Birth Control

The practice of birth control prevents
conception, thus limiting reproduction. The term
birth control, coined by Margaret SANGER in
1914, usually refers specifically to methods of
contraception, including STERILIZATION. The
terms family planning and planned parenthood
have a broader application. METHODS OF
BIRTH CONTROL Attempts to control fertility
have been going on for thousands of years.
References to preventing conception are found in
the writings of priests, philosophers, and
physicians of ancient Egypt and Greece. Some
methods, though crude, were based on sound
ideas. For example, women were advised to put
honey, olive oil, or oil of cedar in their vaginas to
act as barriers. The stickiness of these substances
was thought to slow the movement of sperm into
the uterus. Wads of soft wool soaked in lemon
juice or vinegar were used as tampons, in the
belief that they would make the vagina sufficiently
acidic to kill the sperm. The Talmud mentions
using a piece of sponge to block the cervix, the
entrance to the uterus. Sperm Blockage Several
modern methods of birth control are practiced by
creating a barrier between the sperm and the egg
cell. This consists of the use of a chemical foam, a
cream, or a suppository. Each contains a
chemical, or spermicide that stops sperm. They
are not harmful to vaginal tissue. Each must be
inserted shortly before COITUS. Foams are
squirted from aerosol containers with nozzles or
from applicators that dispense the correct amount
of foam and spread it over the cervix; creams and
jellies are squeezed from tubes and held in place
by a diaphragm or other device; and
suppositories--small waxy pellets melted by body
heat--are inserted by hand. More effective at
keeping sperm and egg apart are mechanical
barriers such as the diaphragm and cervical cap
(both used with a spermicide), the sponge, and the
condom. A diaphragm is a shallow rubber cup that
is coated with a spermicide and positioned over
the cervix before intercourse. Size is important;
women need to have a pelvic examination and get
a prescription for the proper diaphragm. The
cervical cap, less than half the size but used in the
same way, has been available worldwide for
decades. It was not popular in the United States,
however, and in 1977 it failed to gain approval by
the Food and Drug Administration (FDA); in
1988, the FDA again permitted its sale. The
contraceptive sponge, which keeps its spermidical
potency for 48 hours after being inserted in the
vagina, was approved in 1983. Like the
diaphragm and cervical cap, the sponge has an
estimated effectiveness rate of about 85%. The
devices only rarely produce side effects such as
irritation and allergic reactions and, very rarely,
infections. The condom, a rubber sheath, is rolled
onto the erect penis so that sperm, when
ejaculated, is trapped but care must be taken so
that the condom does not break or slip off. A
fresh condom should be used for each sexual act.
Condoms also help protect against the spread of
VENEREAL DISEASES, and, unlike other
barrier devices, condoms made of latex do
provide some protection--but not
foolproof--protection against AIDS (see AIDS).
Another method of preventing the sperm from
reaching the egg is withdrawal by the man before
ejaculation. This is the oldest technique of
contraception and, because of the uncertainty of
controlling the ejaculation, is considered one of the
least effective. Altering Body Functions Even in
ancient times, attempts were made to find a
medicine that would prevent a woman\'s body from
producing a baby. Only within the last century,
however, have methods been developed that
successfully interrupt the complex reproductive
system of a woman\'s body. The first attempt,
made in the 19th century, was based on a legend
that camel drivers about to go on long journeys in
the desert put pebbles in the wombs of female
camels to keep them from becoming pregnant.
Researchers tried to find something that would
work similarly in a woman\'s cervix. The earliest
such objects were made of metal and were held in
by prongs. Later, wire rings were placed beyond
the cervix, in the uterus itself, thus giving rise to the
term intrauterine device, or IUD. IUDs appear to
work by altering the necessary environment in the
uterus for the fertilized egg. It was only with the
introduction of modern plastics such as
polyethylene, however, that IUDs were widely
accepted. Their pliability led to simpler insertion
techniques, and they could be left in place until
pregnancy was desired unless a problem arose
with their use. Copper-containing IUDs, and those
that slowly released the hormone progesterone,
had to be replaced periodically. Some users of
IUDs, however, complained increasingly of the
side effects of the devices. The most common
problem was bleeding, and the devices could also
cause uterine infections. More dangerous was the
possible inducement of pelvic inflammatory
disease (see UROGENITAL DISEASES), an
infection that may lead to blockage of the
Fallopian