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Why is birth control always the woman's responsibility?

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Anonymous asks:

I heard about a male birth control pill a few years ago but have not heard anything about it since. Does it even exist? Other than the condom, I feel like it's always the woman's responsibility. I know that the consequences of unprotected sex are heavier for women but I would love it if it wasn't always the woman who had to throw her body out of whack by taking birth control. That said, the pill and other hormonal birth control methods all seem to have some health risk involved (increased breast cancer risk, cardiovascular risk, etc.) I know we need to protect ourselves, but it seems extreme to take all these health risks to avoid pregnancy (considering the fact that many people who use birth control do not even use a condom or protection against STIs). I just think that if a man loved a woman, he would not want her to increase her risk of certain health problems by taking the pill. Is the condom really a dependable method for someone like me who refuses to take hormonal birth control? There are just so many choices to make when becoming sexually active.

Heather Corinna replies:

Hormonal male birth control is still in development, but there is not yet a method available for men which is hormonal. The options when it comes to birth control for sexually active men are condoms, vasectomy, cooperating with natural family planning (FAM), and/or abstaining from vaginal intercourse.

Is birth control often a woman's responsibility? Yes. Does that stink in some ways? Sure it does, but it's a biological issue, not something any of us can change with our behavior. So long as women are the ones who can become pregnant and give birth, things are going to be unbalanced in this way, no matter what men do, and it's also unlikely we will ever have a reversible method of birth control, for men or women, that is 100% effective. Is it a bad thing, full-stop, for most of the responsibility to lie with women, so long as we absolutely have a choice in having sex or not? I don't think so. After all, we're the ones who will become pregnant, we're the bodies a pregnancy will effect, and we're the ones who will be ultimately responsible in every way when it comes to a pregnancy and managing one. It tends to be a good thing when the person who has to deal with the effects of something is the person with the most power when it comes to preventing it and having choices.

(And I'll be honest with you, and let you in on a possible personal bias. I'm one of those folks who if and when hormonal male contraceptives are available, wouldn't likely be comfortable using only those even with a male partner I know cares for me and who I trust. I just wouldn't want to put all the responsibility for something which could impact me so greatly and so much more directly in someone else's hands. I'd also have a hard time trusting that it could feel as important to someone who was not going to have to deal with, say, missing a pill and the consequence of pregnancy, as immediately as I would, the person who would become pregnant.)

One thing to bear in mind is that even with advances in medical care, pregnancy, in and of itself, is still a very risky thing when it comes to a woman's health. Even in first world countries, there remain plenty of serious risks. Women do still die during labor or pregnancy (especially when we factor in that homicide, mostly due to abusive partnerships, is a leading cause of death for pregnant women), postpartum depression is serious business, and pregnancy poses a good deal of health risks, to physical and mental health, including but not limited to hemmorhoids, yeast infections, tooth decay, hair loss, anemia, various infections, pelvic floor disorder, back injuries and broken bones (my best friend just cracked a rib due to her pregnancy last year), embolisms and eclampsia, gastroesophageal reflux disease, lower breast cancer survival rates than nulliparious women, obstetric fistula, circulatory collapse, future infertility and about a gazillion more. Most of the risks hormonal contraceptives pose are risks pregnancy also poses.

In other words, it's not all that sensible to frame some risks and side effects which exist with some methods of birth control as being needless when it comes to avoiding pregnancy, as if pregnancy did not also pose some serious risks.

Are hormonal methods for everyone? Nope.

Some women can't use them due to the extra risks they pose for certain populations, and some women just don't want to use hormonal methods, for any number of reasons.

Is any of this solely about men? No, it isn't.

Plenty of women are not comfortable risking pregnancy, and want to use hormonal methods because they are more effective than barrier methods often are. For those women, even when their male partners step up to the plate and use a condom on, they still want to use hormonal methods because they want to reduce their risks further. The male partners of some of those women very well do not want their partner to be taking extra risks, but it's not up to them. And part of love is respect, which would include respecting a woman's own choices when it comes to what method of birth control she feels most comfortable using. What method of birth control a woman decides is best for her, and with which she is most comfortable, is her call. Most women who choose to use hormonal methods are not only choosing to do so because either their male partners insist they do, or because their male partners won't use anything else.

It's a big deal to be pregnant, whether you want to be so or not, and it's often a serious life-changer, no matter what reproductive choices a person makes. Doing what a person needs to which is generally healthy and safe -- and really, hormonal methods are safe medications, so long as the are prescribed and used properly and appropriately: very few medicines have been through the kind of rigorous and long-term testing and observation that hormonal BC methods have -- to avoid a consequence they know they don't want isn't extreme, it's sensible. And if and when male hormonal methods do arrive on the market, chances are that the risks of those will be similar to the risks involved for women for female hormonal methods, so when it comes to hormones, someone is going to be taking some risks, no matter who is using them.

Mind you, that doesn't mean you have to choose a hormonal method to have effective protection. When used properly and consistently, condoms are around 98% effective. If you want more coverage than that, you can combine condom use with another barrier method, like a diaphragm, add a spermicidal film or foam, or use condoms combined with periodic abstinence via fertility charting: when you're most fertile, you avoid genital intercourse, and at other times, just use the condoms. Obviously, too, simply having kinds of sex only that are not intercourse is another totally viable alternative.

Again, all of these things are choices, and this all includes you only choosing partners who are willing to wear condoms, and/or cooperate with whatever method you choose to use, and do what they can to play a part in birth control, which is hardly a poor choice on anyone's part.

Here are a few extra links for you:

And if you're curious about keeping up-to-date with developments in male contraception, you can keep an eye on them here: Malecontraceptives.org.

written 27 Jan 2008 . updated 22 Jan 2014

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