The Inequality in Birth Control

by Ohoud Saad

What’s the first thing that comes to mind when you hear patriarchal society? How ingrained do you think this male-dominated approach is in our day-to-day lives? Well, I see it in roles of men and women within the society itself, in the pay-gap in the workplace, in harassment on the streets, in mainly men in charge of making laws and rules, and in sex, to name a few. Almost worldwide, and especially in the Mena region, the burden and responsibility of birth control falls on the female. Tons of money and efforts in research and contraception development has been put into making birth control: the woman’s job. The woman who can only get pregnant between a certain age frame, within certain days per month, with a limited number of eggs she’s born with. Not the man. Not the man who can impregnate as many women as he possibly wants from puberty pretty much onwards. 

Just like we speak about the injustices between men and women in the economy, in society, in politics, we need to speak about this as well. I found no better to discuss this with than Nour Emam, Birth Doula & Sex Educator, as well as Founder and CEO of This Mother Being, the educational platform that has taken social media by storm, debunking myths, talking everything taboo, and more importantly, offering reproductive and sexual health education. 

Nour shared that the most common type of birth control used here is hormonal birth control. “Hormonal birth control in general should be given to women after rigorous testing making sure they don't have any underling health problems or history of any family illnesses. Some hormonal contraceptives can't be taken if you have a history of certain illnesses, it really depends,” she said. Of course here, it’s sold over the counter with no such testing made, she added, “what needs to be said in general is that hormonal birth control affects the natural production of hormones and substitutes it with artificial hormones. They stop you from ovulating, making women temporarily sterile because they're not releasing eggs and they're not actually menstruating; they're getting withdrawal bleed or an artificial bleed. So, it definitely has a negative effect on women’s bodies. There are common side effects like depression, anxiety, weight gain, water retention, bloating, insomnia, among other things. But also, some women take them and they don't suffer from any of these side effects.”

Other than the scientific evidence of these side effects, Nour shares how much women suffer emotionally and mentally about this. Through their day-to-day experiences with women through This Mother Being she says, “women are really unhappy with birth control options. A lot of women are bouncing between different birth control options desperate not to get pregnant and their partners are unwilling to use condoms for very poor reasons such as lack of sensitivity or marriage entitlement: feeling like if you're married then you don't need to use condoms. It's really heartbreaking to see that men would rather see their wives take on that burden and change their body chemistry making them infertile or sterilizing them for a specific period of time than to wear a condom. There are solutions to make condom use more pleasurable, the entire world is using condoms. I think that for us, the most heartbreaking thing to see, is that many women suffer on a daily basis.”

Let’s check the big picture? Here are the birth control options for women in general: caps or diaphragms, hormonal pills, contraceptive implant, contraceptive injection, contraceptive patch, IUD, ring, to name a few. For men? Simple: condoms and vasectomies. That’s it, nothing else. And from Nour’s insight about condom usage within families here, it left little to the imagination on vasectomies.

“It's just the fragility of men in general and their fear of being sterile although no one has ever batted an eye when it came to sterilizing women either permanently or temporarily. Vasectomies are very effective and are reversible, but they are still considered medically as a permanent form of contraception,” Nour says. “When we're talking about abroad, it's not a simple procedure that you can just walk in and do. Usually, most men need to go through counseling to make sure that their mental health is in check; that they know that they're making this decision and that there is a certain percentage of failure to reverse it. So generally, it's not intended as a substitute for condoms. You would not go and do a vasectomy unless you and your partner have consciously decided that you've completed your family or you do not wish to have any kids. Having said this, it is definitely a simple procedure, it's an outpatient procedure in a clinic with local sedation. Recovery time takes around 3 days to a few weeks. I definitely think there are men who do it here but we should definitely be raising more awareness on safer forms of birth control such as vasectomies rather than totally and constantly pushing hormonal contraceptives on women, which is not sustainable and it's not long-term.”

When I first started thinking about this topic, genuinely wondering why there’s blatant inequality in birth control, I thought of all the good that can truly come out of pushing resources and funds towards other forms of birth control, namely, for men. Balance, restoration and equality in this area will benefit family planning, society, economy and everything that falls after. When I asked Nour why else she thinks this gap lies, we went straight back to patriarchal societies. “Women have always been seen as the child bearers and so naturally they would also need to take it upon themselves to be responsible for birth control and that's largely because for centuries, we've been living in patriarchal societies that see women as lesser than men, dispensable, that women's bodies are inferior to men's bodies. All of that plus lack of education gave us no other options,” she said.

“But, there's no excuse currently as to why there's not enough research being done for male contraceptive options. I've heard some doctors say that it's easier to come up with solutions for contraception for women, that it's easier to stop ovulation than creating a pill or an injection or whatever for sperm production. But I don't know how true that is. I'm sure that in 2021, with all the advancements in technology and science, I'm really sure that if half the money that's been put into researching female contraceptives is put for male contraceptive options, we would definitely have more solutions other than just condoms and vasectomies,” she concluded.

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