Family Planning, Men and Masculinity

Holly Ashford

I had been very much looking forward to hearing Katie Jones from the University of Birmingham give her paper on men’s attitudes to contraception in 1970s and 80s Britain. I was not disappointed. Katie’s paper touched on some important themes, asked pertinent questions and prompted lively discussion. The history of family planning in Britain goes back to the 1920s, when Marie Stopes opened the first birth control clinic in London. The term ‘family planning’ illuminates the framework in which contraception was understood for decades – as something used in the context of nuclear, family life. Indeed, we should keep in mind that family planning isn’t just about limiting births but also deals with issues of infertility and childlessness.

Katie’s paper focused on a central issue in the study of reproductive behaviours – both past and present. That is, that men and masculinities are often obscured from the story. This is a problem both in historical writing on the subject, and, as Katie showed, in policy implementation itself. The fact that contraception in the 1970s was seen as being exclusively used in the context of planning a family, meant that single men’s behaviours were not relevant. I know from my own work on family planning in Ghana, that this was not an issue confined to Britain.

What made Katie’s paper particularly interesting was her methodology. In this paper, she isn’t trying to answer the question, ‘what were male attitudes to family planning?’. Her focus rather, is on the perceptions of knowledge surrounding contraception. Women, she argues were ‘sexperts’ because they were expected to know about contraception and family planning. Even those carrying out the surveys were women, this was their sphere of knowledge. The perception of men’s ‘sexpertise’, however, grew, and by the 1980s was being more widely considered. The focus on men’s attitudes coincided with a shift to examining the social and psychological aspects of reproductive behaviour.

Like in Britain, those working on reproductive behaviours in Ghana, especially towards the end of the 1970s, began to see the glaring omission in studies. In Britain, Katie discussed the book, written by Jean Morton-Williams in 1976, The Role of Male Attitudes in Contraception. At the same time, articles began to be published in Ghana on the same topic. Christine Oppong, for example, tried to rectify the imbalance she saw by focusing a study on male attitudes to fertility. Interestingly though, in Ghana, from the beginning of the National Family Planning Programme, which began in May 1970, men were specified as a primary target group for information and education rather than women. It was men who were seen as decision makers and therefore a key group to reach out to. I met Sabina Mensah, who has worked as a family planning fieldworker since 1972 who told me that she immediately saw a problem when women would not take up contraception without men’s approval. She began to arrange informal education sessions based around football matches held at palm oil factories in West Africa. Her efforts led to the IPPF Male Motivation project, which was rolled out across Africa in the 1980s.

The gendered aspects of contraception are fascinating. Katie told us that in Britain, taking control of contraception was seen as a masculine endeavour. My own study in Ghana has revealed a similar pattern. In Ghana though, having as many children as possible was a sign not just of masculinity but of social status, in most communities. Women described to me that they had to defer to their ‘masters’’ or husbands’ decision making. Doctors told me that in the 1970s and 80s, they would only discuss contraception with women if they had their husband’s consent. The had to admit though, it was hard to know if consent was given, when only women came to the clinic. Indeed, the technologies of family planning themselves were, in the 1970s, and are now, gendered. The technologies pushed in Ghana in the 1970s, the IUD and the pill, required women to take action, but not men.

To this day, in Britain, the only contraception available to men are the condom and vasectomy. There is no male contraceptive pill, although this has recently been much discussed in the news. Recent experimental pills have shown to be safe and effective in tests. Interestingly, this article from The Telegraph chose to focus on the fact that the pill would ‘not harm [men’s] sex drive.’ This seems to reinforce the idea that men’s sexual pleasure is of primary importance. Indeed, it is well known that the pill for women causes loss of libido, but this has not seemed to cause undue worry. Beyond this, the pill causes depression, intermittent bleeding, headaches, nausea, ovarian cysts, breast tenderness, acne…the list goes on. It does not, of course, protect women from contractive STIs for their partners. And yet, millions of women rely on it worldwide.

For the male pill, nothing has gone further than the testing stage. The NHS website reports ‘ongoing research’ into the matter. This research has been ongoing since the 1960s at least. I’ve seen archival documents in Ghana from the late 1960s discussing the desirability of a male pill. ‘In the past 50 years’, the NHS says, ‘there have been few changes in male contraception.’ It seems that once responsibility was handed over to women in the 1960s, it felt comfortable there. Indeed, a lot of women have expressed the fact that they would feel uncomfortable, should a male pill be developed. They are unsure whether they would trust their male partners with the responsibility of contraception, since it is ultimately their own bodies that would be affected should pregnancy occur.

One of the responses to Katie’s paper was to ask her own positionality. I know it’s a question I have faced in workshops like this one. One of our audience members asked Katie whether she came to this as a feminist. She answered that although she was a feminist, she was trying to put aside her biases, although argued that it was impossible for historians to be completely unbiased. One way in which she was attempting it though, was through carrying out oral histories with men, to understand their points of view. Linked to this question about her personal perspective on the issue was the idea of women’s rights. What is not widely acknowledged is that birth control and family planning did not originate – for the most part – to protect women’s reproductive rights, although historians such as Alison Bashford have recently made this point. With women’s reproductive rights coming increasingly under attack globally from the US, and period poverty rife in the UK, is it men we should be focusing on? The truth is, until we address the gendered biases of contraception and family planning as a whole, neither women’s nor men’s needs can be appropriately met.