INTRODUCTION

The campaign for 'women's right to choose' is notorious in North America. 'Women's right to choice' has functioned as the political rallying call for those working towards the expansion of women's control over reproduction. And while the expansion of women's 'rights' has been about many things, the infamous case of Roe versus Wade initiated a particular association in North America between women's rights and women's right to choose (Solinger, 2001). In North America, the term 'pro-choice' now asserts a specific political objective: towards safe, accessible and legal abortion care for women.

In her critique of 'the politics of choice,' Rickie Solinger (2001) identifies the discursive move from a 'rights-based' to a 'choice-based' argument as one that demotes the priority placed on women's social positions and reproductive work. Moreover, Solinger (2001) claims that the appeal for choice denies situations of differential access to 'choosing' and obscures a complicated history of abortion and sterilization practices in the United States – a political context in which racialization and poverty have functioned in systematically denying some women control over their bodies and their reproduction. Solinger (2001, 35) makes a claim that is controversial in North American consumer culture: '... that if there is a hierarchy of special guarantees, surely choice must be at the bottom, the lowliest and weakest of all "guarantees".'

The discursive union of 'rights' with 'choice' did not dissolve with the legalization of abortion in Canada. 'Choice' is continually heralded as a necessary objective for improving women's access to abortion care as well as to granting women control over other aspects of their reproductive lives. Lealle Ruhl (2002) also takes the principle of 'choice' to task. Ruhl (2002) challenges the benevolence of demanding women's 'choice' in reproduction and asserts that the contemporary imperatives enacted via assumed liberal subjectivities and their accompaniments (eg 'the rhetoric of control') function to obfuscate what are often women's complicated and contradictory positionings relative to reproduction. Both Solinger (2001) and Ruhl (2002) alert us to the eugenic genealogy of efforts towards reproduction control, and both critics demand attention to the multiple and complex ways in which discourses of control via a concern for 'choice' are put into practice.

In this paper, I take up the work of Solinger (2001) and Ruhl (2002) and consider women's choice in the use of oral contraceptives (OC). I use theoretical analyses of the contradictory qualities and qualifications of 'choice' to work through a study of women's experiential assessments of their right to choose OC. While a growing body of theoretical work addresses the neo-liberal constitution of a 'choosing subject' and whether, where and how such a subject exists, there is little empirical work that then brings these analyses together with women's actual articulations of 'choice' in fertility control. Thus, the present paper is among the first to address young women's critical and experiential assessments of choice in their OC use and in women's access to contraception in general (See also Granzow, 2007; Hester, 2005; Lowe, 2005; Lupypciw, 2006).

Through an in-depth analysis of face-to-face interviews with women from a Canadian university, I explore competing notions of choice as voiced by 20 participants who have used the birth control pill. Against these descriptions, I provide a historical consideration of the liberal notion of the 'right to choose' and argue that the concept fails to capture the complexity expressed in women's decisions to take and stop taking the birth control pill. Offering a theoretical critique of the social invention of 'the right to choice,' this paper then moves to consider what participants express as the very familiar, even daily, paradoxes of choosing The Pill. Their contributions erode claims that 'the choosing woman' is synonymous with 'the liberated woman' and beg the following question: how can the 'right to choose' be realized when 'choosing' is articulated as less than the enactment of a 'right' and more so an act of consumption, characterized not by a selection of viable alternatives but by a compromised 'making due' bound by social expectations? Bringing women's descriptions of choice together with theoretical critiques of choice, I speculate that the discourse around use of OC has had the effect not only of making liberal bodies, but also of making women's bodies into liberal bodies of consumption (Solinger, 2001). This analysis does not leave women without choice, but does work to demystify the contexts and possibilities for choosing, and to complicate and socially locate the variety of forces women work through in negotiating the possibilities for and processes of reproduction.

I will not conclude this paper with the assertion of an alternative to the 'choosing' contracieving subject. What I will do is suggest that women's decision-making around contraception might be more interestingly thought to resemble what Hester (2005, 78–79) appropriates as a process of bricolage in which women are the bricoleurs. Accordingly, women rely on various forms and sources of knowledge, including the embodied, in their negotiations – in the decisions they make or refuse to make, in the ones they regret, and in the ones they may cherish and/or change during the course of their lives. As bricolage, women's decision-making around contraception use can be thought of as relational rather than individual (Lowe, 2005): as Lowe demonstrates, the complicated nature of reproduction puts women in positions of negotiating in relation to others. I return to these possibilities in the conclusion of this paper but for now note that such novel conceptions of decision-making allow for the many (eg embodied, social and psychological) and contradictory ways in which we are in, and we reproduce the social and material world.

