Coitus interruptus and the disappearing diaphragm
Now that I’ve caught your attention–
The title of this NY Magazine article: “No Pill? No Prob. Meet the Pullout Generation” certainly caught mine. Reading it was one of the most bizarre experiences I’ve had in a long time. The gist of it is that many modern women are so dissatisfied with all the many contraceptive choices available to them that they are opting for what used to quaintly be called coitus interruptus.
That is, they’re opting that their male partners opt for it, because unless things have changed an awful lot since I was young, it’s more a man thing.
Hormonal contraception is much simpler, and more effective, as well as esthetically and emotionally pleasing, but not when it makes you feel sick or makes you fear you’re risking your life. The IUD comes with its own health problems, and condoms are a drag.
But they’ve all got to be a darn sight better than the somewhat exquisite timing, control, and renunciation involved in “pulling out,” don’t they? I understand using the latter technique once in a while as a stopgap measure in a pinch. But regularly, as part of a committed relationship, as these women say they (or rather, their partners) do? Not to mention the fact that it’s a notoriously unreliable and ineffective method, more likely to result in a pregnancy than condoms regularly used?
But the most puzzling thing of all about the article was the complete absence of any discussion of the diaphragm. The diaphragm is a far-from-great method of birth control (I say that as a person who used one for many many years). But surely it’s better than the method they’re choosing instead?
Which made me wonder—has the diaphragm, that rite of passage of my mother’s generation (and which featured heavily in fiction such as Mary McCarthy’s The Group and Philip Roth’s Goodbye Columbus)—gone the way of the dodo?
That in turn led me to Google “Whatever happened to the diaphragm?” Sure enough, there it was, an article in a 2010 issue of Ms. Magazine that said that the diaphragm had become nearly non-existent as a birth control method:
Nevertheless, diaphragm use declined after the Pill was introduced, from 25 percent of married women in 1955 to 10 percent in 1965, and kept dropping thereafter, to just 4.5 percent of all women in 1982 and 0.2 percent today, according to the CDC…
Although diaphragms must be accurately fitted by a health care professional and re-assessed every few years, they remain cheaper than hormonal methods and require less frequent physician visits. A diaphragm can be inserted hours or moments before intercourse, and it is a fully reversible, female-controlled method of birth control.
From the comments to the article I gathered that many gynecologists today don’t even seem to know how to fit a diaphragm, and women are often actively discouraged from getting them. I wondered whether most young women and men today even know what a diaphragm is, or how it works.
What’s going on here? Shouldn’t contraception be about choice? Why are choices shrinking rather than expanding? It can’t be because the diaphragm is a barrier method; after all, so is the condom. Clearly, there’s a demand for non-hormonal methods of birth control; the diaphragm fills that need. Yes, it has the drawback of needing to be used with each act of sex, but so do condoms and certainly so does withdrawal. And although its track record isn’t perfect in terms of preventing pregnancy, it compares favorably with most other non-hormonal methods (if “used properly”). It’s somewhat messy, but not all that messy, and many women would gladly trade a bit of messiness for freedom from the health fears inherent in pill and IUD use.
It seems, rather, that the ignoring of the diaphragm has been a choice of the medical profession and/or the manufacturer. And it seems to be in the nature of a self-fulfilling prophecy. The less it’s mentioned to women, the fewer know about it, the less demand there is for it. The less demand there is for it, the less it’s mentioned, the fewer use it—in an ever-decreasing spiral.
And then, and then, I saw this:
…[T]he Caya, a new, one-size-fits-most diaphragm, looks like something Polly Pocket might be into: It’s lilac, squishy, and comes in its own little case. The look is part of its appeal. It’s an attempt to break down the stigma that diaphragms are your grandma’s birth control and to make them relevant again.
It’s made of a material and is a shape that’s easier to insert and remove. It’s smaller and more flexible, and sports a lavender color that apparently appeals to modern women although it wouldn’t do a thing for me. I applaud the makers, who may have built the diaphragmatic equivalent of a better mousetrap.
[NOTE: More about the diaphragm’s near-disappearance here and here. The comments to the latter article indicate that at the time the comments were written, doctors couldn’t even find a set of rings (used to properly fit diaphragms on patients) any more. One women said her family practice physician’s assistant asked her if she was still “taking” her diaphragm. Another commenter said she couldn’t find a drugstore that carried one.]
I, uh, knew someone who used a cervical cap (and a diaphragm during her period) as recently as 2002. (I don’t know what she uses these days.)
Daniel in Brookline:
I bet it’s an old one.
Those things can go on forever.
But apparently there still were and are some doctors who will prescribe them.
Isn’t “It’s OK, I’ve had a vasectomy” one of the three biggest lies?
What do you call couples who use the rhythm method? Parents.
Having a Y chromosome, I was a little disturbed by your reference to a “mouse trap.”
Neo
1. TMI
2. No money in the diaphragm.
neo,
There’s another explanation. The continuing gelding of the American male. I’m confident that ‘pulling out’ rates at the bottom, on just about every male’s ‘satisfaction meter’. As feminist emasculation however it has much to offer. After all, do beta males deserve satisfaction? Arguably, is not emasculation of the male, the end product of female domination?
Before rejecting this admittedly appalling explanation, consider TV’s ongoing, long deluge in commercials, TV and movies in which the male is typically now shown as, at best well meaning but incompetent and at worst, as a murderous, brutal rapist.
Note: my apology in advance, as this comment is likely to fuel Artflgdr’s ranting misogyny.
Probably helps that should the “pull out” method not work they can vamoose any inconvenience with a morning after pill or abortion. Those are two more common birth control methods you didn’t mention.
