DIGEST March 2023

Men are responsible for 100% of unwanted pregnancies

This is the proposition at the heart of Gabrielle Blair’s provocative and clever new book, Ejaculate Responsibly: A Whole New Way to Think About Abortion. Blair, a talented interior designer (@designmom), entrepreneur and communicator, a married mother of six and a Mormon, developed the book from a Twitter thread she posted in 2018. To her surprise, the thread went viral and has remained so for years. She had clearly touched a nerve!

Gabrielle Blair - Credit: Ben Blair

I attended Blair’s in-person conversation with CBS anchor Tony Dokoupil in New York City earlier this month, as she launched her US book tour.

I love the bold, 70s design! A bit like FMUS’ own design!

The book is not primarily about abortion despite its title. As Blair explained during her talk, her purpose is to “re-direct the focus towards men’s responsibility for unwanted pregnancy.” Over the years, Blair had felt frustration about how difficult and expensive it was for women in the US to access birth control and abortion. But it was the 2018 US Supreme Court confirmation hearings for Brett Kavanaugh, said Blair, that broke the camel’s back: “All these male politicians grandstanding about abortion…” A week later, her Twitter thread went up, all 63 posts of it, and Blair has not looked back.

Ejaculate Responsibly is organized in short, often funny chapters backed up by well-chosen evidence on topics such as “Sperm are dangerous”, “Society clings to the idea that men hate condoms” or “The realities and burdens of parenting are unfathomable”. Blair notes at the outset that the book is written from a cisgender heterosexual perspective for people in cisgender heterosexual relationships, but that she hopes some of its perspectives—on power dynamics in relationships, for example—can be useful to anyone.

Blair said that, when she tweeted her original thread, she received the most push back on her first statement: that men are responsible for 100% of unwanted pregnancies. In the book, she lists it as 13th out of 28 statements, to build her case more deliberately and bring readers on side. But she hasn’t changed her mind about “irresponsible ejaculations as the singular cause of unwanted pregnancies.” Blair doesn’t mean that men are responsible for unwanted pregnancy in cases of sexual assault, abuse and coercion, or stealthing (a man removing his condom during intercourse unbeknownst to the woman). Those are obvious cases where the man is responsible. No, she means 100% of the cases.

That is when men become defensive, says Blair. And some women too.

Don’t women sometimes tell men “It’s OK, I’m on the pill” or “I’ve just had my period”, and men feel reassured they don’t need to put on a condom? How can men be responsible for the unwanted pregnancies that might result? Doesn’t saying men cause all unwanted pregnancies suggest women are powerless victims, without agency in the matter? What about when a condom breaks?

Gabrielle Blair in conversation with CBS anchor Tony Dokoupil at P&T Knitwear in New York City on March 1, 2023.

Blair’s argument goes like this:

Men are fertile all the time, and throughout their entire life. Their sperm can live up to 5 days inside the vagina. They control when and where they ejaculate and how often. It’s very easy for men to use condoms. Men can learn which condoms they like, and how to use lubrication if necessary. Condoms have zero side effects, don’t require a prescription or a doctor’s exam, are very cheap and often free. Men face zero (or near zero) social consequences for causing unwanted pregnancies. They walk out on their sexual partner’s unwanted pregnancy remarkably often. Vasectomy is an outpatient procedure that takes 15 minutes, is very safe, requires only local anesthesia, and is largely and increasingly reversible.

For their part, women are fertile only 1–2 days a month. They don’t control and cannot predict very accurately when they ovulate. Birth control options for women are expensive (especially in the US), can have side effects, and can be difficult to access (requiring repeated doctor or clinic appointments, as well as unpleasant and even painful physical exams or procedures). These contraceptives sometimes fail. Safe abortion is not easily accessible everywhere, can be very expensive, and is criminalized in some countries. Pregnancy and childbirth are serious medical events that can be lethal and that leave women’s bodies scarred and sometimes severely injured. Women and girls face major social consequences for an unwanted pregnancy. Women cannot walk out on an unwanted pregnancy; they have to deal with it, whether by abortion or by having a baby. The burden of raising children is still largely borne by women, and it is a massive one. Tubal ligation is (minor) abdominal surgery that requires general or spinal anesthesia, and reversing it is major surgery.

It's not a 50-50 equation, said Blair.

I especially like her chapter entitled: “We’re not honest about pregnancy and childbirth,” where Blair outlines the danger of dying in pregnancy and childbirth (800 people die every day around the world, 800 die every year in the US, with Black women three times as likely to die than white women, irrespective of income and education levels). As a mother of six, she writes authoritatively about the injuries, pain and discomfort of pregnancy and delivery: “I’ve had six textbook ‘healthy’ pregnancies. If you had asked me after each one if I had experienced scarring, pain or loss of function, I would have thought of all the women I know who had medically terrifying pregnancies or childbirth and quickly replied, ‘No, my pregnancies were very straightforward with no big medical issues.’ And while it’s true that my pregnancies were very straightforward, if I think about it for more than a moment, I can identify scarring, pain, and loss of function that my body has definitely experienced from pregnancy and childbirth.”

