This week’s readings begin our discussion of contraception. Please post your comments to the reading(s) here. Remember that I am interested in learning how you relate what you are reading about to experiences you have had, to other ways you have learned about contraception in the past, and then to your reactions to the readings. You do not need to respond to all of the readings–I am more interested in your conducting an in-depth analysis or writing an elaborate commentary on something that struck you in the reading, than in your being able to review all of the themes from the readings.
Growing up in a white upper-middle class town, many of my friends were uncomfortable talking about birth control with their parents or knew it would be strictly forbidden if they asked for their parents input. Instead, they took their birth control into their own hands and had the resources to obtain it themselves without involving their parents.
Their choice of birth control was based on how well it could be hidden from their parents. So that made condoms and the Pill out of the question because it entailed hidden pill packages, prescriptions as well as pamphlets that described the correct usage – all of which could be found by parents and used as proof that they had acquired the “forbidden” birth control. A few chose Depo-Provera that they could have administered by a doctor at a clinic every three months. Friends and boyfriends offered them rides if they couldn’t drive themselves. Most others, opted for Nuvaring because they only had to insert it monthly and could quickly discard the packaging.
What infuriates me most about teenagers using birth control is their parents and society’s view that birth control and sex are unacceptable practices that only throw young women further into immoral lifestyles. They believe that birth control will cause teens to have sex that they wouldn’t if they weren’t on birth control and that female teens aren’t mature enough to make decisions about their bodies.
The young women who do illustrate this belief, are most likely victims of the same puritanical philosophy that doesn’t educate them in matters of sexual responsibility and that sex is a natural act, nothing to be ashamed of. This collision of repressed sexuality and inadequate information puts teens in the most danger of STIs, HIV/AIDS and unintended pregnancy.
Society in general, underestimate its teenagers when if properly educated and not made to feel punished for their need for relationships, I think our nation would be surprised by lower STI , HIV/AIDS, and pregnancy rates. Not to mention more mature, respectful teenagers and young adults.
Another aspect I want to address is the lack of education for bisexual, homosexual and intersexed individuals that don’t beleive they can acquire STIs from their partners. There is such a emphasis on the prevention of pregnancy for heterosexuals also apparent from the many methods of birth control yet with only the condom and dental dam offering some protection against STIs. I hope that sexual education is adopted in all high schools (even though it should be already) and to make it more gender and sexual orientation friendly. I know this is a challenge considering the only governmental assistance for sex ed programs is confined to abstinence only and there is still widespread intolerance to any non-hetero person. However, I hope in the next few years, with a new (hopefully democratic president) and enlightened generation, we can offer more protection for and acceptance of teens that choose to be sexually active.
“The Social Life of Emergency Contraception in the United States”
As someone who worked as a reproductive health counselor at a family planning clinic, I have had much first hand experience with the reasons women state for the use of emergency contraception. My personal opinion combined with my experience resonates with the David Grimes’ statement that’ expanding access to ECP’s could decrease morbidity rates associated with pregnancy as well as reduce abortion rates and provide “peace of mind†for the women taking them’. I am impressed with Grime’s willingness to address the subject of how women experience the fear of unintended pregnancies.
I was working as a counselor when Plan B switched from Rx to OTC. I do not believe Plan B going over the counter increased the incidences of women agreeing to unprotected sex. I also do not believe it resulted in promiscuity or irresponsible decision making on the part of men or women. In my experience I saw first hand that it provided a sense of relief for men and women who had their contraceptive methods fail. It provided an opportunity for women who had been the victims of sexual assault and rape the ability to GREATLY reduce the chance of pregnancy because of being the victim of a horrible crime. It provided women in abusive relationship, perhaps whose partners would not allow them to use birth control with another option. It provided women with a greatly reduced chance of having to decide whether to terminate an unplanned pregnancy.
This also relates to the opinion that if ECP’s were to go over the counter there would be “an epidemic of sexually transmitted†infections. The idea that ECP’s would encourage more unprotected sex, an increase in promiscuity lead by adolescent playboys, and an increase in the ability for sexual predators to engage in incest, rape and molestation of children and eliminate the fear of unintended pregnancy as proof of their crimes. In my opinion this logic posits that we should put the possible use of a medication to the test of whether or not criminals will benefit over whether or not women and their partners will benefit and have more control over major decisions, such as pregnancy, in their lives. The idea that we would subject something that could be so beneficial for so many women to a test of potential criminal behavior is, in my mind, a way of oppressing and discriminating against women. A further insult to women is the idea that the only thing controlling our ability to decide when, with whom and in what manner we have sex is the threat of pregnancy and ECP’s would cause us to become complete “slaves to our bodies†and that the need for ECP results from women not knowing when to “say no†and when to “say yes†to sex.
As I read this article and reflected on my experiences as a counselor and as a woman I realized how fortunate we are to have access to Plan B. Because Plan B is meant to prevent pregnancy (as it is medically defined) it allows women to make decisions about the option of pregnancy immediately after an incidence that could result in pregnancy. I feel that having as much control as possible over reproduction is a major factor in our ability to control our lives. Reproduction can be used as a means of controlling women and as long as we live with the chance that women are being controlled by reproduction that is not of their choice, having unhindered access to medical technologies like ECP’s is essential. In addition to this, when we live with a political administration which undermines true sexual health education and does everything in it’s power to restrict access to contraception and abortion, we need to fight to maintain access to as many contraceptive options and alternatives to pregnancy as possible. It is irresponsible to not educate young adults about responsible, safe sexual behavior and pregnancy prevention and then provide them with no options if their ignorance results in unsafe behavior. This is not to say that all women who seek ECP’s do so because of ignorance or controlling relationships. Accidents happen, contraceptive methods fail, and people are human.
Ultimately, despite the scientific argument that conception occurs at implantation versus the moral arguments that conception occurs at fertilization, I believe the decision whether or not to use ECP’s lies with those who bear the responsibility of pregnancy – women.
Through my own experiences and reading the articles, I have to agree with AutumnRocks. Being a scared teenager in a white-upper class community really laid a lot of pressure on teenage girls. Girls my age would be scared to talk to their parents about contraception and therefore use the most accesible choice. I cannot even begin to think about how tough it must be for minority teenagers and women to find a good contraception choice for them.
