“Why doesn’t he care?”: Talking with friends to figure out men’s role in birth control decisions

Why some men think they don’t have a part to play in birth control decisions
men’s role in birth control decisions

While reading health news as I sipped my morning coffee recently, I stumbled upon a study that found 1 in 3 men believe it is solely up to the woman in a relationship to avoid getting pregnant. This begged the question: why? Much like the art of dancing the Tango, it takes two to achieve a pregnancy. So why would some men place all the responsibility of avoiding pregnancy on the woman? 

A few possible explanations come to mind. For one thing, men don’t carry a child for 9 months, so maybe a man’s seeming apathy is connected to that. But on the other hand, most men have some sense of responsibility, and a sense of obligation ingrained in us toward our significant other (not to mention child-support laws that require men’s financial responsibility for the children they father). And, one would hope, most men love the women they’re seriously dating, engaged, or married to. 

So why is it that even with love toward a girlfriend or wife, some men still don’t feel that they owe the woman any effort when it comes to avoiding pregnancy? Do women want to be alone in deciding to use birth control? Should a man consider speaking up if his partner experiences side effects—but otherwise stay silent on the issue? All of these questions led me to ponder a twofold question: What role—if any—do men play in birth control decisions, and does that role change once a couple marries? 

What the women said about men’s role in birth control decisions

These questions spurred multiple conversations with friends in order to learn how other people, both single and married, viewed this exact topic. I started with a group of both married and single female friends, and asked what their experiences were regarding male buy-in on their reproductive health. At first, I directed my questions to one female married friend, in the presence of the others.

Alex Rico: “Has your husband ever gone to the gynecologist with you?”

Female friend: “No, he doesn’t know very much about women’s health, and honestly I don’t want to overwhelm him with all the ins and outs of the anatomy, hormones, treatments, and birth control methods involved in everything.”

AR: “Have you ever brought up women’s reproductive health to him?”

FF: “Not really. If it ever comes up, we will talk about it briefly, but it gets complicated fast. I usually simplify things to him and move on.” 

AR: “Does he know what birth control you use now?”

FF: “Since we were dating he has always known, but he hasn’t ever had much input to give. I haven’t been on birth control in a while now because I learned how bad hormonal birth control can be for a woman’s body. When I decided to go to Natural Birth Control he didn’t attempt to sway me one way or the other. I presented my case and reasoning for wanting to quit hormonal birth control and all he said was ‘Your body, your choice. I support whatever you decide,’ and that was the end of that conversation.” 

AR: “Did your husband’s role in your reproductive health change after you were married?”

FF: “Not really. The only thing that changed was that we could be more relaxed about not using hormonal birth control. He still leaves this topic largely up to me to handle.”

My reaction

I continued the conversation by sharing the results of my own self-reflection: 

AR: “In my experience, I didn’t know much about women’s health besides what we had learned in anatomy class back in high school (the class was an elective, mind you, not even a requirement for everyone). Most of my knowledge came while dating my wife in college. Years of having to go to the gynecologist, helping her decide what birth control to choose, and trying to diagnose her ailments/side effects by Googling her symptoms forced me to learn quickly. Admittedly, this was initially an obscene amount of effort because of the learning curve. So I have to ask, do you think your husband’s passivity is due to a lack of effort on his part? Should you be alone in birth control decisions? Do you feel like the sole responsible party in preventing pregnancy?”

FF: “I’m not sure if it’s so much lack of effort as it is lack of awareness on how much he doesn’t know. Anytime we discuss other detailed topics he does a great job of following along and staying engaged, but when it comes to this, he’s never really shown much interest past the surface aspects. If he ever asked to learn more I would absolutely be willing to put in hours to teach him concepts in depth. But as of now, I do feel like the only one responsible for preventing pregnancy. He would be welcome in contributing to birth control decisions and learning with me, but it feels like he believes doing that would make him look weak.” 

The rest of the women nodded in agreement with her statement. To the single friends, I asked if a partner had ever asked them or expressed any interest in what birth control they used. Had their past partners ever expressed concern about how birth control affected them? All the women answered with a “No.” One of them even went on to tell a story about how a past boyfriend was upfront and let her know he believed it was entirely her job to prevent pregnancy. 

What the men believed about their role in birth control decisions

Men not caring about birth control or female reproductive health to avoid looking weak was a concept I hadn’t considered before. It felt like it had substance and could possibly be validated. So I decided to talk with some male friends about it. Three of these friends were in relationships that had started within the last 4-8 months. The fourth had been married for over 10 years.