WOMEN'S RIGHT TO CHOOSE

The claim for universal 'human rights' has lost its appeal. Critics assert that the 'human rights' paradigm is a myth: it is an ideology that claims universality while offering security only to those who fit within a very particular version of 'human' (see Code, 1991; Scott, 1996; Ruhl, 2002). According to the critique, 'rights' do not belong to all but only to 'the universal subject' – a subject, who happens not to be universal at all, but very particular and living in a very particular version of the world. Stepan (1998, 28–29) clarifies: 'the abstract citizen is conceived of as male ... Western, European, civilized.' He is presumed autonomous, of rational intellect and free will (Lather, 1991). He claims a distinct separation between mind and body and prioritizes his capacity to contemplate as essentially human (Arendt, 1958). Expressions of rationality, self-discipline and disembodiment define liberal subjectivities in this context (Ruhl, 2002, 642; Stepan, 1998, 29). Those eligible for the status of 'human' and thus for 'human rights,' express themselves accordingly. Denial or deficiency in these critical aspects (eg through an indication of lack of self-control) disqualifies. Subjects constrained by social obligation or tradition, or subjects who simply refuse or who have inadequate resources to demonstrate their primary autonomy fall short of meeting the requirements of 'human' and the associated allotment of 'human rights.'

Those against whom the humanist subject is defined have no chance of approaching these ideals – they are, by definition, that which the rational, self-disciplined and disembodied is not. Feminist scholars have debunked the many ways in which essentialist conceptions of 'woman' have been historically and contemporarily made as fundamentally against or in opposition to conceptions of the male citizen subject (see Code, 1991; Davies, 2000; Lather, 1991), and thus have exposed what has become a 'paradox' of paramount concern for feminisms on the problem of women's rights (Scott, 1996). And despite liberal feminist strategies to incorporate women as citizens, so long as the framework according to which women's 'equality' is sought is that of the humanist subject, attempts run fundamentally counter to their own achievement (Scott, 1996). Mainstream efforts to improve women's social status, however, continue to rely on a liberalist philosophy and on its attendant assumption of women (categorically) as ideal humanist subjects. Women (again, categorically) as reproductive, thus, are such according to a 'procreative ideology' (McLaren, in Ruhl, 2002, 642) that mirrors the same ideals. The present-day ideology around reproduction positions pregnancy as a matter of 'the will' – one congruous with a general 'fetishization of the will' and with the mind/body split characteristic of modern liberal states (Ruhl, 2002). Technologies facilitate the exercise of 'will' (eg The Pill) and pregnancy is materially and symbolically transformed: 'the willed pregnancy rehabilitates pregnancy (and, therefore, women as well) for liberalism; in this way (self-) control is imposed on a biological process widely held to be beyond human control and thus beyond the scope of liberal theory' (Ruhl, 2002, 660). The very aspects of the female subjectivity once construed as inherently out of control and dangerous succumb to the tyrannies of liberalism and are engulfed by its tenets – at least in theory. In practice, with women's status as subjects at stake, there emerges an imperative to control processes like birth. The term birth control speaks volumes about the ideological underpinnings of liberal notions of reproduction. The term implies that spacing, regulating, and otherwise 'interfering' with supposedly natural processes ... are not only possible but indeed desirable and even necessary. Seen in this light, women's reproductive capacities are unruly and damaging to women's liberty... (Ruhl, 2002, 650). If control of her reproductive capacity is what grants her 'freedom' then the question of 'choice' is brought immediately to bear: with freedom at stake, the 'choice' is one between being free and not being free – a dubious 'choice.' Against the imperative to control reproduction, choice does not seem to adequately represent or address women's negotiation of the matter (Ruhl, 2002; Solinger, 2001). 'Choice' no longer appears an isolated possibility or even uniformly desirable but instead requires more cautious thought: 'women's right to choose' is full of complications, problems and paradoxes in relation to women's decision-making, sex and reproduction. But what does this mean in practice? What does it mean in daily life?

