The Contraceptive Compromise
How contraceptive methods available today limit reproductive autonomy
Hello and welcome to the fourth edition of Hysterical Health!
This week, we’re exploring freedom, choice and compromise in relation to contraception - and why I believe the methods available today don’t offer the reproductive autonomy we deserve.
Reproductive Autonomy
Reproductive autonomy is the power to make decisions about contraception, pregnancy, abortion and childbearing.
While evaluating The Reproductive Autonomy Scale for use in the UK, I spent a lot of time thinking critically about what it means to have the freedom to choose our contraception.
Contraception isn’t one-size-fits-all.
Some women are lucky enough to find a method that suits them. Others are forced to take a trial-and-error approach, trying different methods to figure out what works and more often, what doesn’t.
This embodied experimentation stems from the fact that none of the options available offer an ‘ideal’ solution. I devised a theory to explain this: The Contraceptive Compromise.
The Contraceptive Compromise
The contraceptive compromise is based on the idea that each contraceptive method can fit into one of three categories:
Hormonal change: combined pill, progestogen-only pill, IUS, patch, injection, vaginal ring
Mental strain: barrier methods, fertility tracking
Physical pain: copper IUD
By navigating within these categories, women are often forced to compromise on important aspects of their well-being - and in turn, limit their reproductive autonomy.
Hormonal Change
The majority of contraception out there is hormonal. Our hormones shape how our mind and body function in endless ways. So, adding synthetic hormones to the mix can have a powerful and unpredictable impact.
Each person responds differently to hormonal contraception - with side effects ranging from tolerable for some, to downright life-altering for others.
But for those who want to control their fertility without hormonal changes, their options become significantly limited.
Mental Strain
Mental strain is the time, energy and precision it takes to use short-term methods effectively.
Barrier methods are often single-use and must be used precisely every single time. Meanwhile, fertility tracking requires daily dedication for accurate predictions.
One wrong recording, misused or damaged product and you’re at risk of unplanned pregnancy. This ongoing mental burden is draining, especially when the majority of reproductive responsibility falls on women.
Physical Pain
Whilst some will favour mental strain over hormonal change, others are in desperate need of more reliable non-hormonal and long-acting solutions.
We currently only have one: the copper IUD.
The copper IUD was invented in 1976 and has barely changed at all in almost 50 years. Although it’s highly effective in preventing pregnancy, research shows it can increase menstrual flow and pain for many women.
So, if someone (like me) wanted to avoid synthetic hormones and have the peace of mind of a long-acting method - they’re ultimately only left with one option: to put up with longer, heavier, and more painful periods.
Contraception is all about personal choice.
But when we’re forced to choose between hormonal change, mental strain, physical pain, or pregnancy - is that really a choice or a compromise?
The bottom line:
Women deserve more non-hormonal AND long-acting reversible contraceptive options.
It’s a hill I’d happily die on but hopefully, I won’t have to.
What’s next?
Want to join the conversation? Commenting is now FREE for all subscribers!
Enjoyed this post? Sharing with others is always appreciated ❤️
Want to work together? I’m available for freelance writing gigs here:
That’s it for now!
Stay tuned for next week when I’ll be sharing my chaotic relationship timeline with my contraception - it’s a rollercoaster.
Eleanor