In, Contraception in Context, I really agreed with the article stating how contraceptives are used for stopping over-population in minority communities, and how reproduction is viewed negatively. It seems that other countries have such a better view on the beautiful process of reproduction than the United States does. In other countries children produce money, while in the United States children are viewed as a huge expense. It is apparent when you hear women and men talking about how many children they want. They take into account every type of expense and every little detail. I believe child birth is becoming such an unnatural completely planned event, and the blame is on the government, pharamaceutical companies, and doctors.
Another article that really caught my attention was The Social Life of Emergency Contraception in the United States. It takes me back once again to my high school days. I remember a friend of mine trying to get the Plan B pill and how much of a hassel it was. She did not have alot of money because she was only working a few hours a week, and did not want her parents to find out about her trying to get it. I ended up letting her borrow the money and I was with her while she called her doctor. Her doctor was a little weary at first, but eventually prescribed it too her. The next time she went to her doctor, she got a lecture for a half an hour about contraceptives! It is embarrasing to talk to ANYONE about that, never mind an adult. Clearly, it should be discussed to patients but how awkward it must be when your doctor KNOWS you have had sexual intercourse, and your sixteen. I am sure this happens to many girls everyday, and if we could allow that dismiss of awkwardness I think that would really help out. Also, I do not think having Plan B be over the counter would cause sex wildly across teenagers and women. I just think it would make things easier if they did need to use it.
All these other articles discussed different contraceptions and the racial differences that go along with them. I do believe that poorer minorities are influenced by cheaper and maybe more harmful drugs. However, I believe that it is hard for doctors to prescribe medications to lower class people that do not have insurance when the doctors know how expensive these contraceptions can be. I believe it is sort of a double-edged sword in a way. We want doctors to give everyone fair contraception but it is hard when doctors know peoples limitations. What the United States needs to do to protect women’s reprodcutive rights is to allow every women over the age of sixteen insurance for contraception, any type they want. This would only be fair since pregnant women get completely free insurance. Obviously, this would take a lot of money that the government does not want to spend. However, from my personal experiences I think this would solve the contraception and unplanned pregnancy debate.
Hubbard and Gillespie discuss the issue of population control with a refreshingly culturally relative view. It was surprising, as I am sure that is was for others, to know that the most densely populated nations per square mile were West Germany, GB, and the Netherlands- more than India per square mile! They attribute this to unequal distribution of resources, something that had never crossed my mind, but is excruciatingly obvious. The fact that the people who are most concerned with the issue of overpopulation are the “haves†, not the “have nots†and it is most of the “have nots†who are the ones who are most impacted by this deficit of resources. This clearly stems from a Western perspective that it is the third world populations that will ultimately overwhelm the world and put more pressure on our natural resources, but in fact we are the most wasteful and therefore we should be monitoring our reproduction if anyone! They go on to discuss the risks and benefits of contraceptive methods in a unbiased manner. They discuss the ramifications of legalizing and selling new products such as RU 486 as well as the benefits, specifically giving women much more power over their lives. Hubbard et. al go on to basically say that barrier methods along with spermicides, when used correctly are around 98% effective . They don’t have a real risk of complications, and they protect against STIs, and therefore should be considered the safest method. I have never personally read or seen any available information about the possibilities of male birth control methods, and am very happy that this article addresses males as partly responsible for the issue of birth control.
The other article of interest involved an in depth look at the controversy surrounding Depo Provera by Oliver and Dukhanova. It begins by listing the numerous side effects that to me, would outweigh the benefits of taking it, considering there are many other contraceptives on the market. Though its rate of effectiveness is impressively high, more than 70% of woman discontinued its use after one year, or 4 injections at 3 month intervals. A frightening issue they brought up as well was the fact that, for reasons unknown, users of Depo are at a higher risk for contracting STIs and increases the rate of progression of the HIV virus. When this fact was brought up to Pfizer, they claimed that it needs to be used with a condom. If a birth control is over 99% effective, and one is in a monogamous relationship and likes to think her partner is faithful as well, the motivation to use condoms in addition to this method is almost none. The author also discusses the effects of promoting this birth control and relates it to disparities in the health care system, as well as between third world countries and industrialized ones.
The third article by Megan Greenberg also addresses disparities in the healthcare system, particularly “women of colorâ€. Though Implanon itself was not mentioned in the above articles, the affects of a continuous flow of progestin though the implantations of devices were. She goes on to discuss an absurdly racist article that wanted to mandate that women on welfare be given Norplant. The author described them as more fertile, and therefore were a “risk†group. Greenberg talks about the pharmaceutical industry among other agencies that seek a “one shot deal†of sorts to basically temporarily sterilize women without concern to the very real risks of serious side effects. She concludes with the thought that among a lot of the issues surrounding women’s health issues, more research needs to be conducted to create a better variety of birth control, as Implanon does not look promising. She also expresses a need for a better understanding of women’s needs and rights.
A theme that I would like to discuss after analyzing the readings is exploitation. In regards to the reading that dealt with the use of quinacrine sterlization, it is evident that women are being placed in a position of desperation and are in turn exploited on many different levels. Not only are many of these women who use this form of sterilization uneducated about the longterm effects, but women are unethically being experimented on.
This theme of exploitation can be seen throughout numerous cultures and it is unfortunate that women tend to be the victims. However, in order to end this cycle, women need to be educated about all of the options they have, as well as the effects that some methods of birth control might have. In order to put health back into the hands of the individual, it is essential that women have adequate information provided to them.
Another question that came to mind is why women are the one’s who typically use birth control, when men could just as easily do the same. Since women have the ability to give birth, it seems that messing with our cycles could potentially do more harm in the long run. Also, women already have to deal with flucuating hormones every month, but by taking birth control, we are altering the chemical balance of our bodies even more. Personally, my experiences with birth control have included increased mood swings, more intense PMS, and severe cramps and what I don’t understand is why women are the one’s who have to take on all of the responsibility for preventing birth, when men are equally responsible.
Could you elaborate more about the theme of exploitation that you saw through the readings this week? How could you trace this theme across readings on Depo-Provera, Norplant, and the IUD? What do you mean by exploitation?
After reading this weeks articles, I was surprised to learn of new and unsafe contraceptive methods being designed for women of poorer backgrounds or different ethnicities. Implanon, for example, is a rod which is implanted into a woman’s upper arm. This is supposed to be an easy or “ideal” solution for those who cannot be bothered with the responsibily of other known methods, which is targeted to “poor women and women of color”. The long term and side effects of this new method are unknown, yet it is being given to these specific women as a type of population control. Implanon lasts 3 years, which then inhibits a woman from being able to have a child until that runs out, even if she wants to. Or, she can choose to have it removed, which could be another issue for women on welfare without health coverage. The issue with implanon to me seems more of a racial and stereotypical issue than it does an issue of controlling population size.
