Abstract

PIP: Contraception can be perceived by a woman either as a subjugation to socioeconomic imperatives or as a means of escaping the fate of repeated pregnancies or abortions. Whether contraception liberates or constrains depends on the individual attitude. In France, decision of whether to have a child is influenced by the couple's perception of cultural norms such as the ideal 4-member family proposed by advertisers, the organization of collective life, and the design of consumer goods such as 4-seat automobiles. The 2-child norm is rapidly becoming internalized, but may be influenced by such societal factors as declining employment opportunities for women which prompt them to reassume the career of motherhood. Among sources of resistence to contraception are those stemming from the physician who may be reluctant to prescribe potent drugs with obvious societal implications to a healthy woman. The patient seeking cure of an ailment and the patient seeking OCs have completely different psychological encounters with the physician in the position of furnishing supplies rather than of diagnosing and explaining treatment. The resulting loss of power may frustrate some physicians. The woman may however return power to the physician by demanding reassurances about the medical aspects of pill use. Concern about the possibility of thromboses or other side effects also serves to return the OC consultation to the realm of a more traditional medical practice. The attitude of the physician can reinforce resistence of the woman to contraception or provide a scientific rationalization for it. Taking the pill daily, a regular reminder to the woman that she is suppressing her maternal potential, is a cause of stress and perhaps of forgetfulness for some women. OCs, because of their efficacy, may not be seen merely as the means of suspending the procreative function for a given time, but as suppressing and negating it permanently. Women who for various reasons are disturbed by the loss of reproductive function or who subconsciously wish to assure themselves of their fecundity may have recourse to less effective contraceptive methods or to abortion. For some women, taking OCs creates guilt or shame because the total suppression of procreation goes against religious and moral teachings. The dichotomy of woman as mother or woman as prostitute may have become ingrained to the degree that the implications of free enjoyment of sex without fear of pregnancy become unbearable. Such side effects of OCs as nausea, weight gain, and breast swelling may represent a somatic expression of a desire to return to the maternal pole of the dichotomy. The use of OCs may be perceived as castrating by men who at least unconsciously equate fertility with virility. Some men may refuse to let their partners use OCs on the pretext that they will be used to hide affairs with other men.