Hannah Riley talks about women’s health, the contraception gap and the importance of owning the narrative

People who think women’s health inequality is a thing of the past couldn’t be more wrong. It’s 2022 and women still receive worse healthcare and experience poorer health outcomes than men.

It has been over 25 years since the landmark Beijing Declaration and Platform for Action on Women – while some progress has been made, the battle for gender equality in healthcare is far from over.

Women still lack a strong voice in healthcare, which is an issue the communications industry needs to take greater responsibility for challenging. The need for radical change is starkly illustrated by the lack of attention female contraception receives in the healthcare industry.

Double standards

Last month, it was reported that a ‘99% effective’ male contraceptive pill with ‘no observable side effects’ may be available imminently, following a successful trial on mice at the University of Minnesota.

While some saw the availability of a male oral contraceptive as an important milestone in the fight for men to share the birth control burden, why has the elimination of side effects been prioritised in men, when the same side effects still haven’t been addressed for women?

Human trials of the non-hormonal male pill could start as early as this year, and yet contraception remains an area of healthcare rife with barriers and inequalities. Since the widespread availability of the pill in the 1960s, progress has been painfully slow in the female contraceptives market. Noting the many persistent gaps, Julie Kohn, National Director of Research at the Planned Parenthood Federation of America, said in 2018: “I can’t imagine another area of healthcare where we would say, ‘Okay, I think we’re done here’.

Kohn is justified too. Drug companies are reluctant to invest in new forms of contraception. Research by The Gates Foundation shows that only 2% of drug company profits are returned to research and development, despite an estimated ROI on birth control thought to be at around £9 per every £1 spent. This could be due to the perception that studying contraception involves studying the trickiest of experimental subjects – women.

Inconvenient research vessels

In her 2019 work, Invisible Women, Caroline Criado Perez exposes the serious lack of representation women face in clinical trial research. There is a misconception, she explains, that fluctuations in progesterone and oestrogen levels throughout the menstrual cycle render women’s biological make-up too difficult to study.

To circumvent our ‘burdensome’ unpredictable physiology, studies are most often conducted on women in the early follicular stage of the menstrual cycle. Essentially, when we are superficially most like men.

What is perhaps most shocking, is how until recently very little was known about how hormonal contraception affects the non-reproductive systems of the female body, because research on these systems has been done almost exclusively on male subjects.

In her book This Is Your Brain on Birth Control, Dr Sarah E. Hill points to research indicating that the pill changes your brain, increases the risk of depression, affects your stress response and even influences your choice of mate.

Changing the conversation

Public sentiment about the pill certainly seems to be shifting. When a 2014 study of over a million Danish women showed an increased risk of depression associated with hormonal contraception, many women saw this as confirmation of what they’d long suspected.

Indeed, 26% of millennial women surveyed in 2018 reported that they had either considered giving up the pill or had ceased taking it because they were worried about ingesting synthetic hormones.

Yet the widespread availability of the contraceptive pill over the counter suggests that the medical world sees nothing wrong with the current contraception offering available to women. In this regard, women’s voices have yet to be heard, but communicating our personal experiences may help to change the conversation and advance female birth control.

It would be encouraging to see the same progress in contraception that other areas of women’s health have enjoyed in recent years. Bodyform’s 2020 award-winning ‘#Wombstories’ multimedia campaign shifted the period paradigm by starting a movement that encouraged women to share their own emotional, human experiences.

Created by an all-women team, the emotive advertising depicted ‘the imagined life of wombs’ while capturing the ‘emotional roller coaster of the lifelong relationships that women have with their uteruses and vaginas’.

Bodyform’s success hinged on listening to the needs of its target audience carefully. The campaign was born when its uncovered the shocking statistic that 40% of women said their mental well-being had been impacted by not being able to openly share experiences around issues like miscarriage, fertility and periods.

Unlike clinical research, Bodyform embraced the complex nature of womanhood and menstruation. It isn’t aren’t, however, the only brand to catch on to recognise that putting the spotlight on women’s health issues resonates with its target audience.

Oversharing is engaging

Research suggests that one in ten women experience mental health issues during pregnancy, or within the first year of having a baby; this can result in seven in ten women hiding or underplaying its severity.

Maltesers’ 2021 campaign #TheMassiveOvershare sought to break taboos surrounding mental health, pregnancy and motherhood by giving women an online space to share their experiences and connect with one another.

Mars’ website reads: “Maltesers aims to help women build resilience by laughing together through the tough stuff. It’s what we’ve always done and what we will continue to do, now and for years to come”. Maltesers used the #TheMassiveOvershare hashtag to provoke discussion and then amplified user-generated content online and through outdoor ads.

EllaOne’s ‘My morning after’ campaign invites women to share their real-life stories of taking the morning-after pill in an online forum, in a bid to break taboos surrounding emergency contraception. In parallel, EllaOne uses its social media platforms to dispel sex myths and to answer the emergency contraception questions you were too afraid to ask. There are also important scientific developments in this area.

An equal share

Communications leveraging humour and shared experience are undoubtedly effective at pushing forward conversations about women’s health. It seems there is no shortage of women with stories to share, they simply need to be heard.

Saundra Pelletier, Head of Evofem Biosciences, recently raised a reported $306.7 million from investors to bring a newly approved, non-hormonal contraceptive gel for women to market. Pelletier’s success has emerged from the CEO’s refusal to underestimate the importance of women’s health.

She told Forbes: “I wanted people to understand that it wasn’t about me just wanting to be this feminist who wanted to empower women; that there’s really a value proposition in investing in women.”

Big pharma could look to Pelletier for lessons in capitalising on the unmet need for greater contraceptive freedom by simply listening to women.

Equality in women’s health is long overdue and more effort must be made to close the contraception gap. Women make up half of the global population – it is absurd that we don’t make up half of the conversation about our own health.

Hannah Riley is Account Lead at Onyx Health. Go to onyxhealth.com