The Politics of Contraception Week 21 Sociology of Human Reproduction

Recap Considered at the social construction of families and motherhood Considered the concept of ‘good motherhood’ Considered the debates around ARTs and prenatal screening and disability

Outline Outline methods and definitions of contraception Examine the role of health professionals Examine the interrelationship with heterosexuality

Define and give examples of contraception?

Contraception Broad definition – an action, drug or device that prevents pregnancy But when does pregnancy begin? When an egg is fertilised? When a fertilised egg embeds in the womb? When a fertilised egg transforms into an embryo?

Contraception Methods Female condom Combined pill Progestogen-only pill Contraceptive injection Contraceptive patch Implant Intrauterine device (IUD) Intrauterine system (IUS) Diaphragm Cap Female sterilisation Male condom Vasectomy Withdrawal Natural Family Planning Fully on-demand breastfeeding Non-penetrative sex

Contraception Methods No contraception is 100% effective Even vasectomy and sterilisation have been known to fail Ability to access and use contraception is shaped by power relationships States, Law, Religions, Medicine

Religions Opinions vary within religions in relation to contraception Catholic Church outlines all but natural family planning – largely ignored where possible Islamic scholars differ Hadith permit ‘Azal’ (withdrawal) Qur'an "You should not kill your children for fear of want" (17:31, 6:151) Judaism restricts ‘spilling the seed’

Pronatal Tendencies In general terms, most religions are pro-natal Restrictions on contraception can be linked to ideas about religious domination Religious territory conflicts have become wars of numbers Israeli vs Palestinians, Protestant vs Catholic

Should states restrict contraception on the grounds of religion or should it be left to women to decide?

Encountering medicine In the UK, most contraceptive methods are accessed via health professionals Contraceptive consultations structured by: Distinction respectable/unrespectable users Conflict between contraception as ‘drug’ and contraception as ‘beyond medicine’

Accessing contraception Health professionals perceptions of respectable and unrespectable women structure consultations ‘Respectable’ women conform to norms about acceptable sexuality Sexually active women should not be teenagers and should be in a serious monogamous relationship

Accessing contraception Most young women start using contraception in their teens Common pattern short period of condom use then use hormonal contraception Young women see using hormonal contraception as evidence of responsibility and maturity

Accessing contraception Yet using contraception could also define them as ‘unrespectable’ Women fell disadvantaged within early encounters with doctors due to their age ‘Family doctors’ a particular hurdle to overcome

Conflicting ideologies Young and/or single women are ‘unrespectable users’ of contraception as they should not be sexually active But also condemned more if they become pregnant Older and/or married women are respectable users and are potential good mothers

Encountering medicine Taking contraception is now understood as a normal part of heterosexual women’s lives Women often do not consider it as a ‘medical matter’ Conflicts arise when women are refused the method of their choice

Do you think doctors should have a right to refuse a woman the contraception she has chosen? What does this say about women’s bodily autonomy?

Negotiating Heterosexuality Ideas about heterosex impact on contraceptive choices spontaneous, emotional & intense activity Barrier methods necessitate a rational discontinuity and are often constructed as a barrier to sex Condoms are often not considered a ‘proper’ contraceptive.

Whose responsibility? Heterosex and contraception carry embodied health risks for women pregnancy, abortion, side effects, STIs These risks mean that women feel responsible for contraception But this conflicts with ideas that heterosexual relationships should be equal

Embodied Responsibility In the UK, few women are happy with men take responsibility for contraception Women run the risk of pregnancy Current contraceptive choices impact on women’s bodies

Should responsibility for contraception be women’s or should we encourage gender equality?

(Not) Negotiating Heterosexuality Women report rarely discussing it with partners (‘I’m on the pill’) But restrict their choices to ones that they felt their partner would be happy with ‘Choice’ is always structured by power relationships

(Not) Negotiating Heterosexuality Women are well aware of their partners preferences Routinely restricted their choices to ones that they felt their partner would be happy with

Summary ‘Choice’ over contraception is shaped by power relationships Ideas about ‘respectable’ users influence those dispensing contraception Heterosexuality structures and is structured by contraception