Depo-Provera is also a major health concern as of lately. Recently receiving the “black box” warning from the FDA, this contraceptive has been found to lead to bone loss and osteoperosis. This method is injected, and as well as Implanon, designed to be ideal to those who cannot keep up with other contraceptives. Studies have shown links between Depo-Provera and HIV risks, but according to some, women in poor countries such as Kenya, have more to lose from unwanted pregnancies. This disreguard for health concerns seems awful to me, but no one is going to stop giving it to these poor women because it is seen as not one of their biggest worries.
In India methods such as Quinacrine sterilization is also inhumane. There are many many health concerns and side effects, as well as it stops fertility forever. This method is still being given to women, despite the ban placed on it from the supreme court. This contraceptive is not only harmful, its also unethical and illegal. Yet no one is stopping it.
Lastly, I found it interesting to read in “Contraception in Context”, the idea that children are mere commodities. They are viewed in terms of expenses, and are only to be had if they can be afforded. Those who “cannot afford” their children, are looked down upon and seen as irresponsible. Children in the United States also sometimes are seen as ways to gain social recognition, gain love, and boost parents own self esteem. As some women are taking risky and dangerous new birth control methods, other women are having children as accessories.
As a public health major, and a woman interested in my own health, I have gathered a great body of personal knowledge about methods of birth control over the years. Therefore, much of the information in these articles was not new to me. However, one sentence in the article “Contraceptive Methods: Do Hispanic Adolescents and Their Family Planning Care Providers Think about Contraceptive Methods the Same Way?” truly got my thinking in a new way.
The two most commonly used forms of contraceptive are oral contraceptive and male condoms. Oral contraceptives are great because they allow women to be in complete control of the prevention of pregnancy. However, these pills are often expensive, difficult to get, and require regular visits with a health care provider. In addition to the fact they are to be ingested daily, these are all deterrents to their success, especially when considering poor minority groups of women. They also do not protect against STI’s.
Male condoms are good because they supply reliable protection against STI’s in addition pregnancy. However, they are only effective if used correctly and stored in proper conditions, which is again a deterrent to their success when considering the particular group discussed. Also, they are slightly more problematic because they traditionally place the responsibility and control of birth control to the male partner, and he may or may not be as committed to the female’s health and well-being as she is. This, is not news to me. The distinction that surprised me was how Hispanic women perceive the different methods.
Coming from a strict Irish Catholic background I have always been taught abstinence as the only form of sexual health education. Therefore, I was told to refrain from sex before marriage, maintain only one sexual partner in my lifetime, and that sexual activity was only for procreation. Many Christian-Hispanic cultures also follow many of these ideals as well. However, if as a Catholic I choose to engage in pre-marital sex, and use a method of birth control, there does not seem to be any preference as to which one I would choose from a cultural perspective. Interestingly enough, preference seems to exist in the Hispanic culture. In the article previously mentioned, it stated: “Hispanic women prefer coitus independent methods… to coitus dependent methods… This has often been attributed to cultural ideas about female sexual modesty which results in a reluctance of women to touch their own genitals as well as the association between condoms and extra-marital or illicit sex.”. This was a completely new perspective to me, and got me thinking of how this type of thinking makes it even more difficult for Hispanic women to protect themselves.
Because the most preferred form of protection seems to be those that can be applied behind closed doors, it also suggests that there is a lack of communication between sexual partners in these types of situations. Also, when the burden of protection against pregnancy falls completely to the woman, it makes it incredibly difficult for her to protect herself, especially from a financial perspective. This difficulty will only increase with additional pregnancies as trying to support the children she already has will most likely take priority over preventing future pregnancies.
Another huge problem I see with this, is that if a sexually active un-married woman would like to take initiative to protect herself against STI’s and suggests that her partner wear a condom, she will be labeled a whore. Now for ANY woman there are unnumerable double standards sexually, (He’s a stud and gets high fives, shes a slut who gets shunned by her peers etc, but it never occurred to me that simply asking your partner to be safe could earn you a derogatory label. While this article was mainly concerned with teen pregnancy, I think it also raised many points about issues surrounding over-all sexual health, particularly surrounding sexually transmitted diseases and infections.
I would like to start of by saying that I agree with what AutumnRocks wrote about. I was too going to start off my blog by mentioning that I grew up in an upper-middle class, white, small suburb of Boston. Where I grew up had a huge impact on my knowledge surrounding contraception. I can pretty much say that the knowledge I have of contraceptives basically came from college. In high school we had health class, and while we did not have an abstinence only education we didn’t really learn about much else. The only forms of birth control I knew about coming into college 3 years ago were the pill and condoms. As AutumnRocks says in a town such as the one I grew up in talking about birth control with your parents is very uncommon. I like to believe that I have pretty liberal parents for the most part, however, I could never have talked about birth control with them in high school. Heck, I probably still couldn’t talk to them about it inregards to myself. My parents may be liberal, but they are still traditional in many ways and they place stereotypes on things like birth control. Birth control is associated with immoral decisions and promiscuity. Parents of high school students do not want to believe that their children (most girls) are old enough to be exploring there sexuality. However, the majority of them are, without their parents being aware of it. I believe that knowledge is power. Again, as AutumnRocks said, their should be much more government funding for sex education in this country. Teaching all young adults about the possibilities, the differences, and the health risks surrounding sex and birth control would put this country in a better place.
Providing education for all young women in men in the country gives them the possibility of choice, a reproductive right that I believe everyone should have. In “Implanon: A New and Improved Bullet?” the author talks about reproductive rights as well as choice. I think that choice must be extended to include knowledge because without the education about all types of contraceptives women (and men) would not have the ability to make an informed decision. Reading this article, as well as “Contraception in Context” and “Depo Provera: Old Concerns, new risks” I got very angered with the way forms of birth control are being presented to the public. Going along with this idea of knowledge being power I think that we have to look at the inequalities in this country and examine the way that all races and socioeconomic classes are being educated. It does no good to only educate those who can afford a good, private education. What about women and men of color and/or of low class status and the education that they are receiving concerning their reproductive rights?
