Whose baby? Women, Men and Contraception

I got this amazing chance to attend “A workshop on Contraceptives” conducted by the CT Innovation lab. Does it sound exciting? Yes it does. For a young woman who has never heard about anything other than condoms, a workshop on contraceptives would be fascinating. And the best part comes when after learning about the contraceptives, one needs to design it for the users. Here user being you and me.

For those who are not familiar with the term “Contraceptives”. They are methods or devices used to prevent pregnancy. It is also called Birth control techniques. How do they work? The basic principle is to prevent the sperm from getting to and fertilizing the egg. The contraceptives act like a barrier between the sperm and the egg.

There are different kinds of Contraceptives. Condom being the most popular one. Some of them bring hormonal changes and few of them dont. So it is very important to understand what kind of a contraceptive one should use, depending on one’s preferences and likings. However, the biggest challenge here is that not all are aware about contraceptive methods. In a country like ours (India), only married women get to know about contraceptives that to when they are planning for a child. Many a times even married women are not aware about the different methods and the choices available. So the awareness about contraceptives is close to zero.

 

Again for those who have no clue about methods of Contraception, let me give a brief on it. We can divide them in two categories, Hormonal and Non – Hormonal methods. Under Hormonal methods we have the Birth Control Pills, Vaginal Rings, Birth Control Patches, Implants, Injections and under Non – Hormonal methods mainly we have condom (male/female), cervical cap, diaphragm, copper IUD. Imagine there are so many options and we are hardly aware about them. For more information related
to how these methods function and the pros and cons of it, do stay tune for our podcast on contraception.

It was an amazing experience to work with so many experts. Researchers, innovators, biomedical engineers, professors of biological engineering, illustrators, podcaster. The main aim behind this workshop was to create a contraceptive product for women. A contraceptive that was easy to use, simple to understand and also non hormonal in long run. The ideation process was extremely challenging as we were trying to come up with a product which is layered with taboos. The aim was to cover all the women who are sexually active.

CT Innovation lab had an interesting research to share. They had spoken to many women and it clearly showed how these women were highly fed up with the methods. From condoms to injectables all had their own flaws. Some of the male partners refused wearing condoms, the women who got IUDs inserted developed infection and many were unaware about injectables. Many spoke about how it is the mother in law who decides on the method. There were women who got sterilized at the age of 25-27.

Now the question came what are these women looking for? And the response was very interesting. Many of them wanted something which can be worn on the body, such as a toe ring, a duppata, a nail paint, a bangle. Something which is easier to wear and looks very familiar and normal. Something which the mother in law cannot find out and the women can use it as and when she needs it. Many said anything which doesn’t bring hormonal changes or has side effects, few said they want all the tests to be done on male partners now as they were fed of trying new methods.

 

So we have a huge challenge now! First to make women aware about different kinds of contraceptives, how they work, the pros and cons. To Make them aware that one has bunch of options from which she can select depending on her preferences. Second to keep working on how can we come up with a better contraceptive method, which is affordable, easy to use, less of side effects and suits one’s body. And last how to make the women aware that it should be her choice what method to select and not the mother in laws. She needs to take control over contraceptive methods.

 

So finally, I came out as an experience designer as part of this workshop. I saw, I touched and I conquered some of my own myths and fears. There is so much to learn more, but really excited about sharing my experiences with you all.

Acceptability of female condoms In urban India: A study

Hidden Pockets  had the opportunity to chat with Jessamyn Bowling, Research Manager of a study conducted on ‘Acceptability of the female condoms In urban India.’ The principal researcher of the study is Debby Herbenick and the study was funded by the Gates Foundation.

Hidden Pockets: What was the focus of the study?

Jessamyn Bowling: In India, there aren’t as many good mechanisms for contraception that are within women’s control. Barrier methods in the case of relationships that are not actually monogamous or for people who are doing sex work then having a barrier method that the female can insert herself is preferred.

Hidden Pockets: What was the demographic of the participants?

