Unplanned pregnancies impact women more significantly than men. Perhaps that’s one reason why men in India and worldwide are much less likely to participate in family planning by adopting contraceptives. The emphasis historically has been on methods for women, and little effort has gone in to involving men.
Despite being primary decision makers on the size and structure of a family, three in eight men in India believe that contraception is a women’s business and men should not have to worry about it. This is supported by data that says the rate of permanent female sterilisation, or tubectomies, is higher by far, at 75%. Vasectomies, in comparison, make up 0.3% of total contraceptive uptake, despite being safer, quicker and easier.
This is a big divide; but is it safe to assume men are simply not interested? Research says, probably not. Family planning is a contentious issue and not a conversation couples always find easy to have. Social and cultural norms around masculinity, marriage and fertility shape our thinking around the need for family planning despite having little bearing on the issue at hand.
There are several barriers to engaging men in conversations around contraception. At a systemic level, frontline health workers, responsible for awareness building, are women and therefore less accessible to young men. The relatively low number of male contraceptives available – condoms (short-term) and vasectomies (permanent) – in contrast with the six methods available to women, also contributes to lower uptake.
Additionally, norms around masculinity that impede conversations on sexual and reproductive rights result in beliefs in myth, lack of confidence, shame and stigma being perpetuated instead. For example, several studies have suggested that Indian men don’t undergo vasectomies because they are worried about losing their virility.
On the other hand, Indian women say they want fewer children (1.8) than the number they actually have (2.2). The desire for smaller families often runs counter to traditional norms of fertility; without appropriate interpersonal communications women and men run the risk of missing out on the health and economic benefits of family planning.
Also read: The Professor Who Had to Spend Half His Life to Make the Drug India Needs
Engaging younger men and women in comprehensive, evidence-based conversations can enable informed conversations on contraceptive use and family planning. Policies and programmes that are more gender-responsive could have a positive impact on enabling these conversations.
Effective communication – Providing key information about the safety and efficacy of family planning methods can encourage use of modern methods of contraception. Often, hesitancy around the use of available contraceptives arises from fears based on misconceptions or incomplete information. Men and women equipped with credible facts are also better able to engage their partners in conversations around birth control.
Equitable partnerships – By recognising and addressing the fact that men and women’s social roles are different, couples can ensure that their partner is supported in their decisions around family planning. Being respectful of each other’s opinions and decisions is key to ensuring the health and wellbeing of families.
Consensual decision-making – It is critical that men help empower women partners to participate in collective decision making on adoption or continuation of family planning methods. Making visits to the doctor together, helping around the house during mandatory rest periods following certain contraceptive procedures and other similar activities are some ways of encouraging ensuring partners are included and comfortable.
Gender parity – By not restricting women’s roles, couples can protect their families’ interests and ensure basic human rights are delivered. Encouraging women to seek employment and return to work after child birth is an important way to ensure a family’s health and wellbeing. It may take a village to raise a child but it takes a set of well-informed parents to ensure families are healthy and protected.
Enabling action – Men’s roles in family planning extend to the social space in terms of creating conducive environments for key conversations around the safety, efficacy and importance of contraception. Undoing norms and breaking long-held beliefs is a long-term process and the sooner men join in the effort, the faster those around them will begin to recognise the benefits.
Purnima Khandelwal is a senior programme officer and Priyasha Banerjie is manager, communication – both at the Population Foundation of India.