New book examines bias, dissatisfaction with birth control

A UO professor has distilled 10 years of research on birth control and women's experiences surrounding it into a new book that's already sparking conversations across the country.

"Just Get on the Pill: The Uneven Burden of Reproductive Politics," by sociology professor Krystale Littlejohn, was published in August and has been reviewed by Times Literary Supplement and Mashable. Littlejohn discussed the book on NPRA-1A and Jefferson Public Radio, and her op-ed on the book's themes was published in Time magazine.

Littlejohn's work examines the societal pressures for women to be solely responsible for birth control, ranging from unsupportive partners to the importance of access to both birth control and abortion. She contends that preventing pregnancy is something that should be understood as shared between the individuals engaging in sexual activity that could potentially lead to a pregnancy.

Littlejohn's work encompasses the often-overlooked experiences of people who identify as women, gender nonconforming and nonbinary who have used birth control to prevent pregnancy. Those experiences range from the societal pressure for women to be solely responsible for birth control to unsupportive partners and the importance of access to both birth control and abortion.

Littlejohn was part of a research team that conducted 103 interviews with unmarried women, age 20-29, in the San Francisco Bay Area who either had sexual intercourse or experienced a pregnancy. The original research, funded in part by the Elfenworks Foundation, looked at why women who don't necessarily want to get pregnant aren't always using birth control.

Littlejohn said she began to notice a common and overlooked experience in the women's stories.

"I was really compelled by these stories and people's frustrations," she said. "I wanted to give a voice to their experiences and uncover something that I think we take for granted in our society. I saw there was an important story about gender and birth control to tell."

Dissatisfaction with birth control was a common challenge Littlejohn heard from women. That was coupled with the desire to use birth control but having to manage side effects like nausea, headaches and migraines, weight gain, mood changes, and decreased libido.

Hormonal birth control options are thought to be the most effective at preventing unwanted pregnancy, ranging from 91 to 99 percent effective when accounting for user error. But Littlejohn argues that condoms are just as effective at preventing pregnancy when they are used consistently and correctly. However, societal pressure on women and the emphasis on hormonal birth control, accompanied by a lack of attention on dissatisfaction, overshadow condoms as a viable option.

Partner frustration also thwarts women's choices, Littlejohn writes.

People "want their partners to use condoms, but partners don't always respect their wishes," she said. "When people say they're having trouble getting their partner to wear a condom, instead of saying, "That doesn't sound like a person who's really respecting your body," we say, "Just get on the pill," even though hormonal birth control may not be the best option for them and may not be what they want."

Nonconsensual condom removal is a form of sexual violence that Littlejohn says often wasn't discussed as such but rather felt normalized. In her book, she advocates for changing the discourse around nonconsensual condom removal and highlights how that form of violence ties into the importance of access to both prescription contraceptives and abortion.

For some 30 years of their lives, individuals may need or want to prevent pregnancy, Littlejohn said.

"My research shows that even if people have access to prescription birth control, that's not going to be an end-all solution to preventing undesired pregnancy," Littlejohn said. "Paired with a lack of support from partners, access to abortion is necessary in order to support people's reproductive autonomy and help them meet their reproductive goals."

The book focuses on the experience of those who identify as women, but Littlejohn points out that the gendered approach to birth control harms gender nonconforming and nonbinary people. Birth control pills are often discussed as a "woman's method," whereas external condoms are often talked about as a "man's method."

But that approach, she said, creates an unnecessary divide between birth control options while often removing shared responsibility for contraception.

Littlejohn plans to continue incorporating her research on reproductive rights and justice into her class curriculum at the UO.

"It's been really rewarding to see students engage with the material," Littlejohn said. "When the work gets someone to think about the ways they might want to help others change their behaviors to make things more equitable for everyone, that's the best reward."