April 7th, 2009
Linda’s flat was on the seventh floor. As usual the lift was broken. The health visitor, out of breath and struggling to be heard against the loud barking of the Alsatian that greeted her arrival, turned off the television herself. Linda was nursing the new baby born four weeks before. One-year-old Gavin tottered unsteadily among the debris of plastic toys holding a feeding bottle in his mouth by the teat. Three-year-old Tracey had opened the door; ‘Couldn’t get her to nursery,’ said Linda. Paul, Linda’s husband, appeared briefly in the doorway. ‘I’m off then.’ The health visitor groaned inwardly: so he was still here! Away from home for long periods doing ‘a bit of this and that’ she had assumed he was away for a while, long enough perhaps to get Linda down to the doctor’s for her postnatal check. She would have to raise the subject of contraception. Had Linda thought about it? Linda’s eyes glazed as she rocked the baby to and fro. ‘He likes kids, anyway they make you feel special don’t they?’ The health visitor understood how she felt. What was there to feel special about in Linda’s life except for having children; what choices did she have? Her stepfather had thrown her out when she found she was pregnant the first time, even though she had lost that baby. Getting pregnant again and marrying Paul was the only bit of security she knew, but Paul only seemed to care when there was a new baby around. But Linda could barely cope as things were. ‘Couldn’t you do with a break, Linda? Get to meet the other mums here, and make a bit of life for yourself?’ Linda looked doubtful. ‘I don’t want no injections, they make you sterile. I’ve seen the leaflet.’ ‘Not permanently,’ said the health visitor. ‘And I can’t take the Pill, never could remember anyhow, and he won’t use nothing.’ ‘What about a coil? If I took you down to the clinic you could have one put in straight away and then when you want another baby, have it taken out again.’ ‘You mean it doesn’t have to stay in five years? But I’m not sure I want something inside me all the time.’ ‘You had the baby inside. The coil’s just there until the next baby.’ Linda looked interested. Here was someone saying she could have another baby if she wanted to. ‘I wouldn’t mind for a bit . . . we could do with a bit of peace around here.’
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April 7th, 2009
The overwhelming attitude of men to this approach was that they wanted to ask whether their feelings were normal. They had clear preconceptions of ordinary male behaviour against which they considered their own feelings, identifying areas where they felt different. This sense of difference had over the years given rise to varying degrees of anxiety, and several of the men appeared to value the opportunity to talk in more depth.
In the present chapter this study has been used, as well as the glimpses of men’s attitudes to contraception seen during many years in general practice. Because of the strength of the stereotypes some of these common assumptions about male behaviour have been used as headings under which to consider the varied feelings of different individuals.
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April 7th, 2009
The psychological factors contributing to the chaotic lifestyle of some women have been discussed in Chapter 1. Included in this group are women who are psychiatrically ill, depressed, have drug and alcohol problems, or personality difficulties making it difficult for them to organize their lives. Sometimes women who normally manage their lives well may go through short-term difficulties, for example, a sick child or moving house, so that they are distracted and forgetful.
*95/197/1*
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April 7th, 2009
The boys come predominantly for condoms and may be provided with supplies without seeing the doctor. However, many doctors try to see them at least once, or make sure that they are offered an opportunity to come and talk, as a request for sheaths is often a calling card which they have used in the hope of getting help with some other anxiety or problem (Hutchinson, 1983). Insistence on making them see a doctor should be avoided as that could put them off, but if the clinic staff are sensitive to the unspoken needs of patients they may be able to offer help themselves, or smooth the young man’s passage to the doctor.
It is always useful to start by seeing people as they wish to be seen, as individuals, couples or even in more bizarre combinations.
*58/197/1*
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April 7th, 2009
The stability and quality of many relationships can determine whether contraception is used and which partner uses it. Where there is trust and openness in the relationship, contraception can be accepted more readily, though there may be resentment that it is needed and a dislike of the actual methods. When there is change in the relationship or when it is unstable, especially at the beginning or the end, contraception may not be used or, if it is, the use is often erratic.
The sexual relationship may be for mutual pleasure and joy, but it can be used to control, dominate or compensate for feelings of inadequacy. By not using contraception there may be an unconscious wish to control or limit the partner’s sexual activity. Resentment or envy of the other’s sexual enjoyment can also lead to a more overt expression of non-use of contraception exemplified by the phrase, ‘Well, why should I take the Pill (with all its dangers) when he is the one who gets the pleasure?’
*21/197/1*
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