Transformations: Gender, Reproduction, and Contemporary Society

1. Transformations: Gender, Reproduction, and Contemporary Society Week 13: Who Manages Fertility? The Politics of Contraception Dr. Maria do Mar Pereira m.d.m.pereira@warwick.ac.uk

2. Announcements (I) • Changeofkeyreading - Tilleyet al. (2012)readingreplacedwithTilley, Elizabeth et al (2012) '"The Silence is Roaring": Sterilization, reproductive rights and women with intellectual disabilities', Disability & Society, Vol. 27, No. 3, pp. 413-426. • Group Presentation drop-in sessions: they will be held in the Learning Grid (exact location to be announced) in week 5 • Caroline: Monday, February 3rd, 1.30 to 3.00 • Maria: Thursday, February 6th, time to be announced

3. Announcements (II) • Centre for theStudyofWomenandGender (CSWG) Seminaron“ChildhoodandMotherhood” – PLEASE JOIN US! February 12th, 5.00, in R0.12 • Aleksandra Mecinska, University of Lancaster.Breastfeeding as technology: the stakes of a reconfiguration • Jessica Gagnon, University of Sussex.Mother as 'monster': the social vilification of single mothers as told by their daughters • Giulia Zanfabro, University of Warwick.Feminine Normativity in Contemporary Italian Children and Young Adults' Literature: Norms, Identities, Disidentifications?

4. Who Manages Fertility?: The Politics of Contraception • SPECIAL GUEST: Alison Boffin (former Health Promotion Specialist – Sexual Health for NHS Warwickshire • Historical Background and Brief Overview of Types of Contraceptive • The Social Biases of Contraception • Contraception and Social Control • Conclusions

5. The Politicsof Contraception • As a means of controlling fertility, contraception is a fundamental element not just of the sexual and social politics of reproduction, but also of the structure of a society. Contraception must therefore be problematised in the context of the broader social relations, systems of norms, and structures of power that characterise a given society. • To understand contraceptive developments and decision-making we must: • conceptualise them as a site of (re)production of social inequalities and consider the intersections between different axes of inequality • understand contraception as a local/global interface • examine the close relation between technology, economics, political ideologies and beliefs about differences between groups

8. A Brief History of (Selected) Contraception

9. Contraceptive Pioneers Dr Margaret Sanger 1879-1966 Dr Marie Stopes 1880-1958

10. ThePill as Medical, Socialand Sexual Revolution CONTRACEPTIVE PIONEERS http://bobnational.net/record/193467

11. ThePillandWomen’sLiberation http://content.time.com/time/video/player/0,32068,79545976001_1983742,00.html Seealso: http://www.bbc.co.uk/news/uk-15984258 http://content.time.com/time/magazine/article/0,9171,1983892,00.html http://www.theguardian.com/lifeandstyle/2010/oct/30/carl-djerassi-inventor-of-contraceptive-pill

12. Health Risks, Benefits and Side Effects POSSIBLE SIDE EFFECTS OF THE PILL:weight gain, headaches, depression, acne, allergies, breast tenderness, carpal tunnel syndrome, increased cholesterol, cystitis, gingivitis, hair loss, nausea and vomiting, thrush and sensitivity to light USE OF THE PILL WITHOUT CONDOMS:increases the risk of all STIs, including HIV, the human papilloma virus (which can lead to cervical cancer) and chlamydia, which if untreated in a woman can lead to pelvic inflammatory disease and infertility. BENEFITS: there are claims that the pill offers some protection against cancer of ovary and endometrium (womb lining) as well as against heart attacks and strokes. In 2004, a study using data from the Women’s Health Initiative (which tracked over 160 000 women) declared the pill to be safe (Guardian, 26 October 2004).

13. CONTRACEPTIVE: FEMALE USER OtherHormone-BasedContraceptiveMethods Contraceptiveinjections: Depo-Provera, Lunelle, etc. Thepost-coitalpill Implants: Norplant, Jadelle.

14. Female Barrier Methods Cap Sponge Diaphragm Female Condom

15. The IUD and Sterilisation

16. Contraceptive Methods Focused on Men

17. TheGender Scripts ofContraception According to Oudshoorn, ‘contraceptive technologies have a clear gender script: responsibility for contraception and its risks to health is delegated primarily to women, not to men’ (2000: 123).

