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Thursday 3 April 2014

Happy 40th Birthday, free contraception!


From 1 April 1974 all contraceptive advice and supplies became free on the NHS, and available to all women. 40 years on, we celebrate the anniversary of free contraception in the UK and call for the next step forward.
The contraceptive pill was first licensed in 1961, yet initially restricted to those deemed wise enough to use it, and worthy of its privileges – those bastions of moral responsibility who are older married women. So hoorah for the less celebrated year of 1974, when contraception became free of charge for all women, regardless of age or marital status.
It’s hard to think of a development which has brought about such a monumental change in women’s lives, their role in society, and their relationships with men as free access to contraception.
The Pill enabled women to take control of their biology. Family sizes shrunk, motherhood was delayed, and women began to occupy those spaces that had previously been the sole domain of their male counterparts. Alongside access to safe, legal abortion, women could start to make genuine reproductive choices.
Yet while we can celebrate the 40th anniversary of free access to this revolutionary pill, this birthday is also the occasion to reflect on what we want from contraception over the next four decades – and ideally before we reach the last half of the 21st Century.
We should be asking why we are not seeing the investment, effort or drive to develop new methods of contraception that actually meet women’s needs. There seems to be a prevailing sense of “job done” when it comes to contraception, and ongoing barriers to technological advances in this field. While we have seen a few new methods enter the market over the last decade of so, these are by and large variations on the dose and delivery of the same medication.
Hormonal contraception should be celebrated for the huge advances it has brought, but it’s not for everyone. While there are women who will swear by their contraceptive implant, there are others who find themselves begging the doctor to remove it. We need new methods without the side effects such as irregular bleeding, weight gain, nausea or lower libido. We need a greater choice of non-hormonal methods for those women who do not wish to use hormones or who cannot.
We need methods better suited to the reality of women’s lives and an acceptance that some women don’t want to use barrier methods like condoms or diaghrams but also don’t feel they are having sex regularly enough to warrant remembering a daily pill or having a long acting IUD or implant inserted. A pericoital pill, which could be taken at the time of sex, would represent a huge breakthrough for those women.
And we need to take politics out of pills. Researchers have noted that one of the major barriers to contraceptive development is the fear of controversy – so, for example, it would be possible to create a monthly pill that would either stop a fertilised egg implanting or detach it from the lining of the womb, yet concerns about the reactions from those who would see this as an abortion have put the kybosh on its development. Some women may well have their own personal position on whether this method is right for them – but shouldn’t that be their choice to make?
And lastly, we need methods for men. Men need something in between the two extremes of condoms and vasectomies, and the argument that most women wouldn’t trust men with their birth control is insulting to the many men who we know are keen to share the burden of contraception with their partner.
So hooray for free contraception. Thank you 1974. But it’s 2014 now – and women deserve more.
This piece was originally written for and published by Feminist Times

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