THE POWER OF THE PILL

As a cultural icon The Pill (also referred to in this paper as the oral contraceptive pill, OC, or the birth control pill) has come to represent women's social advancement. The Pill is often credited as a major factor in the supposed 1970s' American 'sexual revolution' and in Western women's subsequent 'liberation.' In popular North American discourse, The Pill is frequently associated with women's attainment of the sexual and professional rights and freedoms long exclusively men's. With access to technologies like The Pill, women in Canada start families later (the average age for first birth in 2003 was 28, up from 1983 average age of first birth at 25), achieve higher professional status, make more money and live outside of a traditional nuclear family structure more often than they did 20 years ago (Statistics Canada, 2005, 2006).

It would be a mistake, however, to postulate a causal link between The Pill and women's 'liberation.' That argument is persuasive only if the various forms and histories of gender oppressions are uniformly considered to be due to women's essential biological inferiority. Such theories lack attention to the social constitutions and dynamics of gender oppressions in Western histories and also presuppose a primary and 'natural' heterosexual monogamous reproductive relationship structure. Moreover, such notions ignore the problem that access to contraception may leave patriarchal power relations largely intact or may even work to strengthen that social order. Cultural objects contain the values for their imagining and thus, it is more likely that a technology will work in compliance with, rather than against, a dominant ideology. Contemporary sociological analyses of the current social pressure for women to mother in North America, for example, reveal the complex problems at hand in determining or achieving control over sex and reproduction (see Overall, 1989; Morgan, 2002; Petchesky, 1990). There is, then, a substantial gap between the power of The Pill and the deeds for which it is often credited.

RESEARCH DESIGN

In 2001, I conducted in-depth, unstructured interviews with 20 women regarding their experiences having used or using The Pill. The sample was comprised of women between the ages of 18 and 28 years, who had used the birth control pill, currently or in the past, and who responded to an invitation to share their experiences. All participants in this study were guaranteed anonymity and confidentiality, and each provided informed consent. This research was granted ethics approval from the University Research Ethics Board.

In terms of demographics, these women might be considered the 'privileged' in Canadian society. Most either had completed or were currently enrolled in post-secondary education in Canada (although one participant was in her last year of high school and had plans to attend university in the coming year). The sample's homogeneity in terms of education offers both a challenge to the analysis as well as a unique opportunity. If women in Canada are finding the terms to describe empowerment and women's liberation as related to choice in pill use, we might expect to see such articulations from women with the resources, the social and cultural capital, to enable the pursuit of post-secondary education. This is, after all, the population that national Canadian statistics inform us are putting off marriage and child rearing, and thus, it is this population that a liberal feminist position expects to find an 'empowered' contingent. The critique of choice and of gender equality offered by this sample of women, however, finds this privileged population still struggling with the inequalities of past and now with a paradox presented to them in choosing or not choosing the contraceptive properties and sometimes difficult side effects offered by The Pill.

The homogeneity of this sample cannot provide insight into problems around differential access to contraception. The women interviewed had access to contraception. That many women in Canada and internationally do not have access to contraception is a problem that requires redress.

FINDING CHOICE

All 20 participants stressed the need for women's 'choice' in contraception: having choice was a clear priority. Comparing interviews, however, found no one way in which women spoke about their individual choice in pill use. Participants described the importance of the right to choose, while details of women's stories made frequent reference to a variety of constraints, to a lack of information, and to relationship and social pressures. Few women identified a moment at which they individually made an informed and holding decision to use The Pill. More women provided descriptions of their individually experienced lack of choice in pill use. All women, however, characterized the exercise of choice in pill use as essential for other women. Even women who had described their own pill use as compelled in some way went on to situate pill use for women in general – that is, presumably for 'other women' – as a choice. I postulate that the distinction made is one between identifying a personal experience in using The Pill as, for particular reasons, compelled, against a more general impression of pill use as a freely elected and often desirable option for women (Granzow, 2007). While the nature or degree of 'choice' expressed in these interviews is interesting, this project considers the notion of 'choice' as put to use for a framework according to which many of the women understood women's need for contraception.

ON OPTIONS

That choice does not exist without options seems a banal point to make and yet, it is against what women describe as a lack of options that the choice to take The Pill is often made. A 1984 study (Benn and Richardson, 1984, 220) compared the range of contraceptive options for men and for women and found an 'enormous disparity between the sexes.' At that point in time, most contraceptives were designed for women's use and could be obtained only from medical experts, whereas the few designed for men were 'freely available in public places' (Benn and Richardson, 1984, 220). The side effects of contraceptives for women were extensive and sometimes serious (including an increased risk of death with OC use): men's contraceptives provoked minimal, temporary side effects, if any at all (Benn and Richardson, 1984). Outdated though this study is, the conclusion unfortunately holds: today most options available to women are invasive, with significant side effects and require administration by a doctor or, as in the case of the rhythm method, are not very reliable.