I am appauled that women can be treated medically without being given any knowledge about the treatment that they are receiving. The fact that doctors and clinics have and can get around this idea of informed concent during this century just makes me sick. A few years ago I watched a documentary that included interviews of women of color and poor women who had been given the Norplant treatment. These women were unaware of any side effects that went along with the contraceptive as well as the possibility of it getting stuck in their arms. These women went on to tell their stories and how badly they were effected by Norplant. The majority of the women know little to nothing about Norplant before they received it and said that if they had known what they learned afterwards they would have never agreed to have implant. My heart goes out to women around the world that this has happened to with any contraceptive or form of steralization. I think that it is very sad that doctors and clinics think it is ok to impliment population control on targeted groups. I do not understand how we could treat fellow Americans in this way, or any woman around the world. There must be some other way that we can deal with the problem of over population and lack of resources. A way that does not harm the women of the world.
This week’s assigned readings were all tremendously interesting and engaging. The article I enjoyed reading the most was “The Social Life of Emergency Contraception in the United Statesâ€. It was very fascinating to read about people’s thoughts and opinions on whether or not emergency contraceptive pills should be sold over the counter without a prescription.
As a female in support of ECP’s being sold over the counter, I was quite frankly insulted at some of the arguments made by opposing organizations who believe that ECP’s should only be available by doctor’s prescriptions or not available at all. Many opposing counselors brought up the arguments that ECP access would lead to irresponsible repeat use and were based on the assumptions that young women are not capable of making informed decisions about sex, contraception, and pregnancy. I know of many educated, informed, and competent young women who were practicing safe sex when an unfortunate incident occurred such as the condom breaking during intercourse and ECP was used as an alternative method of contraception. I find these comments to be so offensive because this statement generalizes all women, single, young, married, and old as being too ignorant to make informed decisions about their own health and well being. Instead these organizations want that decision to be made by a doctor or by the government.
A common theme that I found within each article was how women, especially women of color and at lower socioeconomic levels, were treated as scientific experiments. With the sterilization in India taking place, and the government pushing Norplant implantation in women who go to community health clinics it sickened me to see how the government uses and abuses patients who are not as educated or as privileged as others. It was devastating to read about the deaths and hardships for the women who were using the Dalkon Shield under false pretenses that this was an excellent form of contraception, when in reality it was reeking havoc and damaging their precious reproductive organs and in some cases killing these women.
From reading these articles concerning topics from past use of contraceptives, to the contraceptive use around the world I have come to the conclusion that America must strive to inform women of all their different options of birth control methods. Women must not be test subjects used to experiment new devices and forms of birth control. These methods and forms of practice is unethical and extremely dangerous based on the fact that these contraceptives can cause these women hardships and the possibility to never conceive a child when they are ready to be a parent. We have no right to damage or take away the right of a woman to reproduce and we must inform women of all possible side effects that any contraceptive method might have on their bodies.
A passage that really struck home with me was on pg 270 of Devices and Desires: A History of Contraceptives in America. It is a passage speaking of IUD insertions in Hong Kong, a doctor describes his awe with another doctor, “The best IUD manipulator I have ever observed was in Hong Kong…Her record was seventy-five insertions in three hours..that is one every two minutes and twenty four seconds. Dr.Wong kept three nurses busy helping her. One was supervising the removal of the panties of the next patient, the second nurse soothed the brow of the patient on the table and the third passed instruments to Dr. Wong.”. This quote in the reading reminds me of doctors making women’s bodies into an assembly line. It is sickening! It is all about making money quickly and not thinking about the patient. People want doctors/nurses who take the time to make them feel comfortable. Just spending a couple more minutes can really help a patient form a relationship with their practitioner. I had an unfortunate experience at a gynocological exam where a the doctor spoke very sharp and quick, and didn’t make me feel comfortable because she rushed the whole thing. It was like talking to my grandmother about my vagina, it was short quick and to the point and in some way felt wrong. I later went to other practitioners who actually had a nice conversation with me and made me feel comfortable. That is how a patient to practitioner relationship should be.
In elementary school my sex-ed class consisted of separating the boys and the girls and the female teacher told us about how she postponed intimacy until her marriage and how great that was for her, how our bodies would change and that we shouldn’t make fun of our male classmates if they ever got boners in the hallway. There were diagrams and pamphlets handed out. The boys were versed in something similar and when we left our respective sessions, we just looked at each other sheepishly, like we knew too much about them and they about us. It was a religious school, no talk of sex before marriage, contraceptives, orgasms, consent. Nothing. And that’s the culture that I grew up in: Don’t talk about it, be ashamed, sex is very very wrong. Luckily, I transferred a school that was more open minded and we had actual sex-ed which was super informative and lovely but a little too late for a lot of people. My parents never acknowledged sex outside of marriage, which lead to me getting all my information for the sex-ed class. So even if I wanted to go on the pill, I wouldn’t have been able to due to lack of resources available to me. All the information and knowledge I gained, came from the teachers. So, it’s very important to teach sex-ed for obvious reasons, but it’s also important for industries to be upfront about side effects of their products, because their word is often the only thing which can be relied upon.
While reading “Searching for Something Betterâ€, it was interesting to me that when the IUD first came out on the market is was viewed as very revolutionary, an emancipating product for women to use because of the ease, the lack of hormones , the availability, I’m assuming sexually liberating as well and what not. Yet, when the manufacturing company was trying to save face in the scandal, they blamed the deaths, infections and the pain on the sexual promiscuity of the women. Birth control, the way I see it is very interesting because it has the opportunity to free, to liberate as well as to suppress and to harm.
I’ve heard people argue that the pill is one of the greatest inventions of the century because it put birth control in the hands of women, thus liberating them sexually. While I feel this argument has a little bit of truth, when hasn’t the burden of birth control fallen upon the women? When America talks about making girls get the HPV vaccine, we’re ignoring the fact girls don’t magically get HPV all by themselves. There are boys in this equation (also boys with boys and girls with girls). While detecting HPV in men is more difficult, men are mostly the carriers of said STD ( and STD’s in general).
