Birth - Control Wiki

Birth control
Birth control, also known as contraception,

anticonception, and fertility control, is a method or
Birth control
device used to prevent pregnancy.[1] Birth control has
been used since ancient times, but effective and safe
methods of birth control only became available in the 20th
century.[2] Planning, making available, and using birth
control is called family planning.[3][4] Some cultures limit
or discourage access to birth control because they consider
it to be morally, religiously, or politically undesirable.[2]
The World Health Organization and United States Centers

for Disease Control and Prevention provide guidance on
A package of birth control pills
the safety of birth control methods among women with
specific medical conditions.[5][6] The most effective Other Contraception, fertility
methods of birth control are sterilization by means of names control
vasectomy in males and tubal ligation in females, MeSH D003267
intrauterine devices (IUDs), and implantable birth
control.[7] This is followed by a number of hormone-based methods including oral pills, patches, vaginal
rings, and injections.[7] Less effective methods include physical barriers such as condoms, diaphragms and
birth control sponges and fertility awareness methods.[7] The least effective methods are spermicides and
withdrawal by the male before ejaculation.[7] Sterilization, while highly effective, is not usually reversible;
all other methods are reversible, most immediately upon stopping them.[7] Safe sex practices, such as with
the use of male or female condoms, can also help prevent sexually transmitted infections.[8] Other methods
of birth control do not protect against sexually transmitted diseases.[9] Emergency birth control can prevent
pregnancy if taken within 72 to 120 hours after unprotected sex.[10][11] Some argue not having sex is also a
form of birth control, but abstinence-only sex education may increase teenage pregnancies if offered
without birth control education, due to non-compliance.[12][13]
In teenagers, pregnancies are at greater risk of poor outcomes.[14] Comprehensive sex education and access
to birth control decreases the rate of unwanted pregnancies in this age group.[14][15] While all forms of birth
control can generally be used by young people,[16] long-acting reversible birth control such as implants,
IUDs, or vaginal rings are more successful in reducing rates of teenage pregnancy.[15] After the delivery of
a child, a woman who is not exclusively breastfeeding may become pregnant again after as few as four to
six weeks.[16] Some methods of birth control can be started immediately following the birth, while others
require a delay of up to six months.[16] In women who are breastfeeding, progestin-only methods are
preferred over combined oral birth control pills.[16] In women who have reached menopause, it is
recommended that birth control be continued for one year after the last period.[16]
About 222 million women who want to avoid pregnancy in developing countries are not using a modern
birth control method.[17][18] Birth control use in developing countries has decreased the number of deaths
during or around the time of pregnancy by 40% (about 270,000 deaths prevented in 2008) and could
prevent 70% if the full demand for birth control were met.[19][20] By lengthening the time between
pregnancies, birth control can improve adult women's delivery outcomes and the survival of their
children.[19] In the developing world, women's earnings, assets, and weight, as well as their children's
schooling and health, all improve with greater access to birth control.[21] Birth control increases economic
growth because of fewer dependent children, more women participating in the workforce, and less use of
scarce resources.[21][22]
Contents
Methods
Hormonal
Barrier
Intrauterine devices
Sterilization
Behavioral Play media
Emergency Video explaining how to prevent unwanted
pregnancy
Dual protection
Effects
Health
Finances
Prevalence
History
Early history
Birth control movement
Modern methods
Society and culture
Legal positions
Religious views
World Contraception Day
Misconceptions
Accessibility
Research directions
Females
Males
Other animals
See also
References
Further reading
External links
Methods
Birth control methods include barrier methods, hormonal birth control, intrauterine devices (IUDs),
sterilization, and behavioral methods. They are used before or during sex while emergency contraceptives
are effective for up to five days after sex. Effectiveness is generally expressed as the percentage of women
who become pregnant using a given method
during the first year,[27] and sometimes as a Chance of pregnancy during first year of use[23][24]
lifetime failure rate among methods with high Method Typical use Perfect use
effectiveness, such as tubal ligation.[28]
No birth control 85% 85%
The most effective methods are those that are Combination pill 9% 0.3%
