By Nay Alhelou
Nay Alhelou is a Human Rights Research Fellow at the Institute for the Study of Human Rights and an MA candidate in Human Rights Studies at Columbia University. Her research focuses on the intersection of human rights, health and social factors.
If you’ve been spending any time on your social media while in quarantine, you probably saw a joke or two about a coronavirus ‘mini baby boom.’ Notable news outlets have also joined the conversation and even explained why a baby boom is unlikely to happen and even why it should not.
When my first ‘quarantine period’ was abnormally late, the jokes sounded solemn to me and I stopped laughing. After all, I am quarantined with my partner, I am sexually active, and I do not take any birth control pills.
Here’s what’s missing from the ‘baby boom’ conversation: a discussion about how unwanted pregnancies can be prevented. Contraception is surely one of the answers, but it is not a simple one.
On the surface, a list of contraceptive methods gives the illusion that there are many choices of contraceptives and the hardest part is choosing one. If one pays a closer look, however, the issue turns out to be much bigger than having ‘too many’ choices.
For one, there is the problem of accessibility. Certain populations, like homeless women and people without insurance, face many hurdles in accessing contraception because of associated costs and/or restrictive practices by shelters. Even those who do have insurance may also be unable to access contraception because of coverage policies or State laws.
Another less-discussed issue is that of, arguably, ‘too few’ choices. Even women who want and have the means to access contraception, may opt not to use them – or stop using them – because of their side effects. Such effects differ between methods but include: nausea, headaches, moodiness and weight gain.
Studies with women who stopped using hormonal birth control showed that between 30 and 60% of them did so because of side effects like moodiness and weight gain. Similarly, those who discontinued the use of Intra Uterine Devices complained of depression and nausea. All in all, such contraceptive methods seem to be a significant burden for the sake of avoiding a baby boom. Plus, this burden of contraception in the US continues to be largely on women. Only 22.5% of those using contraceptives reported that their male partners used condoms or opted for male sterilization.
In addition, even though female sterilization is on the decline, it continues to be the most popular method of contraception, in particular in the age group of women 40-49. Significantly, it is used three times more often than male sterilization. The reasons for that are socio-cultural as much as structural: even though sterilization procedures are covered by most health insurance companies, vasectomies – a procedure that restricts a biological male’s reproductive capacity – are not required to be covered.
All this points to an urgent need to develop new contraceptive options for all sexes. Yet, the US is not prioritizing the advancement of contraception in research. In 2018, the Gynecology and Reproductive Health Research Portfolio of the National Institute of Child Health and Human Development allocated about $57 million for infertility research and only $38 million for contraception research.
On the bright side, funds for research on male contraception almost doubled between 2018 and 2019. Nonetheless, in spite of recent progress in the development of male contraception, its use remains less socially accepted than female methods.
To be sure, contraception is not the go-to choice for everyone. Many people in fact forego using contraceptives because they find it morally questionable or they simply do not mind getting pregnant. Yet, about 65% of 15 to 49-year-old women in the US were using some method of contraception between 2015 and 2017. These numbers do not include women or other menstruators who want – but don’t – use contraception because of the many reasons mentioned above. Their needs should also be respected and met.
The US contraceptive market was valued at $7 billion in 2019 and is expected to grow even more in the coming years. If ‘baby boom’ warnings are any indication, the COVID-19 pandemic is likely to contribute to the growth of this industry. However, it is not acceptable that the industry continues making profits on the expense of its users.
Women’s complaints about certain contraceptive methods cannot continue to be ignored or dismissed as paranoia. Similarly, they should not be expected to just ‘take what they can get’ and accept both the burden of contraception and its side effects.
More research is needed to improve current methods of contraception and create alternatives for both men and women. More research also means more funding and recognizing that in the field of “contraception and reproduction,” neither should be deprioritized for the sake of the other.
A future where people can really choose what they do with their reproductive systems cannot be reached without better options, equal access to these options, and a social understanding that reproduction is an option, not a must for many. Until then, many like me will continue to welcome menstrual blood with a sigh of relief, an indication that even though the sociopolitical system failed us, our reproductive systems did not.
In Spring 2020, Columbia students and faculty had the opportunity–for the first time ever–to spend a full semester exploring menstruation through many different angles in the course “Menstruation, Gender, and Rights: Interdisciplinary Perspectives.” Students engaged in writing OpEd style short pieces that draw attention to various facets of menstruation neglected in the mainstream discourse. Leading up to the worldwide day celebrating menstruation, we have the honor to present a selection of emerging menstrual voices. If you’re interested in joining, please stay tuned–we plan to offer the course again in Spring 2021. — Professor Inga Winkler