Birth Control

I

Introduction

Birth Control, various methods used to prevent pregnancy. Birth control is also known as contraception or family planning.

Pregnancy occurs as a result of a sperm fertilizing an ovum (egg) and implanting in the womb (see Human Reproduction). One ovum is released from a woman’s ovary on day 14 of her menstrual cycle, and survives for 48 hours. This process occurs from puberty until menopause. Sperm is produced in the male testes from the onset of puberty. Millions of sperm leave the body by travelling through the vas deferens (the tubes that carry sperm from the testes to the penis), where they join with fluid from the prostate and seminiferous tubules, and are ejected from the male’s body through the urethra. This process is called ejaculation. Sperm can live for between three and seven days. For fertilization to occur, the sperm must travel through the vagina, cervix, and uterus to the Fallopian tubes (the tubes that carry the ovum from the ovaries to the uterus). Fertilization usually occurs in the Fallopian tubes, and the fertilized ovum then travels to the uterus where it implants, resulting in pregnancy.

Contraception prevents pregnancy either by preventing sperm from meeting an ovum, or by preventing a fertilized ovum from implanting in the uterus. Contraception can be temporary or permanent, and can be hormonal or non hormonal. There are also natural contraceptive techniques. Which type of contraception people use depends on the availability of contraceptive methods, education, risks, benefits, suitability, and effectiveness.

II

History of Contraception

Birth control has been a human concern for thousands of years; the oldest known medical text, from the 19th century bc, contains information on contraception. The first contraceptive devices were simple mechanical barriers inserted into the vagina that prevented the male sperm, deposited in the vagina during sexual intercourse, from fertilizing the female ovum. Among the many vaginal preparations that have also been used historically to prevent pregnancy are sea sponges, quinine, rock salt, and alum.

In 1798 the British economist Thomas Robert Malthus predicted that the human species would one day outstrip its capacity to feed itself. In succeeding years, as medical care, nutrition, sanitation, and working conditions improved and the death rate began to drop, more attention began to be paid to contraception. The first organized movement towards that end developed during the 19th century. The pioneer Marie Stopes almost single-handedly, and against powerful opposition, succeeded in promoting public knowledge of, and demand for, contraception.

III

Contraception Worldwide

Contraception is essential for people to be able to control their fertility. Despite this, religious, moral, political, and individual opposition to contraception remains strong in many countries. According to figures from the United Nations in 2006, there are more than 370 million couples worldwide who lack access to modern contraceptive services, mostly in developing countries, and it is estimated that demand for services will increase by 40 per cent by 2025. This is important, as pregnancy is a major cause of death and disability among women around the globe. There are approximately 210 million pregnancies globally per year and 80 million of these are unplanned. About 600,000 women die every year as a result of pregnancy-related illnesses. Children’s health is also improved through parents’ ability to control their fertility and space births. Some contraceptives (barrier methods) also protect people from sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS).

People being able to control their fertility is also important, given that global population continues to grow towards a situation whereby people’s material needs will not be able to be met by the finite resources on Earth. According to the United Nations Children’s Fund (UNICEF) in its 1992 annual report, “family planning could provide more benefits to more people at less cost than any other single ‘technology’ now available to the human race”.

IV

Methods of Contraception

A

Natural Contraception

Natural contraceptive techniques include abstinence, breast feeding, withdrawal or coitus interruptus, and the rhythm or calendar method.

Abstinence is where a person refrains from vaginal sexual intercourse entirely. Breast feeding can be a reliable method of contraception as long as there is exclusive breast feeding, the mother is amenorrhoeic (not menstruating), and the baby is under six months. Withdrawal is a technique where the penis is removed from the vagina prior to ejaculation. This method can be unreliable as some sperm may be present in secretions from the penis prior to ejaculation (pre-come). The rhythm method is based on abstinence from sexual intercourse on days when fertility is probable, and its effectiveness depends on accurately predicting the times when the woman is ovulating. Prediction is attempted either by monitoring changes in the woman’s basal body temperature that signal ovulation, or by identifying changes in cervical mucus and other symptoms that indicate ovulation, or both.