Losing (Birth) Control

Navigating Penn’s hookup culture with uncertain reproductive rights


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Photo: / 34th Street

Over Winter Break, Esther Cohen (C'18) was in San Diego with her family when she noticed a black tar–like substance in her underwear. A quick Google search revealed this to be a symptom of early pregnancy. She sat there, staring at the screen, overcome with dread at the decision she might have to face. And then it hit her that it was December 30th—in 20 days, there would be a new President, and the laws protecting her right to choose might begin to disappear.

Esther wasn’t pregnant. What appeared to be symptoms were actually side effects of the new form of long–acting, reversible birth control she had switched to following the election. The Nexplanon protects her eggs from unwanted fertilization by halting ovarian release and causing the development of a thick line of mucus inside her cervix. For the next three years, it will sit beneath the skin in her arm where the Trump administration cannot touch it.

Esther is one of many women to reevaluate her birth control habits. “The day after [the election],” said Penn Women’s Health Nurse Practitioner Joyce McNeill, “we started to see a constant steady stream of women who were concerned about future policy decisions, about insurance coverage and certainly about long acting reversible contraception.”

Esther recalls a time not so long ago when it seemed that women’s reproductive rights were on the brink of a leap forward. She remembers Hillary Clinton’s declaration at the third presidential debate: “I will defend women's rights to make their own healthcare decisions.”

“I just thought, how powerful is it to have a woman on stage saying that? To see a woman, who gets it on a personal level advocating for this kind of policy?” Esther said. “That means so much because it’s never happened like that.”

For Esther, this is what makes the election results so devastating. “The ends at which their policies exist, especially on women’s issues, are so polarized,” she said. “It’s night and day what our country would have looked like.” Esther had hoped for a Supreme Court decision securing her right to an abortion at any stage and access to affordable birth control. Now, a group of men are threatening her right to make a choice that they couldn’t imagine facing—but that the women they govern fear every day.

***

An adequate understanding about the importance of contraception is lacking not only among men in the White House, but also among men on Penn’s campus. Many female students interviewed for this article reported that their partners assume they have taken care of birth control in advance of sexual encounters.

Sara Cerreta (N'18) believes that the feminist movement, necessary though it is, inadvertently fuels this assumption. “I feel like men probably feel like they can take a step back,” she said, “thinking all these women are so independent and they’re so in control of their bodies.”

But failing to take responsibility for contraception is dangerous. Some women cannot take a daily contraceptive due to negative side effects—Liz Flick (C'18) and Breanna (C'18) (who asked that only her first name be used) experienced rapid weight gain and crippling nausea, respectively. Others, like Allison* (C'18), can and do take birth control—but the effectiveness of the method depends on the precision and consistency with which it is used. For the past eight years, Allison’s phone has vibrated at 5 p.m. every day. It’s a reminder that she must stop what she’s doing and take a pill, buying herself another 24 hours of control over her cramps, acne and chances of conceiving a child.

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“All I have to do is go buy a box [of condoms],” said Ben Pollack (C'18), who feels guilty when his female friends talk about the pill. “If a girl has a guy over and she forgot her pill, she can’t just run over to her friends and be like ‘do you have one?’”

“It definitely controls my life in that way sometimes,” said Allison. “It is kind of a burden to have to think about it every day. Just missing it for a couple days can really screw you over.”

Allison knows this firsthand. She remembers the terror she felt before finals season her sophomore year, when she realized she had missed a few pills and neglected to ask her partner to use a condom the previous night. She knew she had to take Plan B no matter the side effects, which, for her, were a night of vomiting and extreme abdominal pain. She also knew she couldn’t tell her partner.

“I just didn’t want him to think I was irresponsible,” she said. “I was on this ticking time bomb, you know, you only have a certain number of hours to take Plan B for it to be totally effective. So I just thought I’d rather be safe than sorry, buy it myself, take it myself and not tell him.”

Looking back, she resents the feeling of shame that prevented her from notifying him of their mutual mistake.

“We [as women] have to hide our bodily functions,” she said. “We have to hide the fact that we could possibly get pregnant. We have to hide our periods every month. It’s crazy to me that we have to hide what our body naturally does so that men are more comfortable with us.”

A year later, he still doesn’t know.

***

Although the Affordable Care Act protects women's access to preventative methods, emergency contraception and abortions, it cannot shield them from the fear of an unwanted pregnancy.

“It’s the most terrifying thing in the world,” said Esther.

“People don’t realize that if it happens, it doesn’t matter how liberal you are,” said Liz, who had an Intrauterine Device (IUD) implanted because of the election results. “I don’t think abortion is bad, but if this ever were to happen to me there would be this underlying moral thing in my head that I wouldn’t quite know how to grapple with.”

For women, this fear is distracting, universal and relentless. “We have to constantly think in the back of our minds, when was my last period?” said Esther. “Am I pregnant? Could I be pregnant? Should I take a test? Should I go to the doctor? Men have never had to worry about that in their lives.”

“Every girl who’s had sex has had a pregnancy scare,” she said. “Every. Single. One.”

