/ 11 June 2015

Be a man: Use birth control

Sperm swarm: There are only two contraceptive choices currently ­available to men - condoms or an irreversible vasectomy.
Sperm swarm: There are only two contraceptive choices currently ­available to men - condoms or an irreversible vasectomy.

One of the fundamental rules of sex is that it takes two to tango. Or more, if that’s your particular flavour. Semantics aside, the notion behind a healthy consensual sexual relationship is that we are all happy to be there. And, bearing this in mind, the festivities can commence.

What often happens at these parties, however, is that everyone has a good time and women often provide the “snacks” while also being left to clean up any mess left behind. They are often the ones who bring the party favours, be it the pill, implant, diaphragm or a good ol’ fashioned condom. When it comes to family planning and birth control, the burden most often falls on women.

Much as the idea of owning your sexual activity is based on ideas of empowerment, it also entrenches inequality. The idea that a woman must be in charge of the home and raising children is instituted from the point of conception all the way until the little bundle of joy is 25 and still taking money from you under the guise of “furthering their education” and “finding themselves”.

There is a need to even out the parental playing field in this regard; contraception is a good place to start.

That so much money, time and effort has gone into making sure that women know what is going on in the reproductive realm means that men are allowed to continue skulking outside the conversation, far past the point of safe sex and well into the child-rearing years. This has led to the tacit acceptance of notions of the “absentee father”.

Not only is there a societal reason for men to play an active role, but also a scientific one.

Science types have deduced that female oral contraceptives and other hormone-based contraceptives can prove ineffective if the user is taking certain medication for tuberculosis, epilepsy or even antiretrovirals. Furthermore, anyone at increased risk of heart attacks, stroke or clotting should avoid these contraceptive options. Women who are breastfeeding cannot use them either.

Big pharma has, over the past 50 years, been fairly uninterested in the development of male contraceptives compared with those it has developed for women.

In South Africa 18% of women use oral contraceptives but this figure obviously excludes those who use diaphragms, implants, have contraceptive injections or actually buy and carry condoms.

Nonetheless, we have been assigned to be the driver for the “condom-free express” since the 1950s when the pill was first introduced. Women have five birth control options to men’s two, one of which is irreversible.

We live in a world where man has landed on the moon and can hold worlds of information on a device the size of a slice of low-GI bread but men still have only two options in terms of contraceptives: a vasectomy or condoms.

Some men also attempt the very dodgy “withdrawal” method, but this cannot be listed as a legitimate method of birth control.

There is, however, a minute amount of research being done on both hormonal contraception and nonhormonal remedies. The science is based on a lot of scary words such as synthetic progestogen and reversible inhibition of sperm under guidance. There is also the (thus far unsuccessful) research option that focuses on the epididymis – but some men, funnily enough, are averse to having a coiled tube placed behind their testes.

There is a clinical study that looks at giving men an injection that stops the production of semen for a period of time. The injectable contraception that suppresses sperm production is a method that is being tried and tested in a number of countries, including Australia. This even has the backing of the World Health Organisation.

As much as this is a bright spark on the horizon, these forms of contraception will probably only be on the market in a few years’ time, meaning that very little can immediately change in terms of contraceptive logistics. It also needs to be seen in the light of the prevalence of HIV, coupled with the rise in the rates of sexually transmitted diseases in Africa being among the highest in the world.

It may not yet be time to throw out the condoms, but it may be time to throw out archaic ideas of who is in charge of birth control.

Men should take an active interest in contraception and the various options on offer, especially if they are in a committed relationship. Taking a more proactive role ensures equality in family planning and child rearing becomes more of a reality that challenges archaic ideas around the “role of the woman”.

She didn’t make that child alone.

Kagure Mugo is the cofounder and curator of the HOLAAfrica! blog