Collective.


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