18. TheGender Scripts ofContraception Oudshoornargues that dominant discourses about contraceptive methods for men are grounded on • an understanding of men as less ‘reliable’, more concerned with sexual pleasure than reproduction (unlike women), less able to tolerate pain, discomfort and inconvenience (than women) ambivalent representation which both reproduces and undermines dominant representations of hegemonic masculinity • a conceptualisation of men’s reproductive systems as ‘more complex’ than women’s

19. TheBiasesofContraception The development of contraceptive apparatuses and procedures is never neutral: it is a historically specific manifestation of particular ideas and norms about sexuality and reproduction. Contraceptive technologies are discursive constructions, based on specific ideals and ideologies, and encoding particular priorities and preoccupations, namely about: • what kinds of people make ‘good’ parents • what kinds of bodies are more ‘valuable’ or less ‘expendable’ • what types of pain or discomfort are acceptable • the extent to which public good outweighs individual costs or risks

20. Scrotal Infection: Only 2 Died “The newest development in male contraception was unveiled recently at the American Women’s Surgical Symposium held at Ann Arbor Medical Centre. Dr Sophie Merkin, of the Merkin Clinic, announced the preliminary findings of a study conducted on 763 unsuspecting male undergraduate students at a large midwest university. In her report, Dr Merkin stated that the new contraceptive – the IPD – was a breakthrough in male contraception. It will be marketed under the trade-name ‘Umbrelly’. The IPD (intrapenile device) resembles a tiny folded umbrella which is inserted through the head of the penis and pushed into the scrotum with a plunger-like instrument. Occasionally there is perforation of the scrotum but this is disregarded since it is known that the male has few nerve endings in this area of his body. The underside of the umbrelly contains a spermicidal jelly, hence the name ‘Umbrelly’. Experiments on 1,000 white whales from the continental shelf (whose sexual apparatus is said to be closest to man’s) proved the umbrelly to be 100 per cent effective in preventing production of sperm, and eminently satisfactory to the female whale since it does not interfere with her rutting pleasure.

21. Scrotal Infection: Only 2 Died (cont.) DrMerkin declared the umbrelly to be statistically safe for the human male. She reported that of the 763 students tested with the device only two died of scrotal infection, only 20 experienced swelling of the tissues. Three developed cancer of the testicles, and 13 were too depressed to have an erection. She stated that common complaints ranged from cramping and bleeding to acute abdominal pain. She emphasized that these symptoms were merely indications that the man’s body had not yet adjusted to the device. Hopefully the symptoms would disappear within a year. One complication caused by the IPD and briefly mentioned by DrMerkin was the incidence of massive scrotal infection necessitating the surgical removal of the testicles. ‘But this is a rare case,’ said Merkin, ‘too rare to be statistically important.’ She and other distinguished members of the Women’s College of Surgeons agreed that the benefits far outweighed the risks to any individual man.” (reprinted in Spare Rib, Vol. 93, April 1980, p. 9)

22. Contraception and Social Control • Contraception has a problematic and dishonourable history (and present), very closely associated with eugenics. • Contraceptive technologies have regularly been tested and ‘dumped’ on women in the global south, as well as poor and ethnic minority women in Western countries (Roberts, 1999).Disabled women, poorer women and minority ethnic women have been forcibly sterilised, or coerced into using long-term contraceptives such as Norplant (Roberts, 1999; Tilley et al., 2012).  These ‘other’ female bodies are seen as more expendable (hence they can more easily be ‘guinea pigs’) and because they are seen to be unable or unwilling to make the ‘right’ reproductive choices, their reproductive autonomy and self-determination is not respected.

23. Contraception and Social Control • Health professionals act as gatekeepers: they manage access to contracep-tive information and to many methods of contraception. This creates power relationships between doctors (and other institutions/actors) as ‘providers’ and women (and men) as ‘users’ of contraception, for e.g. • in their practice, health professionals may draw on, and impose, restrictive understandings of who is capable of exercising control over their own fertility. Women who are seen as ‘irresponsible’ may be denied their right to information about, and control of, contraception (Foster, 1995; Hawkes, 1995; Pollock, 1984; Thomas, 1985); • doctors ignore or reinterpret women’s symptoms and complaints about contraception (Foster, 1995), and dismiss and underestimate the significance of side effects, perceiving them as having less to do with contraceptives than with the fact of ‘being a woman’ (Pollock, 1984).

24. As Always, Many Dilemmas… • The development of contraception has no doubt expanded many women’s agency, autonomy, choice and opportunities, but must not be seen as a linear process of liberation. • Contraception has brought both improvements and risks to health. • Contraception has enabled both greater liberation and greater control – both are distributed in an unequal way, that reflects and reproduces hierarchies of race, class, geopolitics, ability, etc. • Contraception has both led to greater valuing of women’s sexual autonomy and pleasure and reinforced an understanding of sexuality that foregrounds men’s sexual pleasure. (According to Pollock, ‘because those contraceptive methods which interfere least with sex are those which interfere most with women’s health, the former is gained (…) at the expense of women’s health and comfort’ (1985: 72).)

25. Other Conclusions • Throughout history women (and men) have tried to control their fertility. • Contraception is still mainly seen as women’s responsibility, and all the recently developed methods work through women’s bodies. • There is no doubt that contraceptive technologies are wholly social in their development, dissemination and impact.