Contraceptive counseling reinforces burden on women for preventing pregnancy

In US culture, women bear the primary, and sometimes exclusive, responsibility for preventing pregnancy. Birth control methods that put more responsibility on men – condoms, withdrawal, and vasectomy – have the potential to change this imbalance. From a patient perspective, these methods may also best meet some women’s preferences—for example, offering protection against pregnancy without any side effects in women’s bodies.

In a new study, ANSIRH’s Katrina Kimport finds that providers generally devalue male body-based methods in their counseling. To start with, most failed to discuss these methods with their patients at all. Those who did discuss condoms, withdrawal, or vasectomy tended to emphasize aspects of the methods that were presumed “negative,” like the lower efficacy of withdrawal and condoms. They did not spend time on the features such as the high efficacy of vasectomy or the lack of side effects with condoms and withdrawal that may appeal to patients.

Taken together, the counseling marginalized male body-based methods as contraceptive choices. This approach may encourage women to choose a method that does not best meet their preferences. By devaluing methods that could shift the unequal burden of preventing pregnancy, clinicians also contributed to the larger expectation that women bear primary responsibility and reinforced the unequal division of labor.