Introduction
Contraception holds an important potential to reducing unwanted pregnancies especially among the teenage, but has been opposed more than once by the anti-contraception organizations and crusaders as an appropriate initiative. However, although the rates of abortion have been indicated to have decreased since they hit an all times high in 2006, there is need to look for better alternatives to birth control.
Access to the contraception has also been blamed for the higher abortion rates amongst the poor women than those able to access the contraception methods. Education on contraceptives is important not only to empower men and women control populations for economic needs, but also to reduce and/ or eliminate adolescent pregnancy. Reasons for the failure of birth control and lack of its use have been given.
They vary from lack of dedication to offer education by the health specialists, feeling of guilt or shame about sexuality among the young people, lack of or failure of individual personal control in relationships amongst partners, lack of commitments among the young who may not be comfortable with their sexuality, and inappropriate availability of birth control services amongst teenagers. This paper discuses the history of birth control, the options to birth control, the side effects to using the methods, the legislation and the future of contraception, and the benefits of birth control.
History of Birth Control
Historic methods of birth control were simple and mechanical means applied to stop the sperm from being deposited onto the vagina during the sexual intercourse, and so the female egg may not be fertilized (Birth Control, 2009). Other methods involved were the withdrawal methods, considerable imagination, abstinence and trial and error means (“Evolution and Revolution: The Past, Present, and the Future of Contraception”, 2000).
The author notes that modern barrier methods came up in the 1800s while the hormonal methods and IUDs were developed in the twentieth century. Before industrialization of the society, killing newborns was used as control of population and for regulating the sex ratio if need for sexual division of labor dictated so. This is referred to as infanticide. In Pima of Arizona, children who would be born after the death of their fathers would undergo infanticide to ease the possible burden added to the mother (Gordon, 1976).
Infanticide was practiced elsewhere to maintain mobility for instance the Northern Plain Indians. The infanticide mostly practiced as reported by London (2009) was female probably because the decision to carry it out would have mostly been made by men. According to Gordon, infanticide has waned because of presence of better birth control methods and not necessarily moral superiority by humans than before.
Other historical methods that have been used for many years as birth control includes portions or abortifacients like lavender in tea form, thyme and marjoram in Germany, worm fern referred to as the “prostitute root” in French. Diagnosis from animals included paste of mashed ants and camel foams. In latter times women used tansy tea, castor oil, turpentine, ammonia, rosemary, opium, ginger, sea sponges, quininine, honey, rock salt (Birth Control, 2009) and lavender (London, 2009). Such mechanical methods used have been estimated to be only 15% effective. Today, methods applied mechanically to block the sperm from being deposited on the vagina and thus fertilizing the egg are more effective (condom-95-97%). Other methods that are used today include use of sterilization, hormonal, use of spermicidal chemicals and the intrauterine devices (Birth Control, 2009).
Methods of Birth Control
Methods used vary in the effectiveness which is explained as the number of women who on using the contraceptives do not become pregnant on the first year. Continuous abstinence, which means avoidance of intercourse, is the only method that can achieve 100% effectiveness with some others coming closer to 100%. Effectiveness can be accounted for in terms of the correct use of the method and the typical use. Different types of methods of control can be applied together to improve effectiveness, for example the use of condoms and the spermicidal jelly or cream (Birth Control, 2009).
Barrier methods applied in birth control includes the male and the female condoms, the cervical cap, the vaginal sponge, and the diaphragm.
Condoms
Their evolution can be traced in the seventeenth century (“ Evolution and Revolution: The Past, Present, and the Future of Contraception”, 2000). Use of condom can achieve effectiveness up to 86% when used properly. Ideally, this method can achieve an effectiveness of 95% but only 79% typically (Birth Control, 2009). These have also been applied for the purpose of preventing spread of sexually transmitted diseases in addition to birth control. The material used (referred to as a condom) is a thin tube made of polyurethane, latex or lambskin which is inserted on the male erectile penis to prevent deposition of sperm onto vagina that could achieve pregnancy.
Diaphragms and cervical caps
Use of these two can necessitate the attention of a health care professional in order to fit them well and therefore boost effectiveness. Use of diaphragm which is a shallow rubber cap placed over the cervix, can achieve up to 94% effectiveness if used together with a spermicide that kills any sperm seeking to seep out around the edges. The spermicide is placed on the edges and inside the cap. Cervical cap, which is a soft rubber of a thimble-like shape that can be fitted onto the cervix, when used together with a spermicide can achieve an effectiveness of up to 80-90% where no previous birth had occurred, but the effectiveness drops to about 60-70% where previous birth took place (Birth Control, 2009). The cervical cap can be used for protection up to 48 hours.
