by: Dorcas Omowole
My father, elder brother, younger brother, and a long list of male colleagues and acquaintances are men who I love and do not doubt their love for me. They often decide to show me that love in ways that differ from my expectations. When I try to explain how best to express that same love, it becomes obvious that we are looking at the same elephant from different sides. Yes, the intention and effort count. It is a step in the right direction. Subsequent steps then need to be guided patiently with persistent clarifying information. This is the same approach that male engagement in, and usage of, male contraception requires. The need for women to understand men and for men to understand women is a value that will remain relevant, and making judgements based on assumptions leads to unnecessary tensions and stagnation.
This understanding is a needed first step in the process of designing instructions to guide male-female interactions, including around contraception. In every society, division of labor has been shown to lead to specialization, efficiency, and increased output. When resources are misallocated, there is inefficiency and market failure. The same holds true for family planning.
In what ways can the present societal expectations on contraception evolve so that it is efficient and does not burden one at the expense of the other? This change would not come about by blacklisting men or women or by expecting rapid change. The current perceptions and attitudes on contraception–for example that avoiding unwanted conception is a woman’s responsibility and failure in doing so is a failure on the part of the woman–took a while to form. It is fair to expect that these unfounded perceptions might take a while to go away. What society can start doing now to facilitate this process is to begin unearthing the conscious and subconscious barriers to contraceptive usage by men, and restructuring definitions of modern-day masculinity. Some of this is being done already, with men embracing contraceptive options for men. Understanding men and developing initiatives based on those insights can lay the foundation of sustainable change; a change not mired in unintended consequences, such as increased violence against women.
Recent Studies
There are a couple of international documents that highlight the reproductive rights and responsibilities of men and women. Some even detail specific roles for men and duties of various stakeholders to enhance the performance of those roles. However, on the ground, implementation often ends up excluding men. Compared to NGOs and INGOs focused on women, only a few NGOs and INGOs focus on men. A recent study by the Nigerian Urban Public Health Initiative identifies the predictors of how likely a woman is to use family planning:
- having a positive attitude
- knowing about contraception
- approving of her leaders speaking out about it
- believing her friends won’t criticize her
- talking to her husband
- having fewer mistaken beliefs
My instantaneous reaction to this study was to ask, “what are the predictors for men?” I have reasons to believe that they would be similar if not the same as those for women. Shifting or balancing the focus of contraceptive products and marketing between men and women, creating opportunities to engage with men such that they also know and begin to have a positive attitude towards male contraception, having men lead male contraception usage conversations openly, and addressing mistaken beliefs would generate positive peer pressure and increase usage of contraception by men. If infertility or loss of virility is a concern for men, contraception producers and society should put in place systems to manage them, just as it has done for complications from female contraception.
Women as Contraceptive Users
The tilt in family planning methods and communication towards women takes its toll on women’s health and severely limits the options available to women. Pregnancy and managing menstrual cycles already come with unique challenges. Without external additional hormones, women already have a risk of eclampsia and high blood pressure that are associated with normal hormones secreted by the woman’s body. Describing external hormonal methods as more effective, and not seeking ways to make non-hormonal methods effective, puts women in a powerless and increased risk position. The focus on women as contraceptive users also builds an entire industry based on a woman’s vulnerability–her fears and her desire to protect herself. While men need to be onboard with family planning usage, more non-hormonal male and female family planning methods also need to be introduced into the contraceptive mix.
Society is also deprived of some dividends of development by focusing family planning efforts only on women. As more individuals who desire family planning use their preferred methods, contraceptive failure rates, unwanted contraception, and abortion decrease. Overall maternal mortality also decreases. Male methods, because of their low prevalence relative to female methods, have more room for improvements and present an opportunity to increase overall contraceptive prevalence.
Those who assume that men would not be flexible in using existing male family planning methods or adopting new innovative methods for men make those assumptions based on the biases they have about men; that men do not care or would not act rationally when presented with clear expectations and evidence of the value of their contribution. In most cases, rational logical arguments win over subconscious bias. Proponents of arguments based on bias become weak in the face of evidence. The process takes time because the shift has to involve the community or the greatest influencers. I think we can safely say that most men care. They just want to be shown how and that they won’t be hurt. However, if there will be some discomforts either way, then men and women should be able to share discomforts in a balanced way.
Also, a woman’s dignity is compromised, not enhanced, by not engaging men in family planning conversations. It forces the choice of limited options on the woman and does not empower her to choose what gets into her body. Women should not be deprived of options that could be made available by engaging men in the conversation. This enhances the woman’s autonomy and reduces the risk of preventable abortions. The benefits of choosing this route are unending.
Men are our fathers, brothers, children, friends. They are interested in contraception but have their fears. Subconscious and socialized male superiority make male actions borne out of fear misinterpreted as an effort to dominate the woman. Men and women should be equally targeted for contraceptive usage and communications. With appropriate conversations and support, the benefits of contraception for men to society should be reiterated. Someday the commitment to speaking openly about male contraception will pay off in reduced abortion rates, reduced maternal mortality, and a happier society.
Miller, Elizabeth Jordan, Beth Levenson, Rebecca Silverman, Jay G. et al. Reproductive coercion: connecting the dots between partner violence and unintended pregnancy. Contraception , Volume 81 , Issue 6 , 457 - 459. June 2010. https://www.contraceptionjournal.org/article/S0010-7824(10)00089-2/fulltext Johns Hopkins Center for Communication Programs. Nigeria family planning: Nigerian Urban Reproductive Health Initiative (NURHI) ideation video. August 4, 2014. https://www.youtube.com/watch?v=cf361Tvz4wQ Male Contraception Initiative. 10 facts about male contraception. August 31, 2018. https://www.malecontraceptive.org/2018/08/31/male-contraception-10-facts/
Dorcas Omowole is a graduate of the Master of Global Affairs program at the University of Notre Dame. She is interested in global health, governance, and sustainable livelihoods, especially maternal and child health and sexual and reproductive rights. She has researched topics such as women’s voice and its influence on contraceptive use in Nigeria using data from the Demographic and Health Survey (DHS) and macro-level power dynamics through a joint report on Political Economy Analysis (PEA) of Devolution in Kenya.