Man or woman: Who should carry burden of contraception in a relationship?
What you need to know:
- Some partners fear that initiating conversations about contraception in a relationship will be misinterpreted as a gateway to infidelity.
- As the relationship progresses, many couples tend to abandon condoms and adopt traditional methods out of mythical fear such as infertility.
- In Kenya, implants are ranked as the second most used contraception method after injectables.
Although contraception methods cater to both men and women, it is often assumed that the burden of contraception lies with the woman.
Adoption of contraceptives in relationships
According to Dr. Petra Boynton, a psychologist, and author of The Research Companion, some partners fear that initiating conversations about contraception in a relationship will be misinterpreted as a gateway to infidelity. “Others fear that talking frankly might seem overbearing or be perceived as a passion killer. The contraceptive conversation may also seem to question the level of trust in the relationship,” she says.
Research by the Guttmacher Institute on the use of contraception at different stages of relationships found that the timing and method will strongly depend on the type and strength of the relationship. For instance, in the early stages of a relationship, many women will show an urgency to negotiate for condom use while men will show motivation to practice contraception. “As the relationship progresses, many couples tend to abandon condoms and adopt traditional methods out of mythical fear such as infertility. After the birth of the first child, couples will prefer modern contraceptives to space children. However, the side effects often lead women to switch methods or discontinue contraception,” the study found.
In Kenya, implants are ranked as the second most used contraception method after injectables. According to a 2018 review report Lift Off: the Blossoming of Contraceptive Implant Use in Africa, out of every 100 married women who use contraception, 30 use implants. In 2019, Kenya surpassed its FP2020 commitment to increase the use of modern methods of family planning among married women to 58 percent. According to the report, FP2020: Women at the Centre, Kenya has a modern contraceptive usage rate of 60 percent. Also, according to figures from the Ministry of Health, the contraceptive prevalence rate has been rising steadily over the past decade in Kenya. This growth has been widely noticeable among women in marriage. For example, between 2009 and 2019, the rate of contraception use among married women in Kenya increased from 46 percent to 58 percent. “There is a positive ripple effect from this rise as more contraception use means fewer unwanted pregnancies and maternal deaths,” says Dr. Thuthwa.
According to the Economic Survey 2020 report, as of the year 2020, Family Planning (FP) Injections were the most popular method of contraception with 2.3 million women taking it, followed by Combined Oral Contraceptives, which had 681.6 thousand women. With permanent family planning methods, the number of females undergoing Sterilisation Tubal Ligation was 4,435 while male Sterilisation Vasectomy had 334 men only. The report showed a general decline in the uptake of modern contraceptive methods, except for pills which continued to increase.
According to Dr. Janet Thuthwa, an Obstetrician-Gynecologist, decreased sexual desire is among the side effects that women using hormonal contraceptives experience. “The link between mental health and reduced libido is not farfetched. Sexual activity among women is to the largest extent mentally induced,” she says. Other side effects associated with hormonal contraception include inter-menstrual spotting and breakthrough bleeding, missing periods, heavy periods, weight gain, headaches and migraine, and breast tenderness.
Vasectomy vs tube ligation
The procedure for vasectomy usually takes 15 to 30 minutes and is about 99.8 percent effective. It does not affect sexual function or pleasure. Where men have refused to undergo vasectomy, women have had to adopt riskier methods such as tubal ligation (surgical sealing of fallopian tubes). According to Dr. Ramon Suarez, the managing director of No-Scalpel Vasectomy International, the failure of vasectomy could only mean that a child might be sired accidentally, whereas the failure of tube ligation could end up claiming the life of the woman.
Condoms and myths
Apart from being a protective sheath against sexual infections, condoms are also a form of contraception. However, in relationships, condoms tend to face a mountain of myths. For instance, a study on how men in Mombasa rationalised sex without contraception found that many men feel using condoms for contraception denies women sexual pleasure. They also feared that condoms as contraceptives caused pain rather than a pleasure to their women due to friction.
Making the choice
Ultimately, you will need to make a decision on which method of contraception suits you. Learn about all the available options – both hormonal and non-hormonal and their risks and benefits. According to Dr. Boynton, it is a red flag if your partner refuses to use condoms when you want to, or belittles other contraception choices you may have made.