Bowling: We worked in Delhi and Chennai. We restricted it to cis-gender women. So female and women identified who were over the age of 18 with a male partner and willing to use a female condom were part of the study. In Chennai, we had a little bit of issues just gathering people from a larger community due to the floods. So we specifically worked with a group of people who occasionally engage in sex work. So we had diversity in responses. There were similarities and differences (in the responses). However in Delhi, we worked with groups of people that were organized more around their neighborhood. In Delhi, we also had two groups of men because we wanted to also understand some men’s perspectives. We wanted different suggestions that they (the men) would like because we know that to get women to use female condom, it’s really important that their partner likes it as well. Out of the total of 69, 22 of them were men. The inclusion criterion was the same for the men. They just had to be over 18 and had to be living in Delhi and be willing to use a female condom with their female partner.

Hidden Pockets: How did you go about achieving the objectives of your study? What was the research process involved for your study?

Bowling: We did a focus group discussion with 69 individuals. We then did interviews with just a few individuals just to confirm findings from the larger group discussions. All the people in the focus groups were married and the people in the interviews were dating people. We gave people female condoms to use before the focus group discussion or interviews. We asked them to use them and then make sure that you know they had used it before we had the focus group or before we had the interviews. We asked them in the focus group about their experiences with using it (female condom) and what they would suggest to make it better.

Hidden Pockets: Which was the brand of female condom given to the participants, both men and women?

Bowling: We gave them the FC2. The FC2. It is pretty widespread in the US. So I wanted to be give them one from the US and then one that is available in India. I had ordered for one called Velvet through amazon but the shipment never arrived so we were only able to give them one of the FC2s.

Hidden Pockets: What’s the lifespan of a female condom? How many times can a woman use it or is it just for one use?

Bowling: It is officially only for one use. She can insert it for hours ahead of intercourse though but for some populations that accessing the female condom is really a problem. The female condom is stronger in material than the male condom is. Some male condoms that are made out of the same material but they’re rare and expensive. So technically the same partner can use it more than once but you’re not going to take it out and wash it or anything. But if you’re having multiple ejaculations during the same event and it’s with the same person then that generally considered a relatively safe thing to do. You just want to make sure that the female condom is still in place so that the ejaculate isn’t moving around and entering into the vagina but generally its only marketed sort of quote on quote for a single event I guess a single use.

Hidden Pockets: Apart from the cyclone, what were the other challenges that you faced with conducting this study?

Bowling: In Chennai, we had an issue with language. We asked about how sexual pleasure is important for female condoms. We literally had three different people trying to translate the phrase ‘sexual pleasure’ into Tamil. Similarly, in Delhi, the word for clit (in Hindi) wasn’t something our community partners used regularly. So they looked it up and they found the word but if the people working in reproductive health for women don’t use it regularly then obviously the participants may not know it as well. These issues were unexpected. It’s not so much like a real challenge but it’s like an interesting piece that we were working around. This is why working with the community partners was really important. There may have been some participants who didn’t actually use the female condom but they might have lied about it in the focus groups. That might be possible but we don’t really think so because it didn’t seem like that was really a major barrier. It seemed like people were reporting pretty honestly about what was happening with them.

Hidden Pockets: How aware would you say the women (participants) were about female condoms?

Bowling: I think that they’ve heard of it and that’s it. But they’re available apparently in only one or two shops in Delhi but are so expensive, people would say yes I’ve heard of it but they’ve never seen it. And they certainly didn’t know how to use it so we did a demonstration for them which they said was really helpful. Their partners also didn’t really know about it either. There were one or two people in the interviews who were with a little higher level of education who might have seen it on a Buzzfeed video or somewhere online but they hadn’t used it before. From what I understand, female condom can cost anywhere between 200 and 500 (for one condom). You can get them a little bit cheaper online but honestly it is nowhere close to what people pay for male condoms so that it’s just not viable at this point. It why would they know about something that is not feasible? But people aren’t entirely ignorant of them.

Hidden Pockets: How aware would you say the men were about female condom compared to women?

Bowling: Maybe one or two (men) have heard about it but not very aware at all. I wouldn’t say the women are really aware. They just know that this thing exists and the men know less than that. But honestly I think the fact is that the women didn’t really know what it looks like, let alone know how to use it. Even those who are aware of it, don’t think it to be really important because they can’t get a hold of it (due to the cost).

Hidden Pockets: What were some concerns of women who used it regarding the usage of female condoms?