long acting and do not require ongoing health Progestin-only pill 13% 1.1%
care visits.[29] Surgical sterilization,
implantable hormones, and intrauterine Sterilization (female) 0.5% 0.5%
devices all have first-year failure rates of less Sterilization (male) 0.15% 0.1%
than 1%.[23] Hormonal contraceptive pills,
Condom (female) 21% 5%
patches or vaginal rings, and the lactational
amenorrhea method (LAM), if adhered to Condom (male) 18% 2%
strictly, can also have first-year (or for LAM, Copper IUD 0.8% 0.6%
first-6-month) failure rates of less than
Hormonal IUD 0.2% 0.2%
1%.[29] With typical use, first-year failure
rates are considerably high, at 9%, due to Patch 9% 0.3%
inconsistent use.[23] Other methods such as Vaginal ring 9% 0.3%
condoms, diaphragms, and spermicides have
MPA shot 6% 0.2%
higher first-year failure rates even with
perfect usage.[29] The American Academy of Implant 0.05% 0.05%
Pediatrics recommends long acting reversible Diaphragm and spermicide 12% 6%
birth control as first line for young
Fertility awareness 24% 0.4–5%
individuals.[30]
Withdrawal 22% 4%
While all methods of birth control have some
Lactational amenorrhea method
potential adverse effects, the risk is less than 0–7.5%[25] <2%[26]
(6 months failure rate)
that of pregnancy.[29] After stopping or
removing many methods of birth control,
including oral contraceptives, IUDs, implants and injections, the rate of pregnancy during the subsequent
year is the same as for those who used no birth control.[31]
For individuals with specific health problems, certain forms of birth control may require further
investigations.[32] For women who are otherwise healthy, many methods of birth control should not require
a medical exam—including birth control pills, injectable or implantable birth control, and condoms.[33] For
example, a pelvic exam, breast exam, or blood test before starting birth control pills does not appear to
affect outcomes.[34][35][36] In 2009, the World Health Organization (WHO) published a detailed list of
medical eligibility criteria for each type of birth control.[32]
Hormonal
Hormonal contraception is available in a number of different forms, including oral pills, implants under the
skin, injections, patches, IUDs and a vaginal ring. They are currently available only for women, although
hormonal contraceptives for men have been and are being clinically tested.[37] There are two types of oral
birth control pills, the combined oral contraceptive pills (which contain both estrogen and a progestin) and
the progestogen-only pills (sometimes called minipills).[38] If either is taken during pregnancy, they do not
increase the risk of miscarriage nor cause birth defects.[35] Both types of birth control pills prevent
fertilization mainly by inhibiting ovulation and thickening cervical mucus.[39][40] They may also change the
lining of the uterus and thus decrease implantation.[40] Their effectiveness depends on the user's adherence
to taking the pills.[35]
Combined hormonal contraceptives are associated with a slightly increased risk of venous and arterial
blood clots.[41] Venous clots, on average, increase from 2.8 to 9.8 per 10,000 women years[42] which is
still less than that associated with pregnancy.[41] Due to this risk, they are not recommended in women over
35 years of age who continue to smoke.[43] Due to the increased risk, they are included in decision tools
such as the DASH score and PERC rule used to predict the risk of blood clots.[44]
The effect on sexual desire is varied, with increase or decrease in some but with no effect in most.[45]
Combined oral contraceptives reduce the risk of ovarian cancer and endometrial cancer and do not change
the risk of breast cancer.[46][47] They often reduce menstrual bleeding and painful menstruation cramps.[35]
The lower doses of estrogen released from the vaginal ring may reduce the risk of breast tenderness,
nausea, and headache associated with higher dose estrogen products.[46]
Progestin-only pills, injections and intrauterine devices are not associated with an increased risk of blood
clots and may be used by women with a history of blood clots in their veins.[41][48] In those with a history
of arterial blood clots, non-hormonal birth control or a progestin-only method other than the injectable
version should be used.[41] Progestin-only pills may improve menstrual symptoms and can be used by
breastfeeding women as they do not affect milk production. Irregular bleeding may occur with progestin-
only methods, with some users reporting no periods.[49] The progestins drospirenone and desogestrel
minimize the androgenic side effects but increase the risks of blood clots and are thus not first line.[50] The
perfect use first-year failure rate of injectable progestin is 0.2%; the typical use first failure rate is 6%.[23]
Three varieties of Birth control pills A transdermal A NuvaRing vaginal