Medicalization of sexuality may not be that fantastic of a thing,. I think putting all one’s faith in this system of medicalized contraception is a little terrifying. Reading details on the IUD made me realize how much of an industry our bodies are, and when capitalism comes into play, people are disregarded for profit. How do we know the pill won’t have really bad side effects 50 years down the road? Because here we are, adding extra hormones to our body. Everything is connected and it worries me that women and people in general are turning over their bodies to the same companies that exploited them. In “Contraception in Contextâ€, methods for male centered birth control were discussed. The article said that hormonal birth control for men “lowers men’s libido and cause impotenceâ€. But, there have been many cases of women losing their sex drive after going on the pill, as the article reiterates. But impotence? Wow, you’ll have travel getting an erection… that must be really tough, compared to all those women who have died and thousands who have been harmed for the rest of their life.
This week’s articles were eye-opening for me because I never knew there was so much controversy surrounding Depo-Provera and Implanon, and I never even questioned the idea that certain types of contraception are geared towards certain populations, which is probably naive of me. I found it a little disturbing to read that medical professionals push certain forms of birth control, such as Depo-Provera, as a means of population control. I believe that if the women receiving Depo-Provera knew all of the health risks associated with it they would definitely think twice about their choice of contraception.
From the readings it seems that mainly low-income and minority populations are the ones who are really encouraged to use these possibly unsafe birth control measures, while White women are given an array of different options to choose from. I find it very unfair that women of certain ethnic backgrounds are targeted more than others to use unsafe birth control just as a means to control the population. Health care professionals should give detailed information about the possible side effects of Depo-Provera and Implanon to women who are interested because I guarantee many would change their minds if they knew the real facts! When I was 15 a friend of mine got pregnant and underwent an abortion and was then put on Depo-Provera. I think her parents chose this method for her because she was young (15) and would not have the responsibility of taking a pill every single day and it seemed like an easy contraceptive method. If her parents had known about the side effects of this shot and were given other options they most likely would have chosen something else because the side effects are quite scary!
One thing that really bothers me about our society is that birth control is solely the burden of women. In all my health classes, male birth control is hardly ever mentioned and never encouraged. Although it is newly developed, male BC should definitely be taught to students because women should not be the only ones to have to worry about contraception. We have to deal with all the unpleasant side effects, the costs, and obtaining it every month while men do nothing. It also bothers me that men think if a woman is on birth control then no other means of contraception, such as a condom, are needed. I don’t know if this is because they don’t know that BC doesn’t protect you against STIs or if they are just ignorant. Either way, I hope that someday male BC is just as common as female BC because this responsibility should be shared equally between two partners.
One of the articles discusses the controversy surrounding Plan B, and I feel that Plan B is an effective option to stop a possible unwanted pregnancy. I do not look at Plan B as abortion, nor do I think that having Plan B available over the counter is going to increase the amount of unprotected sex or the abuse of this drug. I think this drug can be especially effective in situations such as rapes and sexual abuse because all women who experience these horrible events should have options to deal with these issues. I have taken Plan B once myself, and although I was most likely not pregnant at the time, this drug helped to ease my mind. I took it because I had forgotten to take a few pills on time during the month and I just wanted to be completely sure that I did not get pregnant. I am not an irresponsible person nor do I have casual sex, and Plan B just helped to clear my mind and end my overwhelming anxiety. In no way do I see Plan B as a constant form of birth control, but rather as an option to use only in emergencies.
The article that surprised me the most was the use of quinacrine as a form of birth control or sterilization. I had never heard of this type of sterilization, and many women in India are unknowingly receiving it. It is absurd that the majority of the women the quinacrine are not aware of its side affects and permanent consequences. Methods of birth control are highly debated in our country but looking at the bigger picture makes me realize that the worries and arguments taking place in the U.S. look measly compared to what takes place in other countries. I feel bad that the women are not given the respect and decision making over their bodies but instead the nation is deciding how to control the population.
Some cultures accept pregnancy as a blessing. Reading about the tribe from South Africa intrigued me, having a child every four years and the natural way of the woman’s body being regulated. Our society is too industrialized and women don’t want to devote their lives to constantly tending to a child. Thinking about it, having an abundance of children can be somewhat looked down on because it is seen in our country that children need a lot of caring, and not enough can be given with a big family.
I think it is a shame that sex, birth control, and pregnancy/birth are taboo in our country. Along with some of the other entries, my parents never talked about birth control or sex, they just assumed that I would never take place in such actions. School was somewhat helpful but the subject was also sensitive. My middle class dominantly white town taught us about condoms but that was the only means of birth control I can remember knowing of. I remained abstinent in high school but had plenty of friends engaging in sex although most of them were on birth control, in which they took to “regulate their menstrual cycle.†I am going to be as open about sex with my family as possible, and at the same time I feel like our culture is becoming less conservative about the matter and with time, it will be less sensitive.
Today, we like to look upon ugly parts of history, like eugenics or “racial†purity movements and sentiments, as things of the past. But Gillespie and Hubbard’s analysis of the population control movement draws unsettling parallels between them; the distinction made in the “Contraceptives in Context†article, between population control and birth control-related motivations for contraception, is crucial to understanding the situation.
While birth control activists are driven by concern for women’s rights to control over their bodies and reproduction, population control supporters emphasize the importance of keeping birth rates down so they do not outstrip resources—but to target the areas with the highest population density, West Germany and the Netherlands would be higher on the list than most Third World countries (as aaa1313 mentioned). Unevenly distributed resources, not too many people, are at the root of hunger and other problems in poorer nations. Not wanting “less fit†people to have as many children (hey, eugenics!) has to play some role in the population control argument.
I also thought it interesting that contraception is marketed aggressively to women in countries where, unlike in the United States, children are not expenses but instead can help their family financially by working or contributing at home.
The practice of making contraceptives available to women in developing countries is, in and of itself, not a bad thing—granted distribution and education go hand in hand. I see where Rachel36 was coming from when she mentioned the repeated exploitation of underprivileged women by contraceptive distributors, medical practitioners, and sometimes federal governments. Most contraceptives come with some risks; Depo-Provera, which has been shown to be hardly worth the risks and side effects involved, was marketed to college-aged women but also to women on welfare. While a college-targeted marketing strategy makes sense because most college students aren’t looking to start families, poorer women were targeted as a population control measure. Women in India undergoing quinacrine sterilization were treated like (unaware) experiment subjects; their quality of life and health was judged less important than making sure they did not reproduce and add to the “overpopulation” problem.
For young middle-to-upper class women in the contemporary United States, birth control is a tool of sexual liberation and reproductive choice. However, as this week’s articles highlighted, choice is not always a part of using contraception.