These are some women's assessments of the viable alternatives to The Pill: Condoms just seemed to be a bit of a nuisance. And it's not like we had any concern about STDs or anything like that. I'd heard horror stories about the Depo-implants, so that was definitely not something I would have wanted to do. So it [The Pill] basically seemed like the only option left (Kim). ... I don't really have an option to not have it [The Pill] as a part of my life for the kind of life that I have ... it's just really not an option for me not to be on some kind of birth control (Monica). Renee spoke about switching to The Pill because condoms were less effective and having a baby was not an option: 'I probably wouldn't be able to move onto marriage, and until I really could support myself I know I can't support a baby, so I will not be pregnant and that's my choice.' Kyla, though concerned about side effects, felt she had no choice but OC use: ... I'm engaged, so having sex regularly... the condoms just aren't feasible because they cost so much. We wouldn't be able to afford to keep going to get condoms. I don't like the idea of a diaphragm. I can't imagine the fumbling to try to put it inside myself (laugh). And the other birth control methods just don't seem dependable enough ... I really don't want to get pregnant right now. Ann also described other methods of contraception as cumbersome and The Pill as less embarrassing and thus 'easier' to use: There was something less embarrassing about The Pill ... I'm almost embarrassed to say this (laugh), I guess some jellies and condoms and diaphragms that all have to do with your reproductive stuff and goes down there. A pill you just put into your mouth (laugh). These are strong statements for women's need to prevent pregnancy and for effective and reversible forms of contraception. These statements also reveal an absence of alternatives. Whether it is because The Pill was very effective or because other methods are incompatible with contemporary social norms regarding sexuality (eg as embarrassing) and romance (eg as spontaneous/uninterrupted) (see Colodny, 1989), these women cited an absence of alternatives to Pill use. The OC is not, then, freely chosen as an ideal contraceptive from a pool of different effective options but is selected from a rather small and unviable pool of 'options' – none as effective, all more of a nuisance, costly and embarrassing.

Despite impediments to choice, this sample of women described themselves as informed of the contraceptive options that do exist. Knowledge and access to 'options,' however, must shrink or expand dramatically depending on a woman's relative position of social privilege (Solinger, 2001). Thus, the choice expressed thus far is already to some extent about the ability to access the product and thus is the privilege of few rather than the right of all women (Solinger, 2001). As historian and social critic, Rickie Solinger (in Smith, 2005, 99) claims:
'Choice' has become a symbol of middle-class women's arrival as independent consumers. Middle-class women could afford to choose. They had earned the right to choose motherhood, if they like. According to many Americans, however, when choice was associated with poor women, it became a symbol of illegitimacy. Poor women had not earned the right to choose. What for participants in this study is the troubled selection of a contraceptive from several less desirable and perhaps tried 'options,' might for women with fewer resources be the use of the only available option. Women working against social prejudices that position them as 'unfit mothers' may not be trusted with reproductive decision-making and may, as they have in the past, face brutalities such as forced sterilization or imposed long-term contraception (Solinger, 2000): a phenomenon witnessed in the forced sterilization of some women in Alberta, Canada from 1929 to 1972 (Grekul et al., 2004), for example (see also Solinger 2000). Against these realities, the concept of choice as if it were commonly available breaks up and reveals itself as allowing for only the socially sanctioned chooser and choice.

Setting aside the very crucial problems of limited options and differential access to too few options, I turn now to consider how this rather elite population understands their use of The Pill in relation to 'choice.' The women in this study had access to The Pill – did they, however, have access to choose to use The Pill?

STARTING THE PILL

Categorized broadly, participants in this study identified two reasons for initial pill use: (1) as medicine or to manage menstruation (12) and; (2) as a contraceptive (6).¹ Reasons for pill use changed but all women identified The Pill as functioning to serve at least one, and sometimes both of these purposes. Some women went on and off The Pill a number of times and for different reasons at different points in time, while other women's motives for pill use changed over time while use of The Pill remained constant.