Common damage includes skeletal changes, organ prolapse, bone loss, hair loss, a broken coccyx, extreme nausea and vomiting that damages the esophagus, cracked ribs, massive blood loss, diabetes, chronic high blood pressure, new allergies, hemorrhoids, genital tears, longterm pelvic or vaginal pain, incontinence, abdominal muscle separation, weight gain, widespread scarring, and more, some of which Blair experienced herself and downplayed.

In the US, “A pregnant woman is more likely to die due to that pregnancy than a police officer is to be killed on the job. And it’s not just that pregnancy and childbirth are more dangerous than other work; it’s that 86 percent of women do this dangerous work—and most do it more than once. There is nothing similarly dangerous that we assume 86 percent of men will be willing to do. Men famously can’t handle the pain when connected to a menstrual cramp simulator. Men wouldn’t accept the side effects from a male birth control pill (such as acne and weight gain; and, in fact, research on a male pill was abandoned as a result of men’s reaction of those side effects). Yet men expect women to experience pregnancies that routinely maim them and can even kill them.”

This situation is infuriating and deeply unjust, writes Blair, and yet women have also been conditioned to think that all of pregnancy prevention is their problem. Women buy 90 percent of all contraceptive products in the US. Women are even expected to keep condoms on hand—in the US, women purchase more than 30 percent of condoms! Blair said this all dawned on her when her eldest child was nine and she realized she still thought birth control was her responsibility. How wild is that?

Blair argues that we have to turn the entire argument about unwanted pregnancy and abortion on its head: given their role in causing unwanted pregnancy, men have to take responsibility for preventing it. Men should therefore make sure they always ejaculate responsibly. That means, always, always putting on a condom (or ejaculating away from the vagina) unless both partners are prepared for the woman to become pregnant. Yes, even when the woman just had her period or is using contraception, because as Blair notes, ovulation is incredibly unpredictable and contraception can fail. And when a couple has had the children they want, the man should get a vasectomy. Right now in the US, only 9 percent of sexually active men get vasectomies (vs. 27 percent of sexually active women who get tubal ligations). Come on, men!

But what if the woman tells the man it’s OK not to use a condom?

“A woman telling a man he doesn’t have to wear a condom doesn’t force that man to have sex with her without a condom. He has the right of refusal. If he chooses to have sex without a condom, then he is choosing to risk causing an unwanted pregnancy. No matter what a woman ‘lets’ a man do, she can’t (legally) make a man ejaculate inside of her. When he does, that’s 100 percent his doing. We know this is true because if she ‘let’ him put his penis in a waffle iron, he wouldn’t. If someone tells you to do an irresponsible thing, and you do that irresponsible thing, that’s on you.”

Is Blair turning women into helpless victims of men's sperm? Blair says she isn’t absolving women of responsibility for their own bodies, but that’s hardly saying anything, she also notes, because women already do almost all of the pregnancy prevention work! She states, “Women should be responsible for their own bodies and bodily fluids. They currently take on that responsibility, and they should continue to do so. I’m simply pointing out that men need to be responsible for their own bodies and bodily fluids as well…. Pointing out that men have bodily fluids that can cause pregnancy, and therefore need to take responsibility for those bodily fluids, does not remove accountability for women or make women victims. It doesn’t say anything about women at all.”

Wow. It’s hard to argue with this. And Blair addresses all the predictable rebuttals. OK, maybe not the condom that breaks at precisely the same time as the woman’s birth control fails. That, I would say, could be the one exception to the 100% rule of men causing unwanted pregnancy. But how many cases is that?

To be clear, Blair fully supports abortion access for everyone. In her remarks, she emphasized she is not making a case about whether anyone “deserves” an abortion. Pregnancy should never be a punishment. She is not a proponent of adoption as an alternative to abortion, and devotes a chapter to debunking that favorite right-wing “solution” to unwanted pregnancy. But, since so many conservative men seem to be so preoccupied with reducing the number of abortions these days (!), Blair argues for changing our approach to pregnancy prevention through “a culture of ejaculating responsibly, combined with free and accessible birth control and thorough sex education.” Yes. That would make so much sense.

One nitpick: Blair writes that this new cultural approach would effectively eliminate “elective” abortion (as opposed to medically required abortions). In this, Blair is clearly trying to highlight the hypocrisy of anti-abortion forces who claim to want to end abortion, but are against sex ed and contraception and in favor of punishing women. Is her single-minded focus on getting men to take full responsibility getting her a bit carried away? We can never eliminate elective abortions, and Blair knows that. Pregnant persons can seek an abortion after initially wanting to be pregnant for all kinds of reasons, and it isn’t anyone’s business but their own. I would have preferred if Blair had refrained from going into “abortion reduction” territory, especially at this time when abortion rights and all other reproductive and sexual rights are under such attack in the US. Changing one’s mind about pregnancy and delivery is actually a very reasonable decision, given all the consequences of pregnancy that Blair herself outlines.

When asked about her favorite response to the book, Blair replied: “When a man tells me he read the book and then had a vasectomy.” Next to her, Dokoupil proudly raised his hand, and confirmed that he has been talking to other men about his vasectomy.

Buy the book for yourself and for the men and boys in your life, and begin the conversation. Have the debate! Unwanted pregnancy and abortion are men’s issues, after all.

In solidarity and responsibility,