Unintended Logics

At the age of nineteen, having recently moved to the United States with my family, I was prescribed the contraceptive pill for the first time. It was intended to regulate my period, which had become sporadic in the six months since our move from Delhi to small-town Pennsylvania. My progressive Indian mother, in all her infinite wisdom, saw the irregular period as an opportunity to intervene and ensure that I was making smart decisions about my body if I did decide to become sexually active. When we went to the physician, he did not ask about the changes in my diet, my shift from a very active to a much more sedentary lifestyle, or the emotional toll of trying to fit into a new world as a young immigrant woman. Rather, after a brief conversation, he prescribed the contraceptive pill as a corrective to an irregular period—a symptom of an out-of-control body rather than a body coming to terms with a disrupted life.

The contraceptive pill (the only drug known simply as “the pill”) has historically been prescribed for more than just contraception and without much thought to the long-term consequences on women’s bodies (Watkins 2012; Grigg-Spall 2017). My experience with hormonal interventions, like a majority of women living in Western societies, began with a tiny white pill in pink packaging prescribed to me in order to “regulate” my hormonal body. There was something very American about consuming a pill every day as a healthy person, and I embraced this opportunity as a means of belonging in my new world. My love affair with the pill, however, was short-lived. I went off the pill within six months, as some of the side effects were severe. Yet my interest in the ability of this nonhuman actor to generate medical uses and logics beyond its original intent continued. The pill’s original use was to curtail the reproductive lives of black and brown bodies in the global South, but it was soon used by middle-class women in suburban communities in the North (Tone 2001; Takeshita 2011). Since then, the pill has been taken up for additional “correctives,” including for the treatment of acne and irregular periods, even as new research reveals  the long-term health implications of hormonal contraceptives (see also Skovlund et al. 2016).

In 2009, ten years after my first experience with hormonal contraception, I started fieldwork on the Emergency Contraceptive Pill (ECP) in India. ECPs began being sold over the counter across the country starting in 2007. Over the course of my research, I witnessed the diverse experiences that women have with ECPs (Sheoran 2015). I realized that in addition to enabling bodily plasticity (Sanabria 2016), the newly introduced ECPs were also giving way to new uses and unintended outcomes among the young women I interviewed. Although it was intended to be used occasionally in case of unprotected sex, the ECP has become a leading form of birth control in urban India (Rajaram 2011; Plucinska 2015). One of the persistent arguments for using ECPs no more than a few times a month is to reduce the amount of medicine ingested. ECPs were never designed to replace regular contraceptive pills or to allow for lower levels of hormonal interventions.

While I can provide an easy narrative about the unintended consequences of introducing ECPs as nonprescription pills in liberalizing India, it is their unintended everyday uses and logics to which they give rise that defy straightforward analysis. In My Life with Things, Elizabeth Chin (2016) outlines her relationship with consumer goods while also providing a commentary on anthropological methods. For me, Chin’s work is the latest in a tradition of autoethnographic engagement that allows me to think with and through hormonal contraceptives. The history of the pill shows us how inanimate objects can create their own logics. While hormones are not things per se, they do engage in similar relationships and coconstruct lives with their own internal intra-actions (Barad 1999, 2007). Tracing the agentive possibilities of nonhuman actors from situated positions has been an important move for feminist scholars (Haraway 1988, 1997; Barad 2007). My relationship with the hormonal contraceptive pill began in a medical space, as my nineteen-year old body came to terms with a disrupted life. Today, almost nineteen years after that meeting in the physician’s office, I come to terms with my hormonal body again as I breastfeed my three-month-old baby and study my own changing body even as medical professionals monitor it.

In placing my own body into my analysis of hormonal contraceptives, I have attempted here to unpack the unintended uses of ECPs. The hormonal contraceptive pill, through its manifold intra-actions, has shaped not only the social lives of hormonal bodies consuming the pill but also of the pill itself. The ECP, in short, creates new logics in new spaces. It is these unintended logics that allow us to engage with hormones as material-semiotic actors that are not always disrupting but also creating new bodies and relations.

References

Barad, Karen. 1999. “Agential Realism: Feminist Interventions in Understanding Scientific Practice.” In The Science Studies Reader, edited by Mario Biagioli, 1–11. New York: Routledge.

_____. 2007. Meeting the Universe Halfway: Quantum Physics and the Entanglement of Matter and Meaning. Durham, N.C.: Duke University Press.

Chin, Elizabeth. 2016. My Life with Things: The Consumer Diaries. Durham, N.C.: Duke University Press.

Grigg-Spall, Holly. 2017. Sweetening the Pill, or, How We Got Hooked on Hormonal Birth Control. Alresford, UK: Zero Books.

Haraway, Donna. 1988. “Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective.” Feminist Studies 14, no. 3: 575–99.

_____. 1997. Modest_Witness@Second_Millennium.FemaleMan©_Meets_OncoMouse™: Feminism and Technoscience. New York: Routledge.

Plucinska, Joanna. 2015. “Demand for the Morning-After Pill is Soaring in Conservative India.” Time, August 6.

Rajaram, Poorva. 2011. “Sexing the Pill.” Tehelka, March 5.

Sanabria, Emilia. 2016. Plastic Bodies: Sex Hormones and Menstrual Suppression in Brazil. Durham, N.C.: Duke University Press.

Sheoran, Nayantara. 2015. “‘Stratified Contraception’: Emergency Contraceptive Pills and Women’s Differential Experiences in Contemporary India.” Medical Anthropology 34, no. 3: 243–58.

Skovlund, Charlotte Wessel, Lina Steinrud Mørch, Lars Vedel Kessing, and Øjvind Lidegaard. 2016. “Association of Hormonal Contraception with Depression.” JAMA Psychiatry 73, no. 11: 1154–62.

Takeshita, Chikako. 2011. The Global Biopolitics of the IUD: How Science Constructs Contraceptive Users and Women’s Bodies. Cambridge, Mass.: MIT Press.

Tone, Andrea. 2001. Devices and Desires: A History of Contraceptives in America. New York: Hill and Wang.

Watkins, Elizabeth Siegel. 2012. “How the Pill Became a Lifestyle Drug: The Pharmaceutical Industry and Birth Control in the United States since 1960.” American Journal of Public Health 102, no. 8: 1462–72.