Getting Men More Involved Before

NEW YORK — In an effort to reduce America’s high rate of unplanned pregnancies and their associated economic and psychological costs, researchers from around the nation met here Wednesday to discuss increasing men’s involvement in choosing and using contraception.

“There are 3.5 million unintended pregnancies every year, and in pretty nearly every one of them there was a guy involved,” quipped Dr. Felicia Stewart, director of reproductive health programs for Kaiser Family Foundation, which co-sponsored the conference with the Alan Guttmacher Institute (AGI) and the National Press Foundation.

Reporting on the results of Kaiser’s new national public opinion survey on men’s role in preventing pregnancy, Stewart said that 67% of men and 71% of women said men should “play more of a role” in choosing a contraceptive method.

Furthermore, 72% of men and 73% of women said men should play more of a role in making sure contraception is always used when pregnancy is unwanted.

The national survey covered 1,005 adults--503 men and 502 women--18 and older. It was taken March 3-5, 1997.

Still, when asked about men’s actual role in contraception, only 16% of men and 13% of women said men do enough in choosing a contraceptive method, and only 16% of men and 14% of women said men do enough in making sure contraception is always used.

“Men are definitely involved less than they want and are willing to be,” Stewart said, adding that one reason is that men feel “left out” when it comes to preventing pregnancy.

“We’ve designed our services primarily for women, put the funding with women and certainly did not do what we could have for male methods of contraception.”

William Marsiglio, a University of Florida sociologist and author of a soon-to-be-released book, “Procreative Man” (New York University Press), traced men’s relative lack of involvement in preventing pregnancy to factors including the development in the 1960s of female forms of contraception, such as the birth control pill and the IUD.

“It was then that much of the responsibility began to be placed on women,” he said. “Also, with the legalization of abortion in the early ‘70s, men assumed women could terminate an unwanted pregnancy.”

But given that 57% of pregnancies in America today are unplanned, men have strong incentives to take equal responsibility to prevent them, Marsiglio said.

“There have been a number of strategies initiated by the government over the past decade to make men accountable for the children they father, such as a push for establishment of paternity and enforcement of child support payments. Those strategies have resulted in more financial obligations for men.”

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Equally important are psychological incentives for men to prevent unwanted pregnancies.

“Men experience emotional difficulties when they’re in a position where they can’t request an abortion, so there’s the notion of forced fatherhood for many men,” Marsiglio said. “And some men report the psychological trauma of a woman having an abortion the man doesn’t want her to have.”

He noted several existing social initiatives designed to increase men’s awareness of paternity issues, such as school-based classes for boys and the National Campaign to Prevent Teen Pregnancy, and called for more such programs.

“There are a number of stakeholders growing more and more aware that involving men in these issues is the way to go and certainly will be the wave of the future,” he said.

David J. Landry, AGI senior research associate, noted the paucity of adequate research on men’s role in pregnancy prevention.

“There are only a handful of intermittent surveys,” he said. “There are still very serious gaps in our knowledge.”

He also reviewed various forms of male contraceptives being studied in other countries, such as a contraceptive “plug” being successfully used in China, and hormonal injections and implants, all of which are at least several years away from being available in this country.

In the meantime, there are many things that can be done to increase male involvement in contraception, conference participants agreed, including development of family planning services aimed at men, use of the media as a tool of influence, and improved communication between men and women.