Contraceptive medicalisation, fear of infertility and teenage pregnancy in Brazil

Abstract

In Brazil, as in many other countries, teenage pregnancy is widely recognised as a public health problem. Buttressed by a public health science of the economics of teenage pregnancy that emphasises the postponement of parenthood as key to poverty reduction, young people's lack of appreciation for medical knowledge of contraceptives is most often credited for failed attempts to reduce teenage pregnancy. Based on a longitudinal ethnographic study conducted in Pelotas, Brazil, with young people over the course of 10 years, our study found that young women who became teenage parents did not lack medical knowledge but were, rather, highly medicalised. Not only were they intensely concerned with the ill-effects of oral contraceptives on possible future fertility, they also engaged in intricate routines of contraceptive-use as a way of testing and safeguarding their fecundity. Our analysis attends to the way these practices are shaped by the problematisation of the economics of teenage pregnancy, as well as by the gendering of cultural norms relating to the transition to adulthood. We theorise the results by considering how contraceptive medicalisation enabled some women to engage with the authority of normative society, while developing a potent off-stage critique of this authority and of what they considered to be discriminatory messages imbedded in scientific discourses on teenage pregnancy.

“My partner was not fond of using condoms and I was not on contraception”: understanding adolescent mothers’ perspectives of sexual risk behaviour in KwaZulu-Natal, South Africa

“…Adolescent mothers in both studies reported a distrust in contraception because they had witnessed adolescent women falling pregnant regardless of contraception. The overwhelming fear of weight gain while using contraception was echoed by our participants and also by Brazilian women in a study conducted by Goncalves et al [53] The participants in our study also noted the negative attitudes of their partners towards condoms, which compromises safe sex. The disfavour of South African men towards condoms are noted by Mash et al [54] Likewise, Kanda and Mash [55] found that Batswana men and women in their study believed that condoms reduces pleasure, and interferes with a sustained erection.…”

“…Myths about contraception also influence sexual health practices [17,53], as the beliefs that the participants held about contraception shaped their health practices and their sexual risk taking behaviours. This finding concurs with a study by Ngum Chi Watts et al [17] that was conducted among Australian adolescent mothers who also believed the myth that contraception causes sterility.…”

“…However, some participants had no plans regarding the use of contraception due to their distrust of the efficacy and side effects of contraception. Studies in Australia [13] and Brazil [53] also provide evidence that young women have many misconceptions and fears regarding the use of contraception.…”

Fertile bodies, immature brains?: A genealogical critique of neuroscientific claims regarding the adolescent brain and of the global fight against adolescent motherhood

“…The effort to prevent teenage girls from becoming pregnant and proceeding to raise their children is the hallmark of public health and social policies across a wide range of Western nations (Arai, 2003;Daguerre and Nativel, 2006;Hoggart, 2012;Luker, 1996, 94). This concerted policy effort now has a global reach (Gonçalves et al, 2010;Mkhwanazi, 2010;WHO, 2011). At least in part, this is fuelled by Western global health and development stakeholders such the WHO and the Bill and Melinda Gates foundation (Koffman and Gill, 2013).…”

Os perigos subsumidos na contracepção de emergência: moralidades e saberes em jogo

“…Estudos realizados na área da sexualidade e do gênero apontam o quão difícil tem sido a gestão da sexualidade e da contracepção no par heterossexual, as difi culdades de uso regular de métodos anticoncepcionais, com ocorrência de gravidez imprevista e aborto em condições inseguras 2 para a saúde das mulheres (Bajos et al, 2002(Bajos et al, , 2003Cabral, 2012;Gonçalves et al, 2011;Luker, 1975;Spencer et al, 2014;Teixeira el al., 2012). As difi culdades de negociação entre os casais sobre o uso do preservativo masculino e/ou de outro método de proteção à gravidez, devido à forte hierarquia de gênero e uma cultura sexual que preconiza a "naturalidade" e a espontaneidade do ato sexual, impedem o planejamento prévio dos encontros sexuais, admitindo-se um certo grau de incerteza e do risco de se engravidar (Bozon;Heilborn, 2006;Cabral, 2011).…”