Sponge
This can be used to avoid pregnancy for up to 24 hours. A disk-shaped device which is made of polyurethane foam is placed to cover the cervix after being impregnated with the spermicide. Effectiveness depends on whether the user has had a previous birth (60-80%) or not (80-90%).
Intrauterine Devices (IUDs)
This is a device inserted onto the uterus with the help of a physician and can act either by hormonal or non-hormonal mechanism. The Paragard non-hormonal device works by blocking fertilization of the egg and can achieve an estimated over 99% effectiveness. The hormonal devices are claimed to work by either interfering with the implantation of the fertilized egg into the uterus lining or by affecting the sperm from reaching the egg. Side effects have been reported with the use of these devices, with the most serious having happened with Dalkon Shield which was associated with infertility, pelvic infection, and deaths (Birth Control, 2009). This device was banned from the market in 1975.
Hormonal methods
The ready methods in this class are applied by females, while those for men are currently being researched on. They are delivered in form of a patch being attached onto the skin, vaginal ring, injections and pills. The methods of working is either by causing the mucus of the cervix to thicken and therefore the sperm entry is denied, altering with the lining of the uterus, or inhibiting ovulation (introduced in the 1950s).
The pill has a typical effectiveness of up to 95% and 100% on ideal use. The combined pill consists of the estrogen and progestin while the minipill contains of the progestin. The mostly used is the combined pill. The risk of occurrence of side effects increases with the women aged more than 35 years and have complications such as blood clots, breast or endometrial cancer, diabetes, and those complications involving the following organs; the blood vessels, nerves, kidneys and eyes. The pills however work well without the side effects with women who are below 35 years (Birth control, 2009). Morning-after pills which can be used after unprotected sex can work when applied 72 hours after the intercourse and usually with a second dose after 12 hours from the first one. Pills achieve an effectiveness of about 75-80%.
Hormonal implants are surgically planted into the skin of a woman’s arm and can stay for 3-5 years. They are of a matchstick size and gradually release hormones like the levonorgestrel into the system to achieve effectiveness close to 100%. Irregular bleeding and pain during removal are side effects encountered with the use of the drug. Other side effects include regular menstrual cycles and weight gain with injection types like Lunelle and Depo-Provera respectively. Depo-Provera can also cause end of menstrual flow periods after one year. Vaginal rings are inserted onto the vagina to release hormones and can be removed after some times. An example is the FDA approved NuvaRing which can be inserted for three weeks and removed and a new one replaced after a stay of one week without.
It releases a combination of progestin etonogestrel and ethinyl estradiol. The side effects of the rings include irritation on the vagina, infection and discharge (Birth Control, 2008). The skin patches also operate to release hormones just like the pills, and like the ring, they measure in effectiveness and side effects with pills although a reduction of side effects has been reported among women weighing more than 90kg.
Spermicides
These include creams, gellies, films, foams, suppositories which can be applied to kill the sperms. Some of these may be used alone without barriers, but are most effective when combined. They can achieve a typical effectiveness of about 74%.
Permanent methods of birth control
Permanent methods involves the cutting of the tubes concerned with the transport of the egg in women as well as vasectomy which involves the cutting of the tube involved in the transport of the semen. The tubes can also be tied or clipped to prevent the eggs and the sperms from coming out. Among the women who have finished bearing children, sterilization is the popular method of birth control according to Larry (2009). Safer means of achieving permanent birth control have emanated, with laparoscopic tubal ligation being the most common among the women in the United States according to Larry.
Essure is a type of tubal ligation approved by the Food and Drug Administration in 2002. It involves prompting the growth of scar tissue that blocks the fallopian tubes permanently. The prompt is achieved through microinserts which are small metal coils placed in the fallopian tubes. The blockage of the fallopian tubes is confirmed with an X-ray three months after insertion. Side effects are minimal with tubal ligation with one out of 1000 women experiencing complications and a high efficiency to control pregnancy (only a few times of pregnancy occurring in 1000 cases). Tubal ligation should be carried out in an operating room, but Essure can be done in a local anesthesia for about 10-15 minutes and the victims resuming to their normal duties within 24 hours or even less. The method (Essure) may become more popular with the completion of new non-incisional sterilization (Larry, 2009).