As Rachel36 has already stated, I too saw a theme of exploitation throughout this week’s readings. Before I read these articles I hardly recognized/focused on the extent to which the issue of contraception is, as Malat calls it, a “racialized health issue.” I agree with Lil Dre Dre that it was truly appalling for me to learn about how Norplant and QS were used, not to better the lives or improve the healthcare of women in third world countries and women of color in the U.S., but rather as a way to control THEIR population. One article even used the word “genocidal” to describe certain clinics and their distribution of these methods of contraception. As many have already mentioned, I find this issue to be severely disturbing and upsetting to me. By far, the most enraging comments were made by American doctor, Dr. Elton Kessel, who began the highly unethical QS trials in India. His description of immigrants and people of color could easily be compared to a description of an invasion of a deadly virus: “The threat of immigrants invading and taking over is real, they are swarming all over and draining the resources. Look at the chaos in India’s eastern region with throusands coming in from Bangladesh and in the USA, Mexicans and Caribbeans are pouring in. No civilized government can allow this.” All around, I am ashamed to know that people like Kessel are part of the American medical community, and that he is spreading his xenophobia onto others and irresponsibly/injustly claiming the right to extinguish particular races from his society. His remarks are on the whole, derogatory, infuriating, grotesque and ridiculous. I took particular note of his use of “civilized” in reference to the U.S. government, thus implying that any non-White, non-American is somehow barbaric. It is this preposterous notion that Americans/Westerners alone are the only civilized people in the world that has led this and other countries into war after war, constantly believing that it is America’s place to enter into a culture, country and history older that this one and rearrange/take control of everything.
Even worse is the fact that instability and lack of funding in other governments, particularly of third-world countries such as India and Kenya, only compliments this dangerous bigheadedness that America retains. This is because, as the article on Depo Provera stated, “The non-governmental organizations…tend to be better-behaved and have better services that the government-run clinics.” This leads to the people’s mistrust in their government’s ability to provide adequate healthcare, forcing them to turn to people like Elton Kessel in their time of need.
All the readings to me pretty much came down to asking the same question “is the use of any contraception methods really a choice made by individual women or the society/government/people in economic power?”. I my self have used contraception before, and now by reading all these articles about them really made me realize how i was strongly influenced by external forces more than individual circustances to use it. Reflecting back on my gynocologists one-ones visits about contraceptives, i remember that none of them actually explained completely and in-depth the side effects, in particularly the long-term health risks, or harzadous that involves with the use of contraception. As far i experienced, they talked about long term effects of contraceptives in a sense and vibe like its nothing big, nothing that will acutally happen to me. Since, i consulted three times about contraception types and use with three different medical opinions before actually jumping into one, all of the gynocologists mainly focused and gave a huge emphasis on explaining about the instructions on how to use them, and the short-term temporary health effects once one starts using the contraceptive, but little info on the long-term-life threatning consequences.Due to that lack of information about long-term consequences, i had to experience it my self and thank God i stopped using the pill before i had dangerous health effect.But one thing for sure, is that if i knew and understood all of the risks in depth, sepcially the long-term ones that was involved with the use of pills/contraceptives, i would defenitely choose not to use any. Additionally, im sure many other women are or have been in the same page as me.
With this being said, the articles had true meaning to me in terms of advocationg for women’s health and also for racial and economic disparity injustices. Directly discussing, as Hubbard and Gillespie’s said in their article “middle-and upper class people often frame decisions about childbearing in terms of responsibility-toward society, themselves, and their children”(1rst page 2nd parag), i feel that the huge emphasis on the use of contraception in U.S.A, is more a way for those in power(ex: middle-upper class, the government)to legally practice Eugenics(not sure if i spelled it right)(an event that happened in the U.S.A government some time ago in which they were surgically removing reproductive organs from women they thought that would not conceive a perfect race child….ex: white-blue eyes)undercover, limiting the chances of being confronted by the population and avoiding revolutions. Just the fact that contracetions are mainly used by people who cannot afford babies, which means more responsability for the government(Welfare-programs),underlines that this is an economic/race related issue. Since poverty rates somehow mainly concentrates within the minorities’ groups;meaning they are the ones being targeted to use contraception, specially the long-lasting one such as Norplant(which was a main point made by author Jen Malat).
I could go on and on, about this issue. But i stop here, and as i said before, these articles were really eye opening for me, because it confirmed a lot of things and ideas that i always have been thinking of. Hope that i didnt offend anyone…that was never my interntion.thank you
In all of the articles, the focus was on how to control women’s reproductive systems, but never men’s. Throughout the history of birth control in America men have competed to introduce new and improved methods of birth control, often through exploiting women by testing them without consent and administering BC, without having done enough research. It’s pretty clear that for many of these “inventors” the motive all along was to further commodify women’s bodies for profit, even though initially new methods of birth control was viewed by women as sexually liberating and a way to control their own body. As the article “Searching for Something Better” points out women have always been expected to suffer quietly and endure humiliation, which is perhaps why some men never thought twice about researching their own reproductive systems in the same invasive and painful ways to commercialize BC for themselves.
Even today in our society there is little to no discussion or information on male birth control; the norm is still that birth control is the responsibility of only women. And even when we are responsible for our reproductive health and choose a type of birth control, there can be a stigma attached to that decision within many groups. Coming from a white middle class Catholic family, birth control is definitely not something I can talk openly about within my family, and many of my friends are in similar situations. The double standard is upsetting that it’s often much more acceptable, at times spoken of as funny or boastful in our families, that our brothers can “get away” with sexual relationships. Sex ed. in my Catholic high school consisted of splitting up the boys and girls in our theology class, watching a video promoting only abstinence and the emotional trauma sexually active girls suffer, as well as the take home lesson given by the teacher, “oral sex is bad.” I know the Catholic high school situation is an extreme one, but more and more schools are not receiving funding for sex education from the government under the Bush administration unless they only teach abstinance. In this situation it’s obvious why students still aren’t aware that male birth control is in existence, and that the idea that birth control is solely a woman’s responsibilty is just as prominent as ever. Also, as Gazpacho mentioned, HPV is also an issue that is being promoted as only a concern for women. Women and not men are expected to get vaccinated agaisnt this STI, encouraging the stereotype that women are the promiscuous ones and transmitting it to men.