Bowling: One main challenge was that the insertion takes a little bit of getting used to. We had some women participants who were familiar with using a menstrual cup. Those participants were more comfortable with using it. It’s like a skill to fold the condom up and insert it inside of you. The inner ring was something that they didn’t really like. I asked them about how they would redesign it and that’s one of the things they would redesign. Since they weren’t used to using it while having sex, they were worried that the outer ring would flip inside. So the mental aspect of sexual pleasure was a little bit reduced in that front because they were concerned about it.

Hidden Pockets: What did they like about the female condom?

Bowling: They liked a lot of things about it. They liked the fact that it was in their control. Most said if my partner’s lazy and doesn’t or they’re intoxicated and doesn’t want to use a male condom then I have the ability to be in control of it. Many people both women and men liked how it felt. This comes with some lubricant already inside. They liked how that felt extra slippery. Then women also really enjoyed being able to after sex, if the man had ejaculated, just be able to pull this out. It was an easier clean up for them compared to unprotected sex.

Hidden Pockets: What do you think could be done to increase awareness about female condom among women?

Bowling: I think it’s important to have the government on board in terms of increasing not just awareness but availability. So these aren’t really available in the dispensaries. My understanding is that even if you increase awareness it doesn’t matter because you’re just going to create the demand for something that is so expensive. Even to order them online, the ones made in India, it is nowhere near the cost of male condom so why would people use them? Why would someone pay so much for it? People (participants) suggested that marketing be put out on television and radio and some billboards as well using film actors, bollywood actors and actresses in the same way that male condoms have used to make male condoms seem normal.

 

To read more about User’s experience of a Female Condom : http://www.hidden-pockets.com/female-condom-experimenting-scheme/

5 things that you might not know about condoms and safe sex

“But won’t it ruin the sex?”
“What if I have an allergic reaction towards latex?”
“Why do I need a condom? I only have sex with safe people.”
“Why should I use condoms when there are cost-free alternatives like the ‘pull-out method’ or the ‘calculation of safe days’?”

These are the types of dubious assumptions both men and women have about condoms. The history of condoms is still vague since nobody really knows for sure when the usage of condoms began. But what we do know now for sure is that the invention of condoms has been the greatest blessing to the sex lives of so many. It has contributed to betterment of the sexual health of innumerable people. Condoms not only provide protection against unwanted pregnancies, but are also extremely potent when it comes to reducing the risk of Sexually Transmitted Infections (STIs) such as gonorrhea, syphilis, chlamydia, and HIV/AIIDS by blocking exchange of sexual fluids. No form of protection is effective in totality, but condoms come close. Despite the fact that condoms are actually the most accessible and commonly used form of birth control, they are still more mysterious to many! So here is a list of 5 facts about condoms that will help you bust the myths that revolve around them:

1) Condoms do not really affect the quality of sex

A number of surveys and studies prove that men are capable of getting an erection and having intercourse without any discomfort or complication even when a condom is being used. In fact, couples are reportedly just as satisfied with a condom in use as they would be without one. Condoms are designed in a number of sizes for better fit and can handle great amount of physical pressure, thus making them really effective. With serious risks such as unwanted pregnancies and STIs, using (or not using) condoms will bring significant consequences for a person’s sexual health. According to a survey published in Journal of Sex Research, 50.3% of the men use ‘It doesn’t feel good with a condom on’ as an excuse to escape from wearing one. However, the fact about condoms affecting the quality of sex is actually not a fact; rather, it’s an old wives’ (or husbands’, in this case) tale.

2) Female condoms are almost as efficient as male condoms

The female condom is the underdog of the decade, with inadequate spotlight being thrown on it. It first came around in 1992 in the U.S. and became available in Europe a few years later. The female condom is a lubricated sheath with flexible rings at each end and it acts as a shield from sperm and STIs by completely lining the vagina. There are two types based on the material: 1) FC1 made of polyurethane and 2) FC2, made of nitrile, which is a non-latex material. The female condom can be inserted as early as eight hours before the intercourse. It is said to increase sexual pleasure, and that’s been getting female condom some attention with men. Female condoms are thus an effective way of protection against pregnancy and diseases. So the next time you feel like trying something out of the box or breaking the monotony, female condoms are your go-to option. More power to women!

