What Constitutes A Positive Contraceptive Experience?

Our research project is answering the question: ‘What constitutes a positive contraceptive experience?’. This question is designed to encompass many different aspects of an individual’s contraceptive experience: their ability to make informed choices, the support available to them in making those choices, side effects (both mental and physical), and empowerment.

Together, these concepts dictate if someone will be happy with their contraceptive experiences or not. The 2019 CERT report found that a staggering 95.9% of respondents to their survey thought contraception needed improvements (CERT, 2019). It therefore seems that, currently, contraceptive experiences are overwhelmingly negative. By establishing what someone’s contraceptive experience would look like in an ideal world, we can establish the short-comings in the status quo and provide possible policy-based solutions to bridge the gap.

Furthermore, someone’s contraceptive experience is arguably a significant part of their daily life - and never is this more true than when it goes wrong. As mentioned above, negative side effects can harm someone’s physical and mental health. Per the 2019 CERT report, nearly 4 out of 5 contraceptive users have experienced negative side effects. In serious cases, these can be debilitating. In the words of one participant in the 2019 CERT report, “Poorer mental health, weight gain, low self-esteem and bad mood swings, completely changed me”. Not only can this be beyond unpleasant, but there is a deeper concept at play here: side effects can mean that contraceptive users experience a ‘challenge to bodily control’ (Hoggart and Newton, 2013). They perceive that the sometimes dramatic changes to their bodies make them feel like they are no longer autonomous. This is made even more troubling by how much of the discourse on contraception is centred around personal choice in a positive way.

The scale of the issue also needs to be considered to understand its importance. An estimated 87% of UK women and 74% of UK men have accessed some form of contraception in the past year (French et al, 2018). So, its effects are wide-reaching – problems with contraception can affect a large amount of the population so it therefore follows that a positive contraceptive experience can benefit an equally large number.

However, it is too simplistic to claim that this topic warrants academic attention because of the number of people it affects. It is far more nuanced as contraceptive experiences are inherently gendered. Within heterosexual relationships, there is a tendency for the burden of responsibility for contraception to fall on women - partly due to a lack of so-called ‘male contraceptives’ (outside of condoms) and partly due to the more immediate consequences of not using it (Chao et al, 2014). Even when considering condom use, it is commonplace for it to fall to female sexual partners to insist on usage (Hoggart and Newton, 2013). So, if the burden of contraceptive responsibilities falls on women in this situation, they are the ones disproportionately suffering from problems – but also the ones that will benefit from improvements.

If the feminist discourse surrounding contraception focuses on its integral role in empowerment and deconstructing gender roles (Marks, 2010), then research like this is needed to ensure that it is living up to the lofty standards we have for it. So, this research into ‘what constitutes a positive contraceptive experience?’ matters because it is a gendered issue that has the possibility to improve the daily lives of a large segment of the reproductive population.

References

1. Chao, J., Page, S.T. & Anderson, R.A. (2014). ‘Male Contraception’. Best Practice & Research: Clinical Obstetrics & Gynaecology. 28(6), p845-857.

2. Cheney, E., Lambert, K., McIntosh, E. and Rzewnicki, F., 2019. Contraception Education And Reform Team – 2019 Report And Policy Proposal. Edinburgh: Buchanan Institute.

3. French, R.S., Geart, R., Jones, K., Glasier, A., Mercer, C.H., Datta, J., MacDowall, W., Palmer, M., Johnson, A.M. & Wellings. K. (2017). ‘Where do women and men in Britain obtain contraception? Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)’. BMJ Sexual and Reproductive Health, p16-26.

4. Hoggart, L. & Newton, V.L. (2013). ‘Young women’s experiences of side effects from contraceptive implants: a challenge to bodily control’. Journal of Family Planning and Reproductive Health Care. 21, 196-204.

Editors:

Sophie Butcher is a Sociology and Politics student at the University of Edinburgh. She is the President of CERT Scotland (a policy group campaigning for contraceptive empowerment in Scotland) and student journalist; writing for The Tab and co-founding and co-editing The Panopticon (a student-led Sociology journal at the University of Edinburgh).

Molly Gilmour is a PhD Candidate in Sociology at the University of Glasgow researching humanitarian medical care in Lebanon. Her work specializes in understanding what operational changes in humanitarian medical care are needed to establish more effective and culturally appropriate aid provision.

Researchers:

Federica Cucé is a 6th year medical student at the University of Padova (Italy). She has been a volunteer in the past 4 years in SISM (part of IFMSA), a student-led organisation focusing on raising awareness about global health among medical students and the whole population. She has attended and organised many events focused on sexual and reproductive health and rights.

Elise Kearsey is a final-year BSc (Hons) student in Biomedical Sciences (Hons: Reproductive Biology) at The University of Edinburgh. She is the Biomedical Research Director of CERT Scotland, a policy group campaigning for contraceptive empowerment in Scotland. She has a keen interest in reproductive health & health equality.

Ruwa Mahdi holds a BA (Hons) in Economics and Development Studies from the School of Oriental and African Studies, University of London. She is currently pursuing a dual-degree Masters at Sciences Po Paris and Kings College London to obtain an MA in International Development and an MSc in Political Economy of Emerging Markets. Her key interests include South Asian politics, economic reform and global health.

Kehinde Whyte-Ilori is a first-year medical student at the University of Leeds with an interest in global health, public health, health inequalities and inequities. She has undertaken global health internships in Cape Town, South Africa with the NGO, GVI (global vision international) and with the NGO, PACK (practical approach to care kit) at BMA House, London. 

Commissioner:

The Buchanan Institute is Scotland’s only student-led think-tank. Founded in 2014, it provides a space where all students can come together to engage in the policy-making process in order to inspire and enact change. One of the research groups produced by the Buchanan Institute is CERT (Contraception Education Reform Team) whose mission is to promote positive contraceptive experiences in Scotland.