Planning Paternity: Restricted Birth Control Choices for Men

Life without birth control is almost unimaginable for most in the united states. In fact, birth control has altered American culture and how we interact in heterosexual relationships. In the past, heterosexual couples might save sex for after marriage or once they’ve agreed to stay together long enough to raise a child. Today consensual sex between men and women can come without a major concern for pregnancy and long term commitment. However, even though we have many more freedoms, there are still cracks in the system that leave men vulnerable to unwanted guardianship and forced financial responsibilities. 

The table below compares birth control options for males and females. Due to the physiology of conception and the cyclical nature of female hormones that are essential for fertility/pregnancy, pharmaceutical birth control has been easier to design for women. The market and political demand for female birth control certainly played a role as well. Unfortunately for men, this has left them with two options outside of abstinence and sterilization: condoms and the withdrawal or pull out method. 

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All "effective" rates are retrieved from and are either real life rates or trial rates.

All "effective" rates are retrieved from and are either real life rates or trial rates.

Preventing Pregnancy

Both males and females have good options for pregnancy prevention during sex, but this is where men’s most effective option lies: the condom. In real life, condom use is about 82% effective at preventing pregnancy, and the pull out method is about 73% effective (1). Condom use could be as effective as 98% in perfect conditions, but that’s still one accidental pregnancy every 50 times a man has sex (1). Compare this to the most effective form of female birth control, the IUD, which is 99.9% effective and can last years without worrying about replacing the IUD (2).

In addition to the IUD, females can also choose from implants, shots, patches, pills, and rings. All of these can provide a blanket level of protection that is at least 91% effective (3). I classify these as continuous prevention, a form of prevention that is protective all the time without a need to plan for sex or incorporate protection during sex. This continuous, blanket level of protection does not yet exist for men.

Back Up Plans

Options after conception and after birth do not exist for men either. In the case of an accident, the Plan B pill or emergency contraception is available to females. Additionally, a copper IUD can be inserted up to five days after unprotected sex to prevent pregnancy (2). Finally, for pregnancies past the window for emergency contraception, induced abortion is an option. These options are vital to our human freedoms because accidents happen. Even if a female accidentally forgets to take her birth control pill too many times, she shouldn’t be forced to become a mother. Men have no Plan B when accidents happen which makes this a significant gap when planning parenthood.

Finally, the options after birth. Legal abandonment using Safe Haven programs is always an option when the mother doesn't want the child but what if the father doesn’t want the child? In every state, a woman has time after giving birth to leave their newborn in an approved location anonymously. Time of legal abandonment ranges from 3 days to 1 year after birth although can be difficult to monitor due to the anonymous nature of the abandonment (5). Men have no legal choice to abandon a child after birth. Only by the continual grace of the mother for 18 years can the unwilling fathers choice be honored. 

What if either parent could make the unilateral decision to officially renounce their guardianship and legal responsibilities to a child that they don’t want? In this case, the other parent could become 100% responsible for the child yet still reserve the right to abandon the child within legal restrictions. It’s important to provide men options after birth because some mothers don't inform men of their paternity until after the baby has been born. Lawmakers can design these choices in a way that does not hinder the mother's freedom to keep, abort, or give up the child. 

Although it can be difficult to think of abandoned children, it’s important to acknowledge that these are choices available for women to make autonomously yet no legal equivalent is available to men. If we are to support the freedoms of women then we can not deny reasonably equivalent freedoms to men.

Unreasonable Expectations

With a strong cultural movement for sexual freedoms, it seems unreasonable to expect abstinence, outercourse, and sterilization as reasonable birth control options for anyone, however, these are often brought up when a man finds himself with an unwanted child. Statements like “he should have kept it in his pants” or “if he doesn't want a kid he should get a vasectomy” often come up. These sentiments mean that a man chooses to accept fatherhood every time he has sex unless he gets sterilized. The birth control movement was to free women from the burden of motherhood when they decide to have sex. If fertile, heterosexual men have to abstain from sex to be certain that they don’t have a child, then they’re not much freer than women were before birth control. 

It’s clear that there are gaps in men’s choice about parenthood. The biggest gaps remain in continuous, reversible prevention for men and choices after conception. We have made legal, pharmaceutical, and cultural strides to separate women’s choice about motherhood from their choice about sex. It’s time that we make appropriately mirrored strides for men. 

Up Next

The limitations for men when planning their parenthood are quite impactful. In the next part, Falling Through the Cracks, I’ll provide cases of men who did everything right, but because accidents happen they were held financially responsible for a child they didn’t want. Injurious cases include paternity fraud where non-biological fathers are held financially responsible. Other situations include forced paternity when stolen sperm from a condom is used by a woman to become pregnant and coerced paternity when men are forced to penetrate and held responsible for the pregnancy. Finally, I'll touch on rare cases where the legal system holds boys responsible for the pregnancy after statutory rape by an adult female. These men and boys fall through the cracks and are expected to either abstain from sex, sterilize themselves, or financially support the child they never wanted.



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