Governments have long enlisted women’s bodies to meet reproductive policy goals, often with little forethought to the broader implications. Negligent medical practices as well as unfair societal perceptions and actions are just some of the outcomes women face.

Contraception has long been hailed as the catalyst of female empowerment in enabling women to exercise their bodily autonomy. However, the same cannot be said for how contraception is being used in countries such as China and Indonesia, and even Australia. China is famously known for its One-Child Policy which utilized IUDs (intrauterine device) and sterilization to keep its population growth rate low. Similarly, Indonesia’s current Family Planning Program contains the same coercive pressures, albeit with less enforcement. While China has reversed its One Child Policy with pro-fertility policies, women’s bodies are still perceived as tools of the state. For Australian women, these reproductive control programs highlight the contentious relationship between state policy and a women’s right to bodily autonomy. These programs, along with the emergence of Plan A male contraception in Australia is an opportunity for women in these nations to rethink their position on fertility and renew their advocacy for their inalienable rights to bodily autonomy.

The Family Planning Program in Indonesia has been in place since Suharto’s New Order administration in the 1970s. It has undoubtedly been effective in reducing Indonesia’s fertility rate, ensuring its cornerstone position in contemporary Indonesia. Since the program’s inception, there have been reports that the contraceptives used were provider-dependent, long-acting hormonal contraceptives that prevented many women from discontinuing use when complications arose as these contraceptions required the expertise of a medical professional for their removal. Compounding this issue have been reports that many of the health centers that carried out these gynaecological procedures were extremely lacking in the follow-up medical services.

The most alarming feature of the program was the quota system imposed on village leaders which created pressure for village heads to enforce contraceptive use. It created instances where village leaders resorted to intimidation and violence to meet this quota, and reports of women being detained in the office of village heads to be injected with contraceptives have been made. The duress accompanying the so-called “voluntary” family planning program only highlights the discrepancy in “voluntary” family planning when governments instrumentalise fertility to meet policy and development goals tied to it. This undermines the purpose of contraception in allowing women to be the sole determinant of their bodily and reproductive autonomy.  Such state programs should prompt women to consider the effects of policy on reproduction, including the creation of a socio-economic context that affects the ability of women to exercise their reproductive rights.

By contrast, Australian women can not be said to experience intimidation and coercion when it comes to using contraception. In saying that, there is a widely known disparity in the range of contraceptive methods available to women and men that creates an illusion of contraceptive choice for women.

While women in Australia can choose to solely rely on barrier contraceptives that don’t pose long-term side effects such as condoms, full contraception is not always guaranteed. With typical use, the condom failure rate sits at about 12 percent. Another contraceptive option available to women comes in the form of hormonal contraceptives and long-acting reversible contraception (LARC) which includes IUDs, implants, and the contraceptive pill. With usage duration lasting from 5-10 years and a failure rate from 0.1-0.4 percent, the choice for pregnancy prevention seems clear. However, in choosing hormonal contraceptives and LARCs, women are subject to an uncertain range of side effects varying from physical, mental, and physiological, as the female body adjusts to the intrusion of the contraception. In addition, women are also burdened with the inconveniences associated with contraception, such as researching its mechanisms to ensure effective usage and finding the time to schedule multiple doctor visits. Women are also subject to invasive procedures by medical professionals and the contraceptive itself which causes further stress and anxiety surrounding its use. With that said, the question remains why it is acceptable for women to be subjected to the negative side effects and medical trauma surrounding contraception when pregnancy is not just a women’s business?

In comparison to the range of contraception available to women, men only have two available procedures in the form of a male condom and a vasectomy, neither of which are hormonal nor a LARC. The disparity is problematic in that it forces women to bear the sole bodily and physiological burden (as well as responsibility) for preventing unwanted pregnancies when it can easily be acknowledged that conception requires two contributors. In Australia, Plan A is still in the process of clinical trials, but as it becomes commercially available in the next 10 years women must observe whether this changes governmental policies and societal attitudes surrounding the burden of contraception.

The examples from Indonesia and Australia illustrate that the experience of contraception is not always empowering. For Indonesian women, the choices are less clear and the outcomes more potentially traumatizing. For Australian women, an illusion of choice in underscored by factors such as independent financial situation and bodily reactions to the contraception. In both cases, women often face choices that are much like a double-edged sword, torn between contraceptive burdens on the one side and child-rearing, should her contraception fail, on the other.

Felicia Lim is a student at ANU whose research focuses on women’s security in the Asia Pacific region. Her previous papers have focused on the socio-political perceptions of women’s political participation in Indonesia, particularly after the mass murders of 1965-55. Her work also includes issues on sex work in Malaysia and the policy gaps surrounding it.

This article is published under a Creative Commons Licence and may be republished with attribution.