The pill use was considered a medical treatment when participants described initial use of The Pill as a cure or as a solution to a physical problem. In each of these cases, a doctor was consulted and recommended pill use for the treatment of a complaint. For stopping ovarian cysts, lightening or regulating menstrual flow, or clearing acne, initial pill use was defined as the use of a medicine by 12 of the 20 women. A number of the women in this group articulated menstruation itself as an ailment: that is, they did not describe their menstrual cycles as particularly problematic but they nonetheless required a means to control or diminish or alleviate pain associated with their cycles. That menstruation itself might require medical intervention is a significant point: if a physiological process commonly associated with womanhood (eg menstruation) is likened to an ailment, and if this occurs in the context of a biomedical system of knowledge in which ailments require interventionist treatment, then 'choice' is perhaps not the most appropriate conceptual framework for understanding women's use of The Pill.

When initial pill use was described as a medicine, very few described it as a personal choice. In most articulations, 'choice' was not featured unless it was to articulate a lack of choice in first use of the OC pill. Initiating pill use as medicine seemed outside of the 'choosing' realm: I thought, well this is really strange, I'm so young and so the doctor, who I think is a total jerk-off now (laugh), ... he put me on The Pill ... it was really strange because when I think back about it now, I mean, he just kind of says 'oh here's The Pill' and there's not really much to talk about (Val). They sent me for ultrasounds and whatever else they do to see if there's anything wrong there. They couldn't find anything wrong so he just decided, one of the things The Pill does is regulate your period, so he [the doctor] decided to try that and it worked (Jane). ... I was having bad cramps, really really bad cramping ... so then my doctor said 'let's put you on The Pill'. So he put me on The Pill at 16 (Ellen). I was put on [The Pill] at 16 um, to deal with menstrual cramps ... [it was] the doctor's advice because I'd been on painkillers for cramps and they were getting stronger and stronger until I was on prescription painkillers. And they still weren't doing the job so finally he said 'okay, on to The Pill' (Leslie). I didn't even choose to go on it, because I thought there may be other things that might be better (Marcie). A woman using acne medication associated with birth defects said this: ... my doctor – he didn't force me but for legal purposes he had to make sure that I was on the pill just so that if I was ever to get pregnant that there would be no chance of having a child with physical or mental disabilities .... And then after, I guess my mom just figured it would be a lot easier if I just stayed on The Pill (Angela). Whether directly or indirectly, each of the preceding excerpts offer descriptions of initial pill use as somewhat passive. They feature the doctor in an active role and the woman as 'put on the pill': in the context of these described doctor–patient interactions, pill use was not as much woman-chosen as doctor-prescribed.

But just as these descriptions are not of women freely choosing to use the OC, they are also not instances void of women's decision in the matter. While the doctor's office frequently offers a particularly structured relationship in which the advice/prescription/opinion of the doctor is solicited, starting OC this way does not necessarily entirely eliminate experiences of 'choice' in pill use. One woman details this nicely. Although Rebecca stated that the doctor put her on The Pill she also said that she took The Pill despite her parents' opposition, making her own decision to use it: 'I figured I'm the one who is suffering through this every month (laugh) – I'm gonna make my own decision, you know.' In relation to her interaction with the doctor, Rebecca described a passive role but in relation to her parents' opposition hers was one of active decision-making. What we gain from Rebecca's account is the sense that choice is complex, not dichotomous, and that it is relational and context-specific. One does not either choose or not choose to use The Pill: in some contexts what looks like acquiesce to OC use may in others be an active decision, or it may be somewhere between the two. That women's descriptions of the doctor–patient interaction in initial pill use tend towards a representation of patient-as-recipient is a significant reflection on women's role in this particular 'health' setting.

When The Pill was considered medicinal, women seemed disinclined to see starting The Pill as an instance of choice and instead offered context-specific and relationally oriented descriptions of their decision-making. These articulations open up the possibilities for contradictory choosing and allow for an understanding of choice not as women's right but perhaps as several moments in which irreconcilable social expectations are negotiated. In these cases, irreconcilable social expectations may be in the tension between a commonly held association between womanhood and reproduction (eg menstruation or pregnancy) and in the social necessity that women keep such reproductive processes invisible, private and under control (See Douglas, 1966; Martin, 1987).

