By Sarah Johnson
I can’t help but admire the strength and resilience I see on display every day in my nursing colleagues with whom I’ve served for the past 22 years. Like many Americans, we confront this next phase of the epidemic with a mix of worry and hope.
However, as medical practitioners on the front lines battling the coronavirus, it is impossible for us to ignore a feature of American life that the virus has made all too clear: the deep inequality facing communities of color, who are dealing with disproportionate infection and death rates from COVID-19, as well as longer-term health challenges like lack of access to birth control. In these communities, the epidemic will cast a long shadow — not only as families struggle to recover spiritually and economically, but as young women navigate critical moments of their lives with limited or nonexistent support from medical experts.
For our society to rebound, we must understand and address the root causes of the inequality that the virus has laid bare. Family planning has played a significant role in improving the lives of women and people of color since it was declared a human right, but we still have a ways to go. As we imagine a world after the arrival of this pandemic, we must ensure that the U.S.’ outdated family planning model is replaced in order to address lingering inequality and to prioritize children and communities over corporations and profits. A common-sense set of solutions is the “male pill” and long-acting, reversible male contraceptives such as Contraline and the RISUG. If fully tested and approved in the U.S., such options could empower men to share more equally in family planning, leveraging their own bodies. And studies indicate that men may be open to the idea.
Why Male Contraception Is Essential
Why is male contraception important? Research shows that smaller families benefit children. It also indicates that the economic disadvantage correlated with larger families tends to perpetuate economic inequality that undermines democracy by leaving undue influence in the hands of the few. Yet in the name of economic growth, we see corporations targeting moms with costly ad campaigns to have more children for the purpose of growing the consumer base. We see sexual stimulants prioritized over birth control, and we see the U.S. tax system incentivizing larger families when incentivizing delays in pregnancy may better position women and children for equality. Economic growth-based family planning not only puts in question the planet that we’ll be able to pass down to our children, but it also leaves us more susceptible to future pandemics due to population overcrowding and decreased distance between humans and animals.
Today in the United States, nearly half of pregnancies unintended, costing us about $15 billion each year. I remember several years ago telling one of my patients, a 37-year-old African American woman in Oakland, Calif., that her pregnancy test had come back positive. She instantly froze and began to cry. She wanted the baby, but she did not have the financial resources to take care of the child. She was then faced with a very difficult decision. Scenes like this play out every day across America and the world.
In a few short months, the pandemic has made family planning even more difficult. Condom shortages and lack of access to birth control during this social distancing period can lead to serious socioeconomic consequences for young couples. Going forward, we must empower men with equal opportunity to safely participate in their right to family planning using their own bodies.
Male Birth Control and Modern Family Planning
What options are already on the table? Aside from the “pullout” method and abstinence, there are more than 12 options for pregnancy prevention available to women. Meanwhile, two options are available to men on the U.S. market: condoms or vasectomy. While there have been several attempts over the past several decades at developing viable options for males, critics say that sexism may be the largest barrier, in part evidenced by the early termination of clinical trials on a male version of “the pill,” due to side effects these critics say women have been experiencing for decades.
The obstacles in front of us are not insurmountable, and we cannot afford to decelerate on the road to scientific breakthrough. In today’s politically polarized America, any solution that pushes us forward while side-stepping traditional political divides should be a no-brainer. Falling squarely within the pre-fertilization category of birth control options, male contraceptives are less politically contentious, in part thanks to the current pope’s less stringent stance on contraceptives. Abortion tends to dominate the family planning public discourse, but the real conversation should be about modernizing family planning, so that women and their partners can have equal access to resources and information to plan better lives for themselves and their families.
Downstream approaches to improving children’s welfare are failing kids and endangering our future. The most effective way to eliminate the greatest threats to children, the environment, and our democracies is to ensure better conditions for every child from the moment they are born. Let’s start at the source. When communities and parents cooperatively embrace better family planning, we can invest more in every child and create the future we all deserve.
For these reasons, we at Having Kids call upon the National Institute of Health and U.S. Sen. Rand Paul and U.S. Rep. Anna Eshoo, who lead the congressional committees on health that oversee family planning matters, to increase funding for the development of male contraceptives.
As we salute nurses for their work on the front lines of the pandemic, we should also think about the long-term resilience of our healthcare system and our communities, and how state-of-the-art family planning drives better patient outcomes for a healthier, better-functioning society.
Sarah Johnson, a family nurse practitioner with 15 years serving patients in critical care and 22 years in allopathic medicine, graduated with an M.S. in Nursing with high honors from Georgetown University and currently lives and works in the San Francisco Bay Area. She is a founding board member of Having Kids, a U.S.-based nonprofit organization dedicated to raising awareness for The Fair Start Model, a human rights-based, child-focused approach to family planning.