Six weeks after the birth of my first son in England, my GP asked about my plans for contraception. When I told him I didn’t want a prescription for contraception, he told me to ‘be sure to use a condom’. His bluntness was jarring at best, and certainly didn’t respect my hopes for a growing brood. Here I was, a clearly besotted new mother, promptly being reminded how to prevent another little bundle of joy from entering the world. A bit poorly timed and infantilising, I thought, but I smiled and said nothing.
But the insinuation that I should take precautions to avoid a future pregnancy wasn’t limited to that occasion. At a home visit about ten days postpartum, my health visitor asked if I had given any thought as to what contraception I would use going forwards. She issued a reminder that exclusively breastfeeding won’t prevent pregnancy and advised me to ‘dress for the occasion’ should I choose not to take hormonal contraceptives.
Mothers know the ins and outs of reproduction and aren’t likely to forget in a hurry
This push for contraception post-birth is not unique to England. Having failed to heed my GP’s directive, a few months ago I gave birth to my second son, this time in Ireland. A mere six hours after his birth, a midwife told me that I would be able to ‘sort out a choice of contraception’ at an appointment a few weeks later. I didn’t know if I was experiencing déjà vu or had a bad case of baby brain.
Given that girls spend dozens of hours in school covering relationships education, including the topic of so-called ‘safe sex’, why are GPs and nurses then directed to ask women their plans for contraception so soon after giving birth? It’s not as though mothers are ignorant of how their babies came about.
Do all mothers really need to be asked their contraceptive choices pro forma? I’m a married mother of two in my late twenties. I’ve been blessed with two very straightforward births just under two years apart. I also plan to breastfeed exclusively for a year, which will, in most cases, naturally reduce my chances of getting pregnant for at least six months. Is the prospect of a third child really such a horror?
I understand the abundance of caution if directed towards a mother who’s just had a caesarean or very complicated birth, for whom a little extra spacing between children would minimise subsequent risks. Or even a mother who’s struggling financially and for whom another child would pose great financial strain.
Even so, mothers know the ins and outs of reproduction and aren’t likely to forget in a hurry (especially if their most recent arrival was a little unexpected). Given that a third of births in Britain are unplanned, despite around 70 per cent of women using contraception, a prescription for the pill clearly doesn’t achieve as much as doctors think. Rather than asking women their choice of method for preventing another pregnancy, it would be more appropriate to remind women that there are slightly heightened risks involved in conceiving again soon after birth, add the caveat that some mothers do get pregnant again while breastfeeding, and leave it at that.
I wonder how these conversations play out between young, newly qualified health visitors and mothers over 40. Does the older mother get lectured on so-called ‘safe sex’ by the fresh-faced twenty-something, or is that condescension simply reserved for the younger mums?
Either way, women do not need to endure repeated questions about contraception days after giving birth, as though the conjugal act is a pressing priority for women still experiencing post-birth bleeding and sleeping in two-to-three-hour bursts. And with all due respect, I don’t need to be directed to use condoms by someone I’ve met ten minutes ago, as though I’m a fresher at university sitting through talks designed to minimise the chance of teen pregnancy.
A fertility crisis is threatening the economic and social future of the UK, Ireland, and the rest of the developed world. We might not benefit from pushing women back onto the pill as soon as they’ve had a baby – which assumes pregnancy is a problem to be solved. Against the backdrop of a global birth dearth, maybe women need less, not more, encouragement to use contraception. Without rethinking our approach to contraception, any reversal of current demographic trends is (if you’ll pardon the pun) inconceivable.
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