I initially asked, “Do you know what birth control your girlfriend is on and do you know how it works?” All of the men knew what birth control was being employed. But only 1 of the 4 could coherently articulate the physiology and function of his girlfriend’s birth control method, the copper IUD. The rest were at a loss and felt that it would be intrusive to ask their girlfriend for more details apart from what method was being used. There was a unanimous sentiment of “Her body, her choice” from the group that felt like an easy excuse for not being more informed. The other excuse presented was that it would be “weird” for a man to care so much about women’s reproductive health.

I probed a little further. “Has your girlfriend ever asked for your opinion or help in making a reproductive health decision? Or asked what birth control you think she should use?”

The response I received from one of the unmarried friends was, “‘Her body, her choice,’ you know? It’s honestly all up to her in the end. The subject often comes up but it’s not my place to ever even begin to suggest what she should do. I’m not the one that has to deal with all the weight gain, acne, and hormonal imbalances that go along with birth control.” 

Do men think their role in birth control decisions changes when they get married? 

I clarified, “So you recognize that there are some adverse side effects with birth control but still don’t think you have any place in the birth control conversation? Would that perspective change if you were married?”

Male friend #1: “No, I will always leave it up to her to decide how she wants to prevent pregnancy. My role is going to be very minimal, married or not.”

The conversation continued when I directed these same questions toward the 10 year-married man in the room who was actively working on conceiving his 5th child. His answers were much different than the single, younger men. 

Male friend #2: “Hormonal birth control completely wrecked my wife’s body chemistry, mental health, and physical health. I definitely pushed hard to have her quit that poison. As soon as she quit, all the bloating, acne, and depression went away. I don’t know much about women’s health, but I do know when my wife is not healthy, and that’s enough to make me an active voter when it comes to her birth control and reproductive health decisions. My desire for a large family probably played a big role in my push to ditch hormonal birth control, though,” he said with a large grin on his face. 

Whose job is pregnancy prevention anyway? 

I followed up, “So, is it a woman’s job to prevent pregnancy?”

MF#2: “Both the man and woman are responsible for preventing pregnancy. I viewed my role as somebody that could provide input from the outside since I could see how different birth control [brands and types] interacted with my wife and her body. We (men) can also help by controlling ourselves if we know she’s in a fertile stage and a pregnancy isn’t in the plans. Overall, we can provide recommendations based on factors they (women) may not see from their point of view. It’s [ultimately] her job to decide what method is best for her body. But both parties are participating in this decision if the woman wants the input.” 

Takeaway: Women generally welcome men’s buy-in on birth control decisions, but men are afraid of overstepping boundaries

So after talking to both men and women separately, it would seem that we have reached a stalemate of sorts. On one side, some women are more than willing to teach the men in their lives as much as their testosterone-filled hearts can handle. And, on the other side, men are so scared to overstep boundaries that they don’t push the subject when it comes up, and instead wash their hands of the subject with the mantra of “her body, her choice.” 

After these discussions, it seems that a man’s opinions, when asked for, can be invaluable in a relationship. It doesn’t leave a woman alone in making difficult decisions, especially when she trusts her partner and values his input. After exploring this subject with my friends, it is evident that fostering a sense of shared responsibility and open communication is essential for a couple. Birth control methods have placed much responsibility on women, while men have often assumed a passive role. This one-sided approach has led to confusion and a lack of understanding regarding a man’s responsibilities in preventing or achieving pregnancy.

How fertility awareness leads to shared decision-making and responsibility for family planning

However, this status quo can be challenged in favor of a more inclusive paradigm. With the use of Fertility Awareness Methods (FAMs) and by including men in natural family planning discussions, family planning responsibilities can be shared equally among men and women. FAM facilitates men contributing to the family planning process since it inherently promotes open dialogue, mutual support, and joint decision making. Of course, these rewards can come with a unique set of challenges that couples may not have ever needed to face before—like learning to abstain and show intimacy in other ways during the fertile window, if avoiding pregnancy is desired.

But Natural Womanhood is here to help. This article describes the specific challenges that come with FAM use, and why they’re worth the tradeoffs. This article also showcases our original research on the benefits of using natural family planning, which we gathered through extensive, in-depth interviews of dozens of real-life couples. We believe that through the use of FAMs, and better education, communication, and collaborative work, couples can make more informed decisions that promote both partners taking on active roles in their fertility, family planning, and reproductive health.

Additional Reading: 

Learning to love (with) Natural Family Planning

Marital problems as a side effect of birth control

Men and NFP: When the challenges of periodic abstinence feel unbearable

How men can encourage a switch from birth control to fertility awareness

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