"I talked to a couple of friends that had it": Informal feminized health networks and contraceptive method choices

'That just sounds bizarre': factors affecting heterosexual college students' perceptions of new sperm-targeting contraceptives

Contraceptive responsibility has historically fallen on women in the context of heterosexual relationships, often resulting in a perceived burden on their emotional and reproductive health. We conducted in-depth, individual interviews with women and men in college to investigate factors influencing the choices they make regarding contraceptive use and more specifically their perceptions and willingness to try new sperm-targeting contraceptives. Thematic analysis revealed factors at a societal, interpersonal, and individual level affecting participants' perceptions and imagined decisions. Societally, a perceived gendered divide continues to exist placing primary responsibility for contraceptive use on women. Interpersonally, the context of a relationship increased partners' feelings of empathy and willingness to try alternative contraceptive methods; and individually participants remained concerned about their own sexual and reproductive safety. Findings indicate that societal level norms need to be shifted towards the acceptability of sperm-targeting contraceptives or other versions of contraceptives that act on male bodies, in addition to a greater focus on their development. It is proposed that this would help to ease the continued undue burden placed on women for reproductive health.

Interrogating the pill: Rising distrust and the reshaping of health risk perceptions in the social media age

Since its introduction in 1960, the combined oral contraceptive pill has become the dominant reversible contraceptive technology for controlling female fertility in spite of early and ongoing ethical, critical medical, and societal disapproval. Over the last decade, prescription rates among young women in Western Europe have declined alongside the rise of social media use. This article investigates the mechanisms underlying this change in contraceptive choices and the role played by social media in this trend. Via exploratory online observation and an in-depth interview study with 19 informants in Germany and Denmark, we find social media consolidates the social construction of hazards associated with the contraceptive pill by reshaping young women's risk perception from questions around drug reliability and safety to those of individual physical, mental, and social well-being. We shed light on how social media contributes to the delegitimation of health professionals such as gynaecologists and general practitioners and adds to wider debates on the erosion of medical authority and the attendant rise of peer influencers. We condense our findings into a framework for health-related attitude formation and decision-making in the social media age, which elucidates how social media amplifies and reshapes societal discourses regarding health-related technologies, choices, and risks.

Reasons for high prevalence of contraceptive withdrawal in Tehran, Iran

This study explores reasons for withdrawal use that is highly prevalent in Iran. A face-to-face semi-structured survey questionnaire was designed and 79 married women aged 15-49, who were only using withdrawal when attending five primary healthcare centers in Tehran during September-October 2021 were interviewed. Results showed that withdrawal mostly was chosen by the couple (67%), and partly by the woman alone (19%) or by the husband alone (14%). Participants evaluated withdrawal positively that has no side effect and cost, is easy to use and accessible, and increases sexual pleasure and intimacy. Most women agreed that husbands use withdrawal to protect their wife's health (76%). Women obtained contraceptive information primarily from gynecologists (42%), the internet (21%), midwives in public health centers (19%), and social networks (18%). "Side effects of modern methods" (37%), "fear of side effects" (16%), and "reduction in sexual pleasure" (14%) were the major reasons reported for using withdrawal. While 'side effects' was given mostly by women who alone or with their husband chose withdrawal (52%, 38%), 'reduction in sexual pleasure' and 'fear of side effects' were mostly reported by women whose husband was the sole decision maker in choosing withdrawal (28%, 25%). The 'fear of side effects' was reported mostly by women who had lower education (21%), used the internet for contraceptive information (23%), and whose husband alone chose withdrawal (25%). Cost of modern methods was a trivial reason for using withdrawal. Most withdrawal users (75%) would not switch to modern methods even if they were freely accessible. More educated women and their husbands would be less likely to switch to modern methods even they were provided freely (OR 0.28, CI 0.10-0.80; OR 0.20, CI 0.07-0.59). However, women who were using modern methods before, and those who alone chose withdrawal would be more likely to switch to modern methods (OR 6.4, CI 2.0-20.2; OR 3.4, CI 1.1-11.2). Access to regular contraceptive counselling and public health campaigns could help women to deal with fears of side effects of modern methods, learn their proper use, and to receive education on how to use withdrawal more effectively to avoid unintended pregnancies.