Mechanistic and “Natural” Body Metaphors and Their Effects on Attitudes to Hormonal Contraception

Abstract

A small, self-selected convenience sample of male and female contraceptive users in the United Kingdom (UK) (n=34) were interviewed between 2006 and 2008 concerning their feelings about the body and their contraceptive attitudes and experiences. The interviewees were a sub-sample of respondents (n=188) who completed a paper-based questionnaire on similar topics, who were recruited through a poster, placed in a family planning clinic, web-based advertisements on workplace and university websites, and through direct approaches to social groups. The bodily metaphors used when discussing contraception were analyzed using an Interpretive Phenomenological Analytical approach facilitated by Atlas-ti software.The dominant bodily metaphor was mechanistic i.e. 'body as machine'. A subordinate but influential bodily metaphor was the 'natural' body, which had connotations of connection to nature and a quasisacred bodily order. Interviewees drew upon this 'natural' metaphorical image in the context of discussing their anxieties about hormonal contraception. Drawing upon a 'natural', non-mechanistic body image in the context of contraceptive decision-making contributed to reluctance to use a hormonal form of contraception. This research suggests that clinicians could improve communication and advice about contraception by recognizing that some users may draw upon non-mechanistic body imagery.

Young women’s experiences of side-effects from contraceptive implants: a challenge to bodily control

“…These participants had carefully selected a reliable form of contraception because they were very concerned to avoid pregnancy. Their acceptance of the need to give up what they had initially embraced as an effective form of reproductive control is an indication of the extent of the adverse effects on their bodies, which they associated with the implant: their bodies were leaking, they were embarrassing, not "normal", and -as noted elsewhere 16 -hormonal contraception was viewed as disrupting the "natural" body. Their experience of loss of control was distressing to them, and propelled them towards requesting implant removal.…”

“…The contraceptive careers of 20 young women (aged [16][17][18][19][20][21][22] were examined using semi-structured qualitative interviews. The women were recruited from four London health authorities, and were identified with the help of practitioners at sexual health clinics.…”

“…One personal value often unacknowledged by providers is some women's anxieties about hormonal contraception disrupting their "natural" bodies. 16 In a key feminist text, Judith Butler 17 distinguished between the biological processes of the body and how cultural discourses shape understandings of those processes. This distinction is drawn upon in this paper, as is Shildrick's notion of the "leaky body", 18 whereby leakage (in this case menstrual bleeding) is seen as symbolic of women's lack of control over their bodies.…”

Clinicians should consider the effect of bodily metaphors when discussing contraceptive options

“…This metaphor is reflected in medical education, clinical discourse and in patient information resources. I have published a research article which suggests that a minority of women, who access contraceptive services, may draw upon an alternative ‘natural’ bodily metaphor, which views the body as an entity firmly embedded in the wider ecology, with quasi-spiritual status, whose functions ought not to be disrupted by technological interventions 2. The disruption to the menstrual cycle, and other bodily rhythms, caused by hormonal methods of contraception, provoked particular anxiety for women who drew upon this bodily metaphor, to the extent that they often discontinued hormonal methods.…”

“…It also seems likely that advice about less effective, but more acceptable, ‘natural’ methods of contraception (such as withdrawal or natural family planning) will provide more reliable fertility control for women who are uneasy about methods that are more technologically interventionist. In my paper2 I suggest that clinicians should be alert to alternative understandings of the body, which may influence the acceptability of commonly prescribed methods.…”