Contraception Must be a Shared Responsibility in any Sexual Partnership

One of the hairiest topics in modern marriage is perhaps not who brings in the bacon or who takes charge of changing diapers, or perhaps who loads the washing machine. It is this. Who takes charge of the birth control. More often than not, it falls to the woman to ensure that she is not likely to be saddled with an accidental, unwanted pregnancy.

The Indian man, according to latest research figures, is not one to volunteer for a vasectomy, no matter that the procedure is minimally intrusive, and often even the bait of a monetary reward does not tempt him. The family planning programme in India, therefore, is almost completely dependent on the women of the country.

The male versus female ratio for sterilisation in 2016-17 stood at 1:52 according to latest data released by the Ministry of Health and Family Welfare. And more tellingly, the most popular contraceptive method used in India seemed to be female sterilisation. According to data 36% of married women opt for sterilisation, 6% use male condoms and the pill.

To quote the NFHS-4 report, “Female sterilization remains the most popular modern contraceptive method. Among currently married women age 15-49, 36% use female sterilization, followed by male condoms (6%) and pills (4%). Among sexually active unmarried women, female sterilization is the most commonly used method (19%), followed by male condoms (12%). More than eight in 10 (82%) women who got sterilized underwent the procedure in a public health sector facility, mostly a government or municipal hospital or a Community Health Centre (CHC) or a rural hospital.” The Indian government funds approximately 4 million tubal ligations per year, more than any other country in the world.

Of course, surgical sterilisation of women does not come without risks, after all, it is an intrusive surgical procedure, often performed hurriedly, under less than ideal conditions in government health centres. Deaths, complications are not uncommon. A huge price to pay for the simple decision by a woman to limit her childbearing.

More often than not, a woman going in for sterilisation is the result of the man refusing to even consider it.

Often the decision to go in for surgical sterilisation isn’t even a woman’s decision in its entirety. More often than not, a woman going in for sterilisation is the result of the man refusing to even consider it. This is despite the fact that when you compare a vasectomy with a tubectomy, there are more risks associated with the latter than the former. Also a vasectomy can be easily reversed, and can be done without stitches. But try telling the men that. The Indian male has his virility at stake, and all effort at contraception must necessarily be the woman’s concern. They’re not going to let a surgeon, even one advocating a non scalpel procedure, anywhere near their privates.

Blame the patriarchy. Blame women for not insisting the men take equal responsibility for contraception. Or blame the bad rap that sterilisation got all those years ago when a radio set was the reward for forcible sterilisation in the draconian family planning programme that was enforced, the fact remains that men do shy away from taking charge of contraception, both married and unmarried. The women though are pragmatic. They would rather take charge of contraception than leave it to the men, who might not be always reliable when it comes to keeping a condom handy if that is the method preferred. Last year, Melinda Gates wrote about how taking charge of contraception helps women. She stated, “When women are able to plan their pregnancies around their goals for themselves and their families, they are also better able to finish their education, earn an income, and fully participate in their communities.”

In urban centres too, where the women are professional working women with independent incomes, the onus of contraception does remain primarily with the women.

While some men might be careful about contraception, specifically ensuring they use condoms, when in a sexual relationship which is not a long-term one, most long-term relationships do tend to have the women take charge of their own contraception, either through the pill, the IUD, or post child bearing, permanent sterilisation. Interestingly, the National Family Health Survey 2015-16 showed that condom usage had gone up from 2% to 12% in 10 years. And this was amongst unmarried sexually active women, between the ages of 15 to 49. While on the one hand, it is absolutely great the women are taking charge of their own contraception and protecting themselves from sexually transmitted diseases, it does bear questioning as to why the men aren’t being responsible enough about contraception.

What does this say about the men in such relationships? Is this shirking of reproductive responsibility due to selfishness, immaturity, lack of consideration for the partner, or all of the above?

This is even more pronounced when it comes to long-term relationships? What does this say about the men in such relationships? Is this shirking of reproductive responsibility due to selfishness, immaturity, lack of consideration for the partner, or all of the above?

Or is it just the overarching assumption that contraception is a woman’s issue, because a man just have to scatter seed, whereas the woman has to bear the child in her womb and therefore has much more to deal with in case of an unplanned pregnancy. Or does it mean that women are taking charge of their bodies, and not leaving decisions to the men folk? Contraception must be equal responsibility in a marriage or any sexual partnership, one that both partners must take the onus for. The overwhelming imbalance of these decisions we see in this country, is perhaps but one of the biggest indicators of how women must take charge of their bodies and their reproduction, because the men couldn’t be bothered. And that is what needs to change.

Kiran Manral is Ideas Editor at SheThePeople.TV

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