Another concern: STDs. Condoms don’t just prevent pregnancies. Interesting that this is not a greater concern to the Pullout Generation. (I didn’t read the linked article, so maybe I just missed that part?).
Geoffrey Britain:
I can’t imagine that most women enjoy coitus interruptus very much, either.
I’ll leave it at that.
Anything that increases the birthrate is a good thing. Just sayin’.
I am pretty certain “pulling out” isn’t going to be popular with men or women, and it won’t work. It isn’t like this method is new, and I am about 100% certain that men and women have not really changed how they behave when at the point of orgasm- you aren’t doing a lot of critical thinking.
However, if this is how young people are thinking these days, may they enjoy their unexpected children, abortions, and venereal diseases.
It’s baffling to me that in an era in which so many people, particularly women, are obsessively focused on natural food choices, avoidance of chemicals in makeup and household products, etc. are perfectly willing to alter their body by taking birth control hormones.
And now the diaphragm is “out” and withdrawal “in” (so to speak)?
Talk about bizarro world! What’s next, a reality TV star as the front runner for president?
The CDC estimates than some 80 million people in the US have HPV right now and that almost all sexually active people will eventually get it. Never mind the good ol’ STDs we had when we were kids, which for us Gen X types, includes HIV. Yet now women – when they’re not busy deciding that last night’s hookup was actually a rape – want to return to the birth control method that helped make huge catholic families back in the day while boinking with less discrimination than the average springtime rabbit?
I was surprised that tubal ligation wasn’t mentioned and wondered if many many women were choosing that, once they knew they didn’t want more children. My most enduring romance was with a woman who had had her “tubes tied” before we met. It was continually wonderful to enjoy sex without the hassle or worry with contraception. Today, on Wiki I read that it has the risk of serious surgery and is not foolproof. So, maybe it is not common. We were blissfully ignorant.
What a strange topic.
I’ll put it this way. I’m a Catholic … but I’m not a good Catholic …LOL
jack:
Strange topic?
Well, at least it’s not about Donald Trump.
Well, at least I don’t think it’s about Donald Trump…
I wonder if many moderns are not very concerned if an egg does get fertilized, and simply run off to their druggist for an RU485 pill the morning after?
Once the Lovely Mrs. Firefly explained to me how the pill works; tricking a woman’s body into thinking it’s pregnant 12 times a year, I understood why she didn’t want to be on it. It seems like that can’t be good for one’s body, long-term.
My dad, the research biologist, was not enthusiastic about the Pill, when it first came out and in regard to the use of it by my younger sister and I. I do recall that the question did come up. Our family was rather … freewheeling about topics of general interest. Reproductive medicine was not his specialty, but he was adamant that blindly messing about with human hormone levels was just not a good idea. Dad had also been adamant that we not drink commonly available soft drinks when we were kids because he worried about the effects of cyclamate.
As for birth control methods – yes, I opted for a diaphragm as about the safest, in combination with taking note of the calendar … back in the day when I did need such precautions.
Wow! I may be a prude, though I/we for 47 years remain sexually active (yes I can still get it up without viagra). After the 3rd child, 32 years ago, I had a vasectomy. Shooting blanks does not diminish the pleasure of shooting blanks.
What about the sponge? I guess this post wasn’t spongeworthy.
PG:
Ha ha, as a Seinfeld fan I see what you did there:
https://m.youtube.com/watch?v=sfQBKB4s1ks
That is, they’re opting that their male partners opt for it, because unless things have changed an awful lot since I was young, it’s more a man thing.
Ah, neo, it is not so bleak though for the males now as it once was when I was young. A much larger % of women, in some countries and circles a large majority, in today’s world are not only willing, but enthusiastic, to engage in BJ Clinton’s not-sex. Many men no longer have to beg or wait for Christmas or their birthdays anymore, and I read somewhere that it has even replaced the teenage first-date kiss, and it goes both ways too.
You can of course be forgiven for not knowing, unless that old criticism of Jewish girls really was just a myth all along.
😉
@ CV: Good observation about the “all natural” movement yet ABC is probably the most unnatural thing, but it’s highly lauded and encouraged. Bizarre indeed, and sad.
It is disappearing. I’m not a young ‘un at 36, but I am still interested in contraception. Last fall, when I discussed it with my midwife after giving birth, I was shocked when she told me she’d never fitted a diaphragm. Then the pharmacy told me they didn’t stock them, and they’d have to figure out if they could find one for me. (They did.) I was really surprised too that this form of contraception had been abandoned. So few risks compared to the others! I looked into Lea’s Shield and the cervical cap while I was waiting to see if they could find me a new one, and my main observation was that their failure rate after a vaginal delivery was bad – apx 25%. All are listed at a 5-10% failure rate prior to giving birth, but the diaphram doesn’t change after delivery.
We thought that the sponges were wonderful, after a couple of decades of condoms. Now, we just regret the chances we missed of having more children. The two who made it into this world have been wonderful. However, parents of our generation (b.1950) gave us the distinct impression that children were a burden. We knew we wanted a child or two, but David Rockefeller’s protege, Paul Ehrlich, convinced us that more than one was irresponsible. It was surely not the only lie to fool us, but it was most definitely part of the tissue of lies that, once we realized what had been done to us, contributed greatly to our rightward shift. We wonder, now, what is in store for us as we age, and how we can defend ourselves from it.
Speaking of Ehrlich, the Population Bomb, overpopulation, and those high school assembly hall consciousness raising sessions of the ’70s which informed students that it was your duty not to reproduce, one notes that the Ehrlichian alarm over fulminating population increases does not seem to extend to concern over increasing the population through illegal immigration.
In fact it is assumed as a matter of principle that it not be. Some types of population increase are not so much a threat to man’s fate, the ecological balance, or social justice … or something.