There are lots of myths around contraception (be it condoms, IUDs, or sterilisation surgeries), which lead to the burden of preventing unwanted pregnancies falling solely on the shoulders of women, in rural Maharashtra.
Can you imagine yourself married, staying with your spouse, but you and your partner agree to fulfil each other’s sexual desires only through foreplay, above the waist… No, right?
There is a couple in rural Maharashtra, practicing it for more than a year now. You might think that they may be uneducated or illiterate. No, they are not. The wife is completing her graduation and the husband works in Pune in a design space.
Yes, a mere degree and working in a metro city, does not suffice. Imagine the plight of about every fourth girl, married off before 18 years of age.
My job gave me an exceptional opportunity to dwell deep in the space of women’s sexuality, in rural Maharashtra. Although my work was focused on understanding the behaviours around the use of contraception, it inevitably included sexual behavior too.
It wasn’t easy to make women talk about their intimate life experiences. However, for whomsoever we could create a safe sharing space, the findings were revealing, as much as concerning.
The case introduced above, was one of those cases which has been lingering in my mind for a long time. With sheer curiosity, when I asked her: “Why is it only above the waist? Don’t you feel like having penetrative sex at all?”
“We do, but we aren’t prepared for a child now. I have my exams coming up.”
“Hmm, but there are products that one can use to have penetrative sex safely, like condoms or Mala-D type pills. You won’t have to worry about the unwanted pregnancy then”
“They say if we use them, there might be a problem in conceiving. So, at least till our first baby, we won’t use anything.”
“Okay, who told you they create problems in conceiving?” I asked in an enquiry mode.
“The doctor from the pharmacy (most probably a pharmacist) and besides, my husband does not enjoy using them.”
“Okay, why so? I mean, only if you wish to talk about it.”
“I don’t know, I never asked.”
He isn’t alone. According to data, nearly 95% of Indian men do not use condoms.
During my second visit after a few months, she also shared that her mother-in-law was against the use of contraception.
“Did you ever visit a doctor to consult them on the use of contraception?” I asked because I was worried.
“Why should we? We don’t think we need to.”
It felt like a traditional custom they were obliged to follow, because the diktat came from their mothers or mother-in-laws. I was still happy to know that, at least, there was no pressure to conceive soon after marriage and she was “allowed” to complete her education.
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The other popular misconception was about Cu-T, an IUD (Intra-uterine device): that it goes up from the uterus to the diaphragm and/or causes profound bleeding during menses.
Each contraceptive method comes with its drawbacks. Some women have more symptoms than others. Are they totally safe? Here is what I found:
“In recent years, scientists have started to realise that the brains of women on the pill, look fundamentally different. Compared to women who aren’t taking hormones, some regions of their brains seem to be more typically ‘male’.”
Many women I interviewed were not aware of modern contraception methods, that include injectables, implants, emergency contraceptive pills, as well as the traditional calendar and withdrawal methods.
What they were aware of or had heard of were Cu-T, Mala-D and sterilisation operations. In most cases, as soon as they got married, there was pressure from the family to conceive. It was also about proving one’s ability to conceive a child.
I met women around 20 years of age, who already were mothers to one or two kids. I also met a few women around the age of 25-30 years, who were married for half a decade or more, and desperate to have kids.
It wasn’t always their choice to have babies, but also because they were being threatened to be deserted by their husband and in-laws, if they weren’t able to reproduce. For some women, reproduction was the sole purpose of their lives and if not for child bearing and raising.
They would ask if we know of any doctor who can help them conceive, even when they already have already tried visiting numerous doctors. And, it was always a woman who would first undergo an entire body check-up to rule out that she isn’t at ‘fault’!
Then, if at all, her husband will undergo tests and decide to opt for treatment thereafter. Here, again, not that the women were doubtful of their own fertility, but because it’s like a norm to rule out her chances of being at fault and then ask the men to get tested.
I did find couples using some form of contraception, but again, it was mostly a woman using pills or an IUD, with statements (minus rage, but with the certainty of norms) such as:
“Woh toh nahi use karenge kuch, mujhe hi karna padega na (my man won’t use a condom, therefore, it’s up to me to use something).”
Most women above 30 years of age had undergone the so-called sterilisation surgery after their second child, which was a good thing. However, it was always the woman who underwent surgery, and I found no man who had gotten a vasectomy (male sterilisation surgery) done.
When I interacted with a few doctors on sterilisation surgeries, one of them said:
“Hardly any man comes for the surgery. In my 25 years of practice, I witnessed only one male sterilisation surgery seven years ago. I was so excited with the news that I asked my husband if I could see this man!”
Others said: “We don’t have any specialist doing vasectomy, simply because we have no patients coming in for it.”
As per NFHS (National Family Health Survey) 4 data, against 76.2% women undergoing sterilisation, only 0.5% male sterilisation was reported. The rest of the methods, including condom, pills, and IUDs, contributed to 23.3% of total contraception.
“Reproductive health is intricately linked to issues of women’s and children’s health, the spread of sexually transmitted diseases, poverty, education, gender equality, and human rights. Improving access to reproductive health is thus central to the process of development, as reflected in sustainable development goal 3.7,” according to the Lanclet.
When sexuality is a natural instinct, just like hunger, thirst or breathing, reproductive health becomes key to the overall health and development of human beings. As important as the topic is, it’s gravely neglected.
Men, women and trans people, or girls, boys and trans children, get physically attracted to each other from as early as puberty and are capable of reproduction.
However, in the progressive society we live in, education, career, physical and mental capabilities, as well as financial readiness needs to be considered before conceiving.
Hence, men and women both need to be equally aware of and participate in ensuring the reproductive health of their respective partners.
Women have a bucket of choices and men just have one contraceptive: condom! (and the permanent method of sterilisation)
Given the importance and need of reproductive health, I wonder why there are just male condoms and sterilisation surgeries for men, and so many hormonal drugs for women that actually affect their hormonal cycles.
Every month, there are changes in the hormonal levels of a woman affecting her mood, health, and well-being. Is it really safe to play with them even more? Aren’t the natural, hormonal ups and downs sufficient? Why do we add more through contraceptives?
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Except male and female condoms, I didn’t find a single contraceptive without any side effects. Why do women choose them then? Maybe, because ultimately, it’s women who have to take on the burden of childbearing, or abortion in case of an unplanned pregnancy.
If we talk about equal responsibility, I am sure there might be men willing to use some sort of contraceptives provided there is availability of choices.
We don’t want the availability of so many flavours in condoms, but we want the availability of choices other than condoms that men can use.
This needs to be done so that men can share an equal responsibility in reducing the unwanted burden of pregnancy, and contributing to reproductive health.
I am not an expert at advising about or criticising hormonal contraceptives, but I feel there should be more research for men to carry the equal burden of using a contraceptive, as well as research on safer contraceptives for people of all genders.
Till then, we need more men to sign up for using condoms, rather than expecting their partner to choose from the available yet not so great options. By the way, condoms also protect you from STDs (sexually transmitted diseases), which no other contraceptives does.