When reading the articles on Norplant and Depo-Provera, I thought of how difficult it is for women of color to constantly battle the U.S. health care system that automatically judges them as irresponsible and unfit to be in control of their own bodies. I had only heard of Depo before and did not realize how specific types of BC are still being targeted to minority groups now. In a country where medical doctors are thought of as the highest level of intelligence and prestige, it is difficult to think of a physician seeing a woman in a clinic, and purposely deciding not to tell her vital information and options surrounding her reproduction health. Just blatantly judgeing a woman based on her race, and denying her access to quality health care while personally taking control of her reproductive system is something a health care professional should never have the capacity to do. It seems impossible to accept the notion that women could feel empowered by this method of BC at all when publicly it was suggested to be used as punishment by the U.S. legal system and an answer to control women with “social problems.” The administration of these drugs to women of color on the basis of a bias health care system and lack of understanding of individual life circumstances is just furthering their exploitation as experiments of drug companies. The fact that many people in society today still believe in “population control” could be because those in power have the ability to control who gets what or how much health care, and who are eligible for what type of drugs including BC. I thought it was interesting that the article mentioned how Depo is now being promoted as a contraceptive for white college women. This reminded me of how in “Searching for Something Better” when the A.H. Robins Company realized their IUD product was very detrimental to women’s health, they tried to cover up these findings with new advertising strategies and refused to recall the device because to do so would be to admit defect in the product and company ruin and law suits would be the result.
I agree with many of the previous posts that coming out of high school and even in college, I was fairly ignorant of many of the issues surrounding contraceptive choice in the United States. Although I have attempted to educate myself on the more mechanical aspects of contraceptions – which options are available, their “actual” vs. ideal effectiveness, potential side effects – I was not aware of the political and economic forces that shaped how I and others viewed those factors. I was naive in assuming that an expansion of reproductive choice was always at the heart of family planning initiatives, and bought into the idea that devising newer and better contraceptive technologies would benefit women who reportedly did not have the means to effectively use current methods.
I was completely struck by the comparison of population control motivations for pushing contraceptive use to concerns for women’s reproductive choice. The drive to produce implants and injectibles as arising from a motivation to reduce fertility among “the poor” and women in developing nations was not something I had previously understood. The promotion of contraceptive availability as empowering poor or disadvantaged women masks a more hidden objective of controlling their choice to reproduce for some distorted vision of social good. With an American “value” of it being responsible to only have children one can so-called adequately support within our society, it can be too easy to look at the coercion of poor women at home and abroad as conforming to what is acceptable and right to do, whether those women recognize it or not. We see it as being in their best interest, when in reality we are actually pushing a more socially-acceptable form of eugenics.
The discussions surrounding implants in particular were striking when pointing out the fact that, from the perspective of population control, implants were ideal because the health care provider controlled their physical administration, and many women would be unable to choose to stop the method without considerable trouble and resources they may not have available. The unethical nature of pushing injectibles, such as Depo-Provera, in developing nations was also not only due to an agenda of population control, but also to the fact that those communities did not have the resources to address the sometimes serious side effects caused by the hormones. In that example – as well as the articles concerning Quinacrine sterilization in India, the increased risk of STI/HIV infection with Depo, and the lack of follow-up provided to Norplant users – it becomes clear that not only is the desire for population control enough to overcome ethical concerns for women’s reproductive rights, but is also enough for those in health care and government to place women at risk for various other negative health effects.
I felt the article on the dynamics between Hispanic young women and family planning care providers showed an example of what providing more real reproductive choice to a population that has been stereotyped as being relatively unreceptive to such options would look like. Many of the articles advocated for shifting the focus on contraceptives from developing better and better semi-permanent forms to instead focusing on educating individuals better on how to use the already very effective and safe methods available. The family planning care providers in the article remarked on what a learning experience it had been to see from the Hispanic youths what making a good reproductive choice would mean for them. Rather than by default assuming that the methods requiring the least responsibility would be the best for the youths, the care providers saw that the youths were capable of working with the resources they had to manage effective birth control. One care provider had a revelation that supporting a woman’s choice of something as non-medically controlled as withdrawal and the rhythm method could actually be a decent option for some of the young women.
I found this week’s readings to be very interesting and I found myself wanting to know more. I personally use the pill form of contraceptive and I never realized how many different forms of contraceptives that were being used in a way to exploit women of color in the United States and internationally. I never knew about QS and how it was being used so frequently in India and other countries. It angers me to see that researchers and doctors were persuading women to use quinacrine sterilization to supposedly reduce “overpopulation.” In the meantime these women were being lied to and basically being used as esperiments. Thousands of women should not have gone through the QS procedure because the side effects were severe. Another issue that bothers me is the fact that some of these women in India trusted their long term doctors and did not think these doctors would give them something harmful. Kessel made a comment in the QS article comparing the number of incoming immigrants to the nuclear threat. This shocked me because I could never see the severity of these two issues as the same. I feel that the QS ban was definitely a smart choice because it was harming these women.
I see a relation between all the readings because each one describes a form of contraceptive and how women are once again being exploited and controlled. I never knew that contraception methods were being used to control the lives of women, more specifically women of color who are economically disadvantaged. Women on welfare were being targeted to use Norplant to keep them from having kids but when these women wanted to take the Norplant out the government was not as eager to have to pay for the costs of it. What happens to all the women who do not have access to health care and or want to have kids? I just don’t feel like it is ethical to take these poor women and require them to implant something in their own bodies that they should have control over. A woman should be able to have as many kids as she wants. Rather than spending all this money on trying to implant these women with Norplant, why doesn’t the government spend more money on trying to create programs for these children to widen their opportunities? Another issue that bothered me was the fact that male contraceptive methods are not researched as much because it reduces their libido and is not considered as safe. It always seems to be the responsibility of a woman when it comes to child bearing, it is always her fault when she gets pregnant and it was her responsibility to prevent it. But its important to keep the male’s libido high. It just does not make any sense to me. What about the women who have to go through these painful procedures and how their safetiness is ignored. The health of women should be a priority and they should have the right to reproductive freedom.
Birth control has been very controversial in my life since I went on it at what many people thought was an early age to help with issues with my menstrual cycle. I thought the article Contraception In Context was very very interesting! Reading the paragraph on the first page,third paragraph about how in the U.S. cost is a big issue when deciding on whether or not to have children. I never thought that it was just a U.S. thing I just assumed it was like that everywhere, which shocked me. The more I thought about it the more rediculous I realized it was that money would make a decision on whether or not to keep a child.To say a person is irresponsible because they have a child when they don’t necessarily have the money I think is ludicrous. To give up unconditional love because of lack of financial income?