If choosing exists as context-specific, relational and thus on a moving continuum, rather than as a dichotomy, three women who used The Pill as a medicine described their experiences starting The Pill as their active pursuit. Susan pursued pill use when her doctor's prescriptions for painkillers failed: ... when I got to university I said, 'Enough's enough! I have to. I can't afford to miss one day of school every month or two because I'm off sick. So I went and I got the pill from Health Services and it was actually pretty good, my periods stabilized, the pain diminished by a lot. I could get up and do things that I had been able to do during all the other days of the month (Susan). Yet, her active procurement was prompted by an 'enough's enough!,' which is not the choice but the imperative to address a pain that would otherwise keep her from full participation in post-secondary education. I suggest that this too represents a moment of irreconcilable social expectations. Even an informed and active consumer is not necessarily choosing if the alternatives exist only at the cost of full and active citizenship in a neo-liberal context – in this case, through participation in education.

In general, 12 women described starting The Pill as use of the appropriate and prescribed medicine for a specific condition (although the condition may be physiological womanhood, eg that one menstruates at all) and not as a free choice. It is perhaps the case that such descriptions, by virtue of their nature as health-related, do not required one to offer a specific claim to having chosen The Pill. Perhaps the medical/health-oriented 'nature' of the issue disqualifies initial pill use as an instance of choosing or not. The matter is not about women's right to reproductive choice but is a matter of 'health.' As a 'health' concern the user does not need to formulate pill use in feminist rhetoric of the liberated and choosing subject: health is apparently beyond politics and does not require a choice-emphasized framework. In these accounts, The Pill was described as enabling a more full social participation and thus was a requirement and not a choice. In modern Western and neo-liberal societies, there is an expectation that the body not infringe on social life (Douglas, 1966) and so efforts toward circumscribing the porous body do not require 'choosing:' they are instead necessities and the matter is one of women's health and the manageability of daily life. When the reproductive body threatens to breach the public/private divide, one's humanist subjectivity is at state and a 'cure' seems imperative.

'IT'S A RESPONSIBLE CHOICE': STARTING THE PILL AS CONTRACEPTION

When I first started taking the pill I was proud of myself for taking the initiative to take precautions before I'd ever started sleeping with someone, and that I did it on my own, that I went to the doctors on my own and said 'This is what I'd like to do. This is who I am. Can you give me the information?' I felt I went about it in a very adult way even though I wasn't an adult and I still carry that with me (Ann). Fewer (six) women started The Pill as contraception and each indicated a general sense of pill use as a clear and personal decision. All women who started The Pill as a contraceptive did so while they were in or planning to start a sexual relationship and each expressed that they were taking responsibility for contraception. Comments that speak to the high priority placed on individual responsibility in this regard run throughout these texts, such as: 'doing the mature thing,' making 'the responsible decision,' and 'to me it's a responsible choice.' But what if the imperative to take responsibility is no freer than that to control a body considered socially unmanageable or out of control? Contained within what McLaren (in Ruhl, 2002, 644) terms the contemporary 'procreative ideology' is that '... responsible women ought to control their reproductive functions, indeed, that is what constitutes responsibility where reproduction is concerned'. Thus, a woman is not responsible first and therefore chooses to use contraception. Rather, in using contraception she demonstrates her responsibility. I return to Ann's request to her doctor, 'This is what I'd like to do. This is who I am.' 'The willed pregnancy demands that individual women internalize a paradigm of responsibility that assumes forethought and planning in reproductive matters' (Ruhl, 2002, 645), thus, being responsible via pill use might be a well-internalized imperative. Again, 'choice' as a one-dimensional concept drops away and appears to look more like an element of constituting subjectivity.

It is important to emphasize that if The Pill is the responsible choice, responsibility is not associated with women's protection from sexually transmitted infections or diseases. It is, rather, associated with sexual availability, with sex without reproductive consequences and, if one is concerned with their protection from infection or disease, it is also associated with monogamy. It is, thus, a form of asserting responsibility open only to those engaged in heterosex. The choice to use the OC or not is not as clearly about the presence of choice as it is about women's negotiation of social expectations to be heterosexual and areproductive, and to be individually responsibility for a relational act.

Women who procured OC for contraception tended to describe knowing that they wanted to get The Pill and also knowing where and how to get the OC. Describing an active role in obtaining OCs is, of course, not synonymous with having 'choice' but it does indicate a desire to express some autonomy in obtaining the contraceptive. At minimum it seems that in the situations described, the self is situated as a chooser and as a sexually mature, responsible agent. In these stories, health is not the central issue. And in fact a consideration of health is remarkably absent when it seems that what is the responsible choice may be one that leaves women at some risk of sexually transmitted diseases and infections or may itself constitute a health risk. Choice, however, is the primary used framework for explaining this process.

