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Ejaculate Responsibly. The Conversation We need to have with Men about Contraception (Book review)

17/10/2024

 
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Anyone irritated by the way women are blamed for every contraceptive failure should read Gabrielle Blair’s international bestseller: "Ejaculate Responsibly. The Conversation We Need to Have About Men and Contraception."  

It's a rousing and thought-provoking polemic about the uneven contraceptive burden. A call for men to take responsibility and, er, ejaculate responsibly.
It's not a perfect book. Unfortunately, like many others, Blair dismisses fertility awareness methods, which can be up to 99% effective (NHS) when you choose the right method, and use it correctly.

Blair is right that you can't predict ovulation in time to avoid pregnancy. There's no alarm clock that goes off "like a turkey timer at Thanksgiving".

It's a shame she doesn't add that, with enough data, you can work out the earliest time you might be fertile each month. Your first fertile day.

She could also have added that you can work out when ovulation has been and gone and your green days have begun. The infertile days before your period.


Still, her insight into the cultural pressures on men and women are invaluable.

On condoms she says:
“Perhaps the problem isn’t condoms but the way we talk about condoms. Or more accurately the way we don’t talk about condoms – if a man believes sex without condoms is a conquest, he’s not likely to talk about the benefits of condoms with other men he knows.”
Incorrect, or typical, condom effectiveness is only 82%. But correct use, which can be learned like any other skill, is up to 98%. Combine that with a “just in case” supply of emergency contraception and some knowledge of your cycle and effectiveness will be even higher..

Withdrawal, or pull out, is not recommended by the NHS website, or many healthcare practitioners, but the US site Planned Parenthood states correct use can be as high as 96%, though typical or incorrect use is just 78%. 
"When learning that 78 percent statistic, a responsible man would not respond: Well, the Pull-Out Method isn’t effective enough, so I won’t bother. But rather: I’d better learn what mistakes to avoid with the Pull-Out Method. This is serious business. I can’t mess around with someone else’s life like that." 
Effectiveness can be improved by combining pull out with a diaphragm like Caya and/or knowledge of when a woman is fertile.

On vasectomy Blair says:
“Again, because of privacy issues and the stigma around vasectomies, men don’t often talk to other men about their experiences or the advantages. But the advantages are real... Couples commonly report much improved sex lives after a vasectomy...Men also frequently report that the procedure is quick and easy, almost pain-free, and the recovery is straightforward and simple.”
You might not be at this stage in your life, but it’s worth knowing about. Again the US is a little different on this subject. Planned Parenthood even has a campaign "The Ball's in Your Court" to help promote it. 

The NHS can't match this campaign at the moment but it does provide free vasectomies, though there's often a waiting list.

The NHS also provides free support for using fertility awareness as contraception (Natural family planning) in some areas, and lists people like me who provide support on a Pay What You Can basis. 

Of course fertility awareness is not right for everyone. If you're considering it, please read Is fertility awareness right for you?

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    Author

    Fertility awareness (natural family planning) practitioner and advocate. Wants to see fertility awareness become a routine contraceptive option, not the only option. read more...

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