‘I Was Unassertive’: Why Contraception Tales Go Beyond Health
Like many, Neha, 26, had never consulted her parents regarding information on contraception unless it was referred to in the passing. “But I think that they felt that my sister and I were ready because we indicated that we knew stuff about the world.”
Yet, when she felt that the time was right, she claimed that she was “nervous about the whole thing”. It was not part of a series of calculated moves but it was rather a requirement to ensure that she would engage in safe sex for that time – something that she felt didn’t require the need to see a medical professional, especially when she didn’t know if she would have a sexually active life.
Echoing the same is Tara (name changed), a 27-year-old based out of Bhopal, who recalled her first time, around six years ago, with her partner who was considerate towards her feelings and insisted on using contraception.
Even then she worried about a potential “mess-up” – a term she used to refer to an unplanned pregnancy in case the chosen contraceptive method doesn’t work for any reason. The lack of counselling on the usage of contraceptives makes her worry. The bearing of being her parents’ only child and their financial dependence meant that she couldn’t afford a pregnancy.
Sarah (name changed), 28, remembers a time prior to being married when accessing information about contraception was a far more cumbersome process.
Like Sarah, there are millions of women who seek information but due to societal perceptions and biased service providers, there remains a huge unmet need.
It is a fact that among sexually active, unmarried women, only about one-third use a contraceptive method (NFHS-4). It is pertinent to note that as per findings from the Guttmacher Study, 15.6 million abortions took place in India in 2015 – a reflection on the poor quality of existing contraceptive services for young people in the country.
But that explains only part of the story.
When Sex is ‘Not Very Consensual’
Common across testimonies was the silence or lack of communication as well as positivity when talking about sex. The complete lack of conversations regarding sex with parents, half-hearted biologically-specific modules taught as ‘sex education’ as well as biased health service providers not only contribute to a culture of silence and shame around sexual activity but also fosters covert forms of violence among young people.
For instance, when partners either refuse to use contraception, or when sexual experiences are not entirely consensual, especially among young couples there is a lingering feeling of putting oneself at risk – and that’s something that stays with you especially if you feel like you cannot talk to someone about it.
Arti (name changed) describes her first sexual experience, which she states as “not very consensual.” But she never spoke to him openly about it.
And that’s where peer educators play a significant role. When people of similar ages – be it a close friend or a cousin - who have similar body types and are themselves going through changes and experiences that they have to live with, situations dealing with a hostile partner need not go unspoken. There opens a space for intervention.
But when things change for the better, they can truly make a difference. Financial independence, mobility, sex-positive experiences & conversations, better access to information online from credible medical platforms and offline (helplines, friends etc) in a changing culture that is different than it was just a few years ago can be attributed as a steps in the right direction
A sensitive service provider can make all the difference. If Sarah had found a friendly service provider, her experience would have been very different. Counselling, with specific reference to the attitude of the health provider, has the potential to bridge the gap between an unmet demand and the supply of services especially, for this age group. It also helped that her husband helped her ease into the process by sitting her down for an open dialogue.
The Need to Talk Contraception
Often, sexually active unmarried young people are left out of crucial conversations simply because they don’t fit into the family planning landscape. But knowing and understanding that their specific needs and requirements, if not met, would leave generations of young people vulnerable is central to reorienting the paradigm.
While it is important to create safe spaces at homes, schools and colleges, parallel efforts have to be made to promote open dialogues, provide sex education and make systems more amenable for young people, besides of course equipping them with the correct information and increasing the choice in contraceptives. Further access to counselling services will help to address individual-level concerns like the nuances of sexual intimacy, power relations as well as consent, which is key to safeguarding against violence and promoting the overall health and wellbeing of the individual.
Through the adoption of a rights-based approach, whereby young people are engaged from an early age on their sexual and reproductive health needs, 368 million young people will have the opportunity to move on from a needs/emergency-based situation to one where are prepared to take informed decisions and don’t have to tread around sex like it’s a ticking time bomb.
(Edwin Thomas is currently a fellow at Population Foundation of India (PFI) and is supporting their youth engagement strategy that realizes a key focus on young people. You can contact him at firstname.lastname@example.org)