ON AGE AND CHOICE

Women who started The Pill as a medicine or as a menstrual control were, in general, younger at the age of initial use than were those women who began The Pill as a contraceptive. Two of the women were 14 years old when put on The Pill as a medicine whereas the youngest woman starting OC for contraception was 17. This difference in age of first use probably accounts for a very significant difference in how women express their role in initial use. Liberal subjectivities are age-bound: that is, they are the domains of adults. Children do not have access to the position of rational actor. Thus, these interviews may offer a sense in which articulations of self-responsibility in relation to sexuality become important. The interview hour itself may also offer an opportunity to retroactively constitute one's self as either lacking or asserting self-determination in pill use. Most who started The Pill for medical reasons did so when they were 16 years of age or under, whereas those who started The Pill as a contraceptive were most often between the ages of 17 and 19 years. Age, social factors relating to age and articulations of the self as age-specific are thus central aspects of how and when these women came to describe their initial pill use – whether they are described as moments of relative lack of autonomy or of autonomy. Moreover, the issue of 'choice' in pill use continued for some women even long after they had quit The Pill. In these cases, the exercise of choice, often juxtaposed against past experiences of choicelessness, seemed to call for rearticulation throughout their adult lives.

The epistemology utilized here does not presuppose a participant who looks back on their life and communicates a 'real' historical moment. Instead these interviews are examined as temporally and context-specific articulations of self. Thus, while age influences experiences and memories, these interviews are concerned with the articulations made in interview and not with experiences as though they were lived. The two categories used to describe initial pill use (health versus contraception) are not to function as comparison groups. The questions raised by paralleling the processes are towards considering 'choice' insofar as it does not pan out in either 'type' of experiences as a useful way of understanding women's contraceptive needs and options.

PARADOXICAL CHOOSING

Finally, seven women spoke in directly paradoxical ways about choice in pill use. These women told of how they did not personally choose to use The Pill but were, for various reasons, compelled to use it. Later, the same women offer assessments of pill use as a choice for women. Having identified their own pill use as compulsory, seven women went on to claim that use of The Pill is largely a personal option, an individual and voluntarily made decision. I propose that in these contradictory statements women are exploring the deficient nature of 'choice' as meaningful for understanding women's reproductive decision-making. These women are perhaps working inside a sense of the incongruity between an experienced degree of choice and a more abstract or theoretical (socially applauded) degree of choice. In describing an experienced lack of choice within the social construction (and discourse) of unlimited options, there is struggle and perhaps necessary paradox (Granzow, 2007).

Despite mainstream liberal discourses of choice and of choosing around reproduction, it appears that choice is experienced in troubling ways. It is realized only incompletely or paradoxically. To say women have the right to choose The Pill, or for that matter, to choose reproduction or contraception is an oversimplification, even if we were to imagine unlimited contraceptive options. 'Choice,' however, is put into use in relation to women's sexuality and reproduction. Descriptions of initial pill indicate that when a body is defined as pathological, there is little need for a discourse of 'choosing' The Pill. When medical concerns prompt pill use, statements of choice are either unnecessary or implied. For the liberal subject, the need to control the body is not a choice but the condition for being. When sexual 'responsibility' motivates pill use, however, articulating choice seems a very high priority. For women who started The Pill as responsible sexual agents, the framing of pill use as choice was frequent and explicit. For the liberal subject, the assertion of the self in 'responsible' ways is an ongoing project. The tenants of a liberal subjectivity require of women both a body confined and a self-realized. Thus, while the fight for 'women's right to choose' has been an effective and strategic tool, the paradigmatic assumptions have also functioned to constrain and obscure more complicated matters. Paradoxical expressions of choice reveal a contradiction and demonstrate that the current means by which women's reproduction is negotiated are too few.

I now return to the work of Hester (2005) and Lowe (2005) and the alternatives to choice that they offer in their respective studies of contraceptive use. With Hester's (2005) post-modern version of Levi-Strauss' 'bricolage' (defined as including the making of new knowledge through the process of incorporating the variety of practical knowledges and tools at hand in sense-making), comes an interpretation of women's decision-making as outside of the intellectual/mind and as instead embodied and relational. Lowe (2005) too highlights the crucial role of the relational in women's contraceptive use and claims women's decisions to use contraception are always in reference to relationships with their sexual partner(s). These articles, in company with the present one, argue that it is not 'women's right to choice' that is up for grabs here. What is on the table is women's complicated status as subjects in a history of patriarchy and in a predominantly consumer-oriented culture. The point now is not to reassert discourses tethered to inherently oppressive regimes (eg by continually demanding women's choice) but to isolate the multitude of ways in which such discourses fail in ways that prompt interrogation of their ideological attachments. Choice is in question. How and why millions of women come to take a daily and time-specific hormone pill for decades at a time, can only inadequately be understood as women's 'choice.'

