Seven Ways to Practice Mutuality in Reproductive Responsibility
While also recognizing that, because of the unequal burden on women in this process, mutuality is one of those “we’ll do the best that we can to get as close as we can” processes.
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This week on Sexvangelicals, we’re talking with the amazing Lindsay, Meg, and Sarai from the Holy Ghosting Podcast about making intentional decisions to move into parenthood.
While mutuality, the participation and accountability of both partners in a relationship dynamic, is a high value of our work as relational therapists, there are situations that mutuality is never fully achieved.
Pregnancy and family planning with heterosexual couples is one of the primary ways that we see this in relational health. Women literally carry the burden of developing a fetus in their uterus. Almost all contraceptive methods are designed for women’s bodies. Women also experience any side effects that go along with contraceptive methods, from the pain and recovery of the surgery for IUD implantation to the physiological responses to contraceptives that impact hormones.
When it comes to pregnancy and family planning, mutuality is one of those “we’ll do the best that we can to get as close as we can” processes.
Cassandra Caddy, Dr. Meredith Temple-Smith, and Dr. Jacqueline Coombe of the University of Melbourne wrote the article “Who does what? Reproductive responsibilities between heterosexual partners”, published in the December 2023 issue of Culture, Health, and Sexuality. They explore the idea of reproductive responsibility, work, and/or burdens, which they define:
“Any task requiring active engagement or management (physical, emotional, mental, financial, or time) from an individual during any reproductive event. This can maintaining sexual health, initiating conversations with partners about sexual/reproductive issues, and managing side effects of contraceptive method” (p. 1642).
Caddy and her colleagues delve into 17 different research articles that explore the possibilities for mutuality and collaboration in the family planning process for heterosexual couples, as well as dynamics that prevent collaboration from happening. They describe seven strategies that can be practiced by individuals, couples, and larger systems to create a little more mutuality in the family planning process.
Men need to initiate a higher volume of interactions about family planning. Caddy and colleagues observed that while many men and women wanted to practice mutuality regarding family planning, a smaller percentage of couples actually practiced dynamics of mutuality. While initiating interactions could include specific practices about contraceptions, as we’ll talk about in item 5, many women report feeling a sense of camaraderie (not quite mutuality, but still relational connection) when men initiate conversations about the emotional experiences of family planning.
Men need to initiate conversations about contraceptive use in a sexual experience before talking about pleasure. One of the most damaging narratives about sexuality is that sex “should be spontaneous”, and that spontaneous sex is more desirable and pleasurable than intentional, responsive sexual experiences. Physiologically speaking, spontaneous sex favors penis-owners, as the erection of the penis happens much quicker than the lubrication of a vulva (average of 15-20 minutes). In sex therapy with opposite sex couples, we invite men to be aware of this physiological difference and explore sexual options that move beyond spontaneity. Caddy and colleagues also described a dynamic where men purposely avoided conversations about contraception until after intercourse, leaving the female partner with the burden of responsibility for how to protect herself against an unwanted pregnancy.
Navigating the double bind between respecting women’s autonomy and engaging in collaboration. They noticed that conversations about family planning often get avoided because many men perceive they are practicing the feminist value of bodily autonomy by not initiating conversations about contraception and family planning. It’s important for couples to distinguish elements of family planning that are enacted unilaterally by the female partner, and elements of family planning that require engagement from both partners.
The funding, research, and development of a male-centric contraceptive device that isn’t a condom. A 2019 Australian study showed that 69% of people aged 15-29 didn’t use condoms when having sex with regular partners, and 24% didn’t use condoms with casual partners. Caddy and colleagues observed consistent complaints from men and women about condoms leading to decreased physical sensation, vaginal dryness, and interruption to sexual experiences. While men also have the option to have vasectomies, which are inexpensive and often covered by insurance companies, reverse vasectomies aren’t typically covered by insurance companies, and cost an average of $9800. As a result, men were more likely to assume that women were either using contraception and had the financial resources to access emergency contraception (i.e. abortion) should an unexpected pregnancy happen.
Sharing contraception usage. This could include larger elements, such as making collaborative decisions about what contraceptive option(s) work best for this particular relationship and sharing the costs and implementation of contraception devices. One study described the relational connection that happens when women and men (gently) work together to assess for correct usage of the contraception, such as checking the position of intrauterine device.
Healthcare providers including men in conversations about family planning. I provided a men’s group at an IVF clinic in Boston that provided 12 weeks worth of intensive psychological and physiological care for folks receiving IVF. That one 90 minute men’s group was the only form of support that male partners received throughout this process; everything else was dedicated to the care of the female partner. Clinics need to design policies that allow both potential parents to be part of all elements of the medical components of family planning. Caddy and colleagues brilliantly write, “Health professionals reinforced gendered ideas of contraception in their interactions with men, either by not discussing contraception during health care visits, or by assuming men are disengaged or resistant to reproductive work, such as discussing the “nagging wife” who instigates their partner’s vasectomy” (p. 1648).
The disconnection between ideals of masculinity and virility. Men and women, both described the existential stress, deemed as “loss of manhood”, that comes with the practice of male contraception. This existential stress simultaneously reinforces the practice of rigid gender norms and injects anxiety into the sexual relationship, which can lead to issues with erections, ejaculation, and genital pain.
Ultimately, mutuality requires a combination of the awareness of the unequal burden of reproductive responsibility of women and the vulnerability of men to initiate intentional conversations about what each partner can do to contribute to family planning, contraceptive usage, emotional care, and pregnancy support.
If you’d like additional assistance in practicing these conversations with your partner, Julia and I would love to help, either through our own therapeutic services (for those who live in Massachusetts), or by connecting you with a trusted relationship therapist in your own community. Email us at sexvangelicals@gmail.com for more info.
Let’s heal together!
Jeremiah and Julia