I also thought on the second page in paragraph three was interesting about what is said about how the issue doesn’t lie in too many people in the country or world but the lack of resources that really makes the whole “overpopulation” issue so real. The quote that starts with “THe severe scarcities…” really says it all and if we used each person to their potential to make resources there would be no issue.
Birth control has been very controversial in my life since I went on it at what many people thought was an early age to help with issues with my menstrual cycle. I thought the article Contraception In Context was very very interesting! Reading the paragraph on the first page,third paragraph about how in the U.S. cost is a big issue when deciding on whether or not to have children. I never thought that it was just a U.S. thing I just assumed it was like that everywhere, which shocked me. The more I thought about it the more rediculous I realized it was that money would make a decision on whether or not to keep a child.To say a person is irresponsible because they have a child when they don’t necessarily have the money I think is ludicrous. To give up unconditional love because of lack of financial income?
I also thought on the second page in paragraph three was interesting about what is said about how the issue doesn’t lie in too many people in the country or world but the lack of resources that really makes the whole “overpopulation†issue so real. The quote that starts with “THe severe scarcities…†really says it all and if we used each person to their potential to make resources there would be no issue.
I also never knew Depo Provera was not legalized for birth control but is used because doctors can prescribe it for anything seeing as it treats other illnesses.I took peer health for two semesters and never learned that and just found it really interesting and also how it doesn’t make sense.
Along with my classmates, I found this week’s readings very interesting, relative, and easy to relate to. I was shocked and amazed by much of the information I gained from this week’s reading. One article that caught my interest was ” Searching for Something Better” in reference to the development and history of the IUD. Many of the early models were painful to apply to a woman’s body and included a long list of serious side effects such as endometriosis and susceptibility to PID. One anecdote that I found strange but which illustrated a good point was that the critic and well-known obstetrican Williams used to carry a watch adorned with a gold intrauterine ring. He explained that he personally extracted such a ring from a ” placenta at term”. This was visible proof that IUDS had flaws and did not always work.
IUDS were created with the goal of population-control, especially in lower-income families, which often meant Black women, Hispanic women, or other women of color. IUDS were not designed with the women’s body, comfort, and personal feelings in mind. Mass numbers of IUDs would be inserted into women’s bodies in a short time period, with no regard to the individual woman.
Another article that interested me was “The Social Life of Emergency Contraception in the US”. As someone who has taken the EC pill on two or three occasions, this article hit close to home. If I did not have that option, I don’t know what I would have done. I would not say that I participated in promiscuous and risky sexual behavior because I had the option of taking the EC pill afterward. Once I realized I had screwed up, I scanned my brain to try and figure out my course of action. The fact is I made stupid decisions, but I was not ready to become pregnant.The EC pill is contraceptive that was there for me when I needed it, in some desperate circumstances. Personally, I wished that it hadn’t come to the point where I had to rely on the EC pill. I wasn’t using it for a good reason like ” The condom broke” or ” I forgot to take my pill”. I was using it because I hadn’t even attempted to use another form of contraception. Yes, this was a mistake and irresponsible…but having the availability of the EC pill OTC was a godsend. I knew that I had royally screwed up, but I also wasn’t in the mood to be lectured by an M.D. as to what I did wrong and how irresponsible I had been. Believe me, I already knew it.
First, many of these articles interested me. I enjoy the topic of birth control, as I myself am struggle with decisions surrounding it. Primarily, I think there is a deficit on information surrounding birth control and alternative options in the United States and the rest of the world. Strongly, I feel that due to this lack of information women’s health is severely jeopardized on many levels. In addition, I feel that a lack of information contributes to a woman’s lack of self-esteem and confidence and her abilities to make an educated decision regarding her body.
In the article, “Contraception in Context” I was interested in the section discussing hormonal birth control options. I had no idea that birth control changed the way your body absorbs vitamins. Personally, I am what my doctor terms, “a bad absorber” because I have many allergies my intestines don’t absorb nutrients normally, I believe he terms it “leaky gut”. Due to my “leaky gut” I have a lot of vitamin definciencies that affect my overall health. Lately, I have been struggling with the idea of coming off birth control pills. A couple years ago I stopped taking them for an entire year and my primary care physician was outraged… I have no idea why. I had stopped taking them because I am diabetic and they increase your risk for heart disease. More so, as a diabetic my risk for heart disease increases 3 fold. Yet somehow, my doctor convinced me that birth control was perfectly safe and that in fact, it gaurded me against certain cancers. But since then, I still feel that dumping hormones into my body doesn’t feel right for me. But now I have a longterm boyfriend and I feel pressured to continue on the pill. Luckily, I have talked with him and we’ve decided to pursue other alternatives, also a decision inspired by this class. My point is, I have always felt a lack of trustworthy information on the pill. I feel like everyone I talk to has a different opinion on whether or not the pill is okay for me. More so, for some reason I have been socialized to believe that I need “expert” opinions on my body and the decisions I make in regards to my body. THis is rediculous. If I feel like something isn’t right for me, then it is not right for me.
I was shocked by the quote (same article), “A Red Cross worker in Thailand described women receiving the shot [Depo-Provera] routinely upon marraige without being asked whether they might be pregnant; some did not know it was a contraceptive.” (p.5) Unfortunately, this is a reality for many women around the world. I once read an article in a women’s studies class that said many minority women in the US, after giving birth, are sterilized by force without an understanding of what is being done to them until it was too late. It angers me that women have such a lack of information and constantly fed disinformation about their bodies.
An additional point I find interesting is that the United States decided to stop funding international programs taht provide abortion services. I don’t understand why something acceptable to our country is deemed unacceptable for other countries.
In the article, “Searching for SOmething Better,” I found it interesting to learn that the US government funded contraceptive to the poor, which consisted predominately of ethnic minorities. I had been under the assumption that in the 40s, 50s, and 60s the government was against funding contraceptives. Of course, the motives behind the funding were based on biases against the poor and minority races. More so, I was shocked by the rhetoric revolving around women’s inability or un-trustworthiness in relationd to their ability to take the pill.
In the end, I feel that women have a wealth of disinformation surrounding their own bodies. I think that women need to have access to reliable information so that they can confidently make informed decisions about their bodies. In addition, I feel that not much has changed over the years, even with the introduction of new birth control methods. If anything, I think that the availability of more options has created a greater wealth of information that women don’t and need to have access to.