Contraception and "Natural" Fertility in America

Abstract

(not sure where this if from, maybe published elsewhere too) This book chapter uses insights from African ethnography about natural fertility in order to achieve greater insights into the meaning of reproduction and contraception in the US. The comparison of contraception among Gambian and American women reveals much similarity in women's greater concern for infertility than for high fertility. Contraception is used for securing proper timing and circumstances for "planning wanted" children. The US media does not clearly identify contraception as fertility control. Gambian women also disassociate contraception from birth control. The author wonders how many women view contraception as devices to reduce their fertility. The natural fertility population in Gambia knows that Western contraceptives can be used to limit fertility, but their focus is on "secondary potentials." US women discuss contraception as if it were disconnected from sex, pregnancy, and birth and focus on contraception and "secondary potentials" and side effects. US women are concerned about a lack of children and infertility rather than about high fertility, when the prevailing fertility pattern also favors large proportions of intended pregnancies. Theoretical frameworks for understanding contraceptive use focus either on the burden of children or women's natural control over childbearing. Qualitative cultural information reveals that Gambian women's concern about the long-term fitness for childbirth had a greater impact on contraceptive behavior than desires to limit children. A review of books in bookstores in the US reveals little on contraception as a means of achieving low fertility. Popular books focus on contraception for managing relations with men and spontaneity of sexual relations. These concerns may well translate to long-term contraceptive choices that reduce the risk of unwanted infertility. Sterilization and abortion are the preferred methods for limiting fertility. -"My discipline has convinced me that culture is very powerful; a dominant set of ideas may saturate reality, obscuring patterns and contradictions that a foreigner might notice immediately." -article take opposite approach to that usually used, taking rural Gambia as the baseline of normality and our own culture as the object of scrutiny. GAMBIA -in Gambia found that women recognize W. contraceptive technologies as able to limit fertility but also serve other purposes (few use them to "limit"; use to space, time, rest, etc) -American too have culturally dissociated contraceptive use from idea of low fertility -discussion focuses on "a theme that emerges strongly in recent American popular media: concerns about the infertility risks of contraceptive, particularly among educated and/or professional women who have been delaying childbearing in greater numbers. Among these women, worries about contraceptives are increasingly expressed as preferences for "natural"--that is, the mildest possible--methods." then, wonders how with such mild methods use, fertility among this group is still so low. -most contra use in Gambia does not occur for stretches of time (more in LAC), but for slivers of time. Women know a lot about the methods available and approach them with a real pragmatism--cannot interpret current users as a group of "bold acceptors" because of these small slivers of time women use them for. -older women in Gambia use contra not to limit still but because fear the consequences of child birth, which they correctly perceive to be worse for high parity births (women in the US fear inability to conceive which would affect early contra choices rather than later ones as in Gambia). Cant call them "limiters" as such. -young women in Gambia try to keep a steady childbearing pace, so fear unexpected delays and are more likely to rely on traditional methods. -rural Gambians dont assume that age and its effects on fecundability pose absolute limits on reproduction, refer instead to something that is more like "reproductive senescence", bodily capacity and varies between women. Decline in capacity to carry and give birth to kids through sequential pregnancies. AMERICAN -American media talked more about the potentials of contra for controlling the timing and circumstances of women's birth (esp first births) than their numbers of births -like women in rural Gambia, American women have the long haul of fertility in mind. Less about maintaining the energy of childbirth than protecting ability to conceive, and where there are questions about this b/c of contra and possible short and long term side effects, women will veer towards more "natural" mild methods -major repro worry in US media is not too many unintended pregnancies but too few -like in Gambia, "limiting" is not the framework in which peopel think about thier fetility; contra described not as limiting or stopping but as means of controlling the timing of one's planned or wanted births until a certain time or stage of life (when presumably she should know how to control her fertility-sey) -middle class americans appear confident that htey will not end up with excess children, so secondary issues become primary around contra -rapid increase in post-coital methods suggests a clue to why sex and even pregnancy can be so dissociated in popular consciousness from births. -from a Glamour article--a condom failure brings up "issues we too often ignore--ambivalence about abortion, lack of trust in partener, a deep fear of AIDS." "B/c few women in either country beleive that they have excessive chilren, they see contraceptives as devices for ensuring the proper tining and curcumstances by "planning their "wanted" children. The characteristics of the techologies that they use for these purposes, however, are critical: especially for women who want more chidlren in the near future, there is a strong preference for methods that are as mild as possible. Indeed, boith American adn Gambian women appear far more worried about infertility than about high fertility." "Perhaps every society perceives the primary utility of contraceptives to be one of gaining tighter control over its existing patterns of reproduction and conjugal life." --may not be perceived as devices to reduce fertility primarily, no matter how analysts interpret the data!