Notes

¹ Twelve women started The Pill as a medicine and six for contraception. It is these 18 experiences that I take up in this article. The other two women gave dramatically different reasons for initial pill use: one woman claimed it was purely to imitate her sister, the second woman began taking the pill after a sexual assault in an effort to prevent conception should such an assault occur again.

References

1. Arendt H (1958). The Human Condition. University of Chicago Press: Chicago.
2. Benn M., Richardson (1984). Uneasy freedom: women's experiences of contraception. Studies International Forum 7: 219–225. | Article |
3. Code L (1991). What Can She Know? Feminist Theory and the Construction of Knowledge. Cornell University Press: Ithaca.
4. Colodny N (1989). The politics of birth control in a reproductive rights context. In: Overall C (ed). The Future of Human Reproduction. Women's Press: Toronto.
5. Davies B (2000). A Body of Writing: 1990–1999. AltaMira Press: Walnut Creek.
6. Douglas M (1966). Purity and Danger: An Analysis of the Concepts of Pollution and Taboo. Fredrick A. Praeger Publishers: New York.
7. Granzow K (2007). De-constructing 'choice': The social imperative and women's use of the birth control pill. Culture, Health & Sexuality 9: 43–54. | Article | PubMed |
8. Grekul J, Krahn H, Odynak D (2004). Sterlizing the 'feeble-minded': eugenics in Alberta, Canada, 1929–1972. Journal of Historical Sociology 17: 358–384. | Article |
9. Hester SJ (2005). Bricolage and bodies of knowledge: exploring consumer responses to controversy about the third generation oral contraceptive pill. Body and Society 11: 77–95. | Article |
10. Lather P (1991). Getting Smart: Feminist Research and Pedagogy with/in the Postmodern. Routledge: New York.
11. Lowe P (2005). Contraception and heterosex: an intimate relationship. Sexualities 8: 75–92. | Article |
12. Lupypciw, D (2006). 'I did not want to leave anything to chance': an exploration of accountability in women's contraceptive choices. Paper presentation at the Qualitative Health Research Conference, Edmonton, AB, Canada, April 2–5.
13. Martin E (1987). The Woman in the Body: A Cultural Analysis of Reproduction. Beacon Press: Boston.
14. Morgan KP (2002). Brave new baby, brave new world: The gender politics of contemporary reproductive technologies. Lecture at Wilfred Laurier University, Waterloo, ON,. 8 February.
15. Overall C (ed.) (1989). The Future of Human Reproduction. Women's Press: Toronto.
16. Petchesky RP (1990). Abortion and Woman's Choice: The State, Sexuality & Reproductive Freedom. Northeastern University Press: Boston.
17. Ruhl L (2002). Dilemmas of the will: uncertainty, reproduction, and the rhetoric of control. Signs: Journal of Women in Culture and Society 27: 641–662. | Article |
18. Scott JW (1996). Only Paradoxes to Offer: French Feminists and the Rights of Man. Harvard University Press: Cambridge.
19. Smith A (2005). Conquest: Sexual Violence and the American Indian Genocide. South End Press: Cambridge.
20. Solinger R (2000). Wake up Little Susie: Single Pregnancy and Race Before Roe v. Wade. Routledge: New York.
21. Solinger R (2001). Beggars and Choosers: How the Politics of Choice shapes Adoption, Abortion, and Welfare in the United States. Hill and Wang: New York.
22. Statistics Canada: Health Statistics Division (2005). Births, Catalogue 84F0210XIE, Minister of Industry: Ottawa.
23. Statistics Canada: Social and Aboriginal Statistics Division (2006). Women in Canada: A Gender-based Statistical Report, 5th edn. Catalogue 89-503-XPE. Minister of Industry: Ottawa.
24. Stepan NL (1998). Race, gender, science and citizenship. Gender & History 10: 26–52. | Article |

Acknowledgements

Thank you to Dr. Amy Kaler for helping me to develop this paper.