3) There are different types of condoms to fit your personal requirement

Choosing what suits one best from the wide range of condoms available is important for practicing safe sex. Condoms are divided into four categories on the basis of the material which is used to make them. These are-
Latex condoms: This is the most widely used condom type. Latex is a type of rubber that is extracted from plant resources. Latex condoms are very effective in preventing pregnancy and protecting against STIs. However, the effectiveness of the condom is reduced when it comes in contact with oils.
Polyurethane condoms: This is the go-to option for people who have an allergy to latex. Polyurethane is a type of plastic. The condoms made out of this are thinner, yet stronger and looser than the latex ones.
Polyisoprene condoms: For people who have latex and/or polyurethane allergies, this is the best option available. Polyisoprene is synthetically produced. It is equally effective in protecting against unwanted pregnancies and STIs. However, the increased thickness of these condoms can be said to be their only con.
Lambskin condoms: These are not literally made from lambskin, but they are made from animal intestines. Although this is a viable option for people who suffer from latex allergy, it would still be better to go for a polyisoprene female condom than use condoms made out of this material. The reason behind this is that even though lambkin condoms can effectively protect against pregnancy and diseases like chlamydia, gonorrhoea and syphillis, they are not as effective in the case of HIV/AIIDS. Female condoms in this case would work more effectively.

Condom are available in different sizes. They come in different sizes such as small, standard, regular, medium and large. So if a condom feels uncomfortable to you, you are probably not using the right size. So ‘it doesn’t fit’ will not be an excuse enough to chuck the rubber!

4) There is a proper way to store condoms

Condoms should be stored in a cool, dry place away from the sunlight and sharp objects which could directly damage them (like sitting for too long with a condom in your back pocket. Ouch!). They should not be stored anywhere warmer than 100 degrees or cooler than 32 degrees Fahrenheit. It is also very important to keep in mind that expired condoms create a ‘touch-and-go’ situation and produce more risks when it comes to protection.

5) Incorrect usage can decrease the odds of protection

Although male condoms promise 98% effectiveness when it comes to protection against pregnancy, improper usage reduces the effectiveness to 82%. Similarly, the female condom can be effective up to 95% in preventing unwanted pregnancy when used properly. If it is not inserted correctly, it will be about 79% effective. Thus, people are advised to either be extremely careful of the instructions given for wearing a condom or use another birth control method along with the condom itself.

Know your condoms and take your pick!

Condoms are highly accessible and have proved to be the most practical form of protection against unwanted pregnancies and STIs. Since they are so in demand, there are a number of companies offering to sell condoms. They vary in quality, price and availability. Here is a list of some of the brands of condoms available in the Indian market for you to choose from-
1) Durex:  Durex produces latex as well as non-latex condoms. It is easily available on online platforms as well as pharmacy outlets. A pack of 10 condoms is priced at Rs. 165/-. You can choose what fits you from their wide range of products.
2) Manforce: Manforce offers latex as well as non-latex condoms. However, one should be careful while choosing the product. The flavored condoms of this brand are said to contain sugar which cause imbalance in pH levels of the vagina, causing irritation and discomfort. Manforce condoms are commonly available in pharmacy outlets as well as online platforms. A pack of 10 condoms is priced at Rs. 80/-
3) Kohinoor: Kohinoor variants come in both latex and non-latex using condoms. A pack of 10 condoms is priced at Rs. 72 /-
4) Velvet: Manufactured by HLL Lifecare Ltd, Velvet female condoms are made of Natural Rubber Latex. They have a shelf life of up to five years and they are the cheapest brand of female condoms available in India. They are selectively available in pharmacy outlets but commonly available on online platforms. A pack of 4 condoms is priced at Rs. 100/-
5) Cupid: This brand makes natural rubber latex female condoms. It comes with a flexible octagonal ring at open end polyurethane foam at the closed end. It is selectively available on both pharmacy outlets and online platforms. A pack of 4 condoms is priced at Rs.170/-

About the writer:

Purnima P.V is pursuing History(Hons) from Miranda House, University of Delhi. Although a huge history buff, sociology is her one true love. She is also a photographer by passion. She describes herself as an ambivert, an amateur traveler, an avid reader with a special interest in the genre of fictional non-fantasy, a politically opinionated feminist, and an ally as well as a member of the LGTBQIA community.