Given the daily and emergency precautions—both physical and emotional—that women undergo to prevent pregnancy, it’s no surprise that many navigating Penn’s hookup culture find it frustrating and confusing when men are reluctant to use condoms.

“There’s generally a push among dudes to not use condoms because it’s cool to go raw,” said one male student, a junior in the College. “And it feels better.”

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“You put yourself in these situations where this person doesn’t care about you at all and you don’t care about them at all,” said Breanna. “But then you know that you’re the one taking on all the risk. I guess it’s like a power dynamic where you see the risk in something and they just don’t see it.”

Not using condoms is dangerous because condoms are the only form of contraception proven to prevent disease transmission effectively

“It doesn’t make sense to me when you’re randomly hooking up with someone and they don’t want to use a condom,” said Breanna. “Why would you trust me? With STDs and birth control, you’re putting a lot of trust in someone you met like 20 minutes ago when you were really drunk.”

“The burden really falls on the girl to prevent herself from getting pregnant [and] to prevent herself from getting STDs,” said Allison. “With men being also the carriers of these things, it’s hard when one side won’t cooperate.”

She notes that Penn students are, given the time and money they invest in their professional futures, generally responsible and forward–thinking. “You’d think that would extend to being safe sexually,” she said. “But it’s not the case.”

Penn students “play Russian roulette” with STDs, Allison observed. “We really just hope that the other is smart enough to be safe with their other partners and we worry about it the next day.”

Given her experience with contraception, Allison finds it insulting when men treat Plan B “like a magic candy pill” and condoms like a disappointment. But they do, and some women feel forced to choose between satisfying their partner and feeling safe.

“You just feel bad because you want to be fun and carefree,” said Breanna. “But sex is just a little more serious than that. You’re like, I guess you expected this of me. And I can’t live up to that expectation.”

***

In such situations, some men resort to deception. Liz remembers one hazy night in which she discovered that—despite her repeated requests that he do so and his repeated affirmation that he already had—her partner had failed to put on a condom. Breanna had a similar experience in which she received a text the following morning expressing a hope that she was on the pill. She wasn’t.

“Why are you just mentioning this now?” she recalled thinking. “This would have been much more helpful four hours ago.”

“It just puts you in this situation where you feel awkward and helpless and you don’t have control over your body,” Breanna said. She didn’t feel comfortable asking for her partner to pay a share of the $49.99 emergency contraception she bought from CVS.

“After that happens it’s really hard to go back and be like, hey, that wasn’t ok,” she said. “Because they’ll be like, ‘Well, why didn’t you say something in the moment?’”

The word “consent” is rarely used in the context of contraception, but some students view the two as indelibly linked.

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“A lot of times it gets completely overlooked, but asking if you want to use a condom is a huge part of consent,” said Breanna, citing a case in Switzerland in which a man was convicted of rape for failing to comply with a woman’s contraceptive preferences.

“[Consent is] not just about yes or no and an action,” said Ben. “It’s about how and when.” For him, pressuring, deceiving or coercing women into sex without a condom is a violation. “It’s manipulating. It’s taking advantage. It’s all the things that you have to look for when asking for consent.”

Penn Women’s Health views helping women to negotiate for condom use as an essential part of their work. “Part of what we talk about in this office is women’s self–worth and feeling worthy of being able to protect themselves,” said McNeill. She believes that, when women provide the condom themselves, they can often prevent awkwardness or uncertainty in the interaction.

“My standard line with women is that life’s too short for bad sex. And worried sex is bad sex,” said McNeill. Using a condom every time removes that worry. “You can have great, worry–free sex and enjoy it. That’s what it’s all about anyway.”

***

Most Penn students remain in a privileged position. At a school where 71 percent of students come from families in the 80th percentile for income, most are insulated from the potential effects of policy change. When Esther told her father, an oncologist, about her plans to get a Nexplanon, he assured her that she didn’t have to rush; he would cover it later should her insurance fail to. “But I’m not worried about me,” she said.

She’s worried about women whose parents are not doctors—women like Anea Moore (C'19). A first generation student from a low–income family, Anea has no one to depend on financially. Following the death of both her parents in 2015, Anea has had to work three jobs in addition to her full course load. She cannot risk gaining a dependent. She is not currently interested in hookup culture, but she laments that her participation is, realistically, no longer an option. “I just want the freedom to decide,” she said. “Right now it doesn’t feel like I have any freedom.” 

As a first generation college student, she wants “all social, academic, and other parts of college” to be open to her. “It just really sucks that someone like Trump is undermining what my mother and my father worked so hard for all of their lives,” she said.

Nonetheless, for most Penn students, resistance to these policies is born not of practical personal fear, but of fundamental moral outrage.

“It’s not that I can’t pay for the co–pay of birth control,” said Sara, who had an IUD implanted following the election. “It’s that I feel like I shouldn’t have to.”

Esther speaks for many women when she says that she is proud of her choice to arm herself against unplanned pregnancy and crippling medical bills. But as much as she appreciates the security, she resents the context in which the decision was made.

“It’s ridiculous that I have to make this choice,” she said. “In a way, I’m not even really being given a choice.”

*Name has been changed.

This article has been amended to reflect anonymity


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