Benefits of birth control
The discussed methods of birth control carry various advantages depending on the method in question. The following are the general benefits of birth control;
- Reduction of increase population which may help overcome stress on natural resources
- Many methods help avoid harsh and more unsafe methods of population control like abortion which can lead to death of even the parent
- Reduction of family economic pressures and burden
Law on contraception
The cost of contraceptives was reported in 2007 to have increased through the Congress regulation with the exclusion of the university health centers clinics that serve the women of low-income on narrowing of the definition of those qualifying for Medicaid. This could have led to impediment on the access to contraceptives by women. Even the prices of some generics were reportedly higher than some brands bought under the old system and this means that the option of using generics may not be 100% good. Unavailability of generics that can substitute drugs which are of low hormone levels and do not require daily dosing may have affected the usage options (“Affordable Family Planning”, 2007). This need be changed so as to improve access and the cost of contraceptives in future.
Although the number of people reliance on Title X, the contraception program in the United States has increased in the past, it has faced opposition from the anti-abortion organizations who have ended-up undermining it through under-budgeting and appointing “anti-contraception ideologues” to oversee it (Page, 2008). The Law dealing with abortion has allowed women to decide when they want to terminate pregnancy, without the interference of the outsider. In 1999, abortion cases among those aged 15-44 hit an all time high of 1.6 million in total. The figure dropped to 1.2 million in total in 2005-the lowest figure since 1974 (Tucker, 2008).
It was found that the rates hit a 50% between 1990 and 2004 according to the Centre for Disease Control, and the reason has been the policy approach on contraception (Page, 2008). While different presidential candidates in 2008 held differing opinions in 2008, a Supreme Court decision that legalizing abortion nationwide has been set up. The future of birth control could still end in practical support of contraception as the option for abortion if access to contraception is increased. This is because the women in America showed support of contraception from the two sides of the differing 2008 presidential candidates debate (Page, 2008).
Reach to contraceptives has influenced the number of pregnancies that can end to abortion which is about 40% of those that are left unattended. Reach of these contraceptives has been indicated to be lower in poor women than in higher income women (Tucker, 2008).
There are indications of opponents to birth control via contraception, for example the North Kentucky’s Right to Life decision not to endorse any candidate unless “he or she does state that the standard birth control pill is an abortion method” and the effort by Wisconsin to have emergency contraceptives banned from campuses in the state’s universities, and opposition to the efforts of provision of pregnancy prevention in victims of rape could derail the switch from the support of abortion to contraception (Page, 2008).
Further, family planning program was discontinued in Missouri state through the conviction of the state legislature by the state’s Right to Life, and a bill that would see hormonal methods of contraception classified as abortion, have been witnessed in the country. Support for anti-contraception has been expressed by the Virginia pro-life legislature to send home a legislation that utilized scientific evidence in denial that “contraception is not abortion”. This means that the future of contraception hangs in the balance (Page 2008). The author has blamed the anti-contraception groups for negatively affecting the access of contraception methods to Americans by influencing the FDA.
The support of the use of contraception by politicians especially those in the highest level of government could boost the access and use of contraception methods amongst the Americans in future. However, there has been indication that candidates eying the top office are not directly asked of their opinion on contraception and this should be improved by requiring the candidate to express their support or opposition to contraception. Candidates need explain the initiatives they would undertake if in office to ensure that the masses have it (Page, 2008).
Future access to the birth control methods can be increased by teaching the masses the advantages over abortion, so as to help them have a positive turn to use of the safer methods of contraception. In addition, the government should increase funding of the contraception programs throughout the country, and lobby for appropriate legislations that seek to increase usage of contraception. This would come with other advantages such as lowering the rates of unwanted pregnancies in the country, and especially among the teenagers. In addition to these initiatives, greater efforts must be focused on increasing the access to contraception among the group of economically unable women.
Annotated bibliography
References
Affordable Family Planning :[Editorial]. (2007). New York Times (Late Edition (east Coast)), p. 4.13. Web.
BIRTH CONTROL. (2009). The History Channel website. Web.
Cristina Page. (2008). BIRTH CONTROL FACES A PRO-LIFE THREAT, TOO. Roanoke Times & World News,B.9. Web.
Cynthia Tucker. (2008). Contraception silences most abortion debates. Philadelphia Tribune. 5A. Web.
“Evolution and Revolution: The Past, Present, and the Future of Contraception”. Contraception Online (Baylor College of Medicine) 10 (6). 2000. Web.
Glazerman Larry. What Are A Woman’s Options For Permanent Birth Control? Tampa Tribune. 2009. Web.
Gordon, Linda. (1976). Woman’s Body, Woman’s Right: A Social History of Birth Control in America. New York: Penguin Books.
London Kathleen. The History of Birth Control. Curriculum Contents. Yale-New Haven Teachers Institute. Web.