birth control pills in contraceptive patch ring
calendar oriented
packaging
Barrier
Barrier contraceptives are devices that attempt to prevent pregnancy by physically preventing sperm from
entering the uterus.[51] They include male condoms, female condoms, cervical caps, diaphragms, and
contraceptive sponges with spermicide.[51]
Globally, condoms are the most common method of birth control.[52] Male condoms are put on a man's
erect penis and physically block ejaculated sperm from entering the body of a sexual partner during
intercourse and fellatio.[53] Modern condoms are most often made from latex, but some are made from
other materials such as polyurethane, or lamb's intestine.[53] Female condoms are also available, most often
made of nitrile, latex or polyurethane.[54] Male condoms have the advantage of being inexpensive, easy to
use, and have few adverse effects.[55] Making condoms available to teenagers does not appear to affect the
age of onset of sexual activity or its frequency.[56] In Japan, about 80% of couples who are using birth
control use condoms, while in Germany this number is about 25%,[57] and in the United States it is
18%.[58]
Male condoms and the diaphragm with spermicide have typical use first-year failure rates of 18% and 12%,
respectively.[23] With perfect use condoms are more effective with a 2% first-year failure rate versus a 6%
first-year rate with the diaphragm.[23] Condoms have the additional benefit of helping to prevent the spread
of some sexually transmitted infections such as HIV/AIDS, however, condoms made from animal intestine
do not.[7][59]
Contraceptive sponges combine a barrier with a spermicide.[29] Like diaphragms, they are inserted
vaginally before intercourse and must be placed over the cervix to be effective.[29] Typical failure rates
during the first year depend on whether or not a woman has previously given birth, being 24% in those
who have and 12% in those who have not.[23] The sponge can be inserted up to 24 hours before
intercourse and must be left in place for at least six hours afterward.[29] Allergic reactions[60] and more
severe adverse effects such as toxic shock syndrome have been reported.[61]
A rolled up male An unrolled male A polyurethane A diaphragm

condom. latex condom female condom vaginal-cervical
barrier, in its case
with a quarter U.S.
coin.
A contraceptive
sponge set inside its
open package.
Intrauterine devices
The current intrauterine devices (IUD) are small devices, often 'T'-
shaped, containing either copper or levonorgestrel, which are
inserted into the uterus. They are one form of long-acting
reversible contraception which are the most effective types of
reversible birth control.[62] Failure rates with the copper IUD is
about 0.8% while the levonorgestrel IUD has a failure rates of
0.2% in the first year of use.[63] Among types of birth control, Copper T shaped IUD with removal
they, along with birth control implants, result in the greatest strings
satisfaction among users.[64] As of 2007, IUDs are the most
widely used form of reversible contraception, with more than
180 million users worldwide.[65]
Evidence supports effectiveness and safety in adolescents[64] and those who have and have not previously
had children.[66] IUDs do not affect breastfeeding and can be inserted immediately after delivery.[67] They
may also be used immediately after an abortion.[68][69] Once removed, even after long term use, fertility
returns to normal immediately.[70]
While copper IUDs may increase menstrual bleeding and result in more painful cramps,[71] hormonal IUDs
may reduce menstrual bleeding or stop menstruation altogether.[67] Cramping can be treated with
painkillers like non-steroidal anti-inflammatory drugs.[72] Other potential complications include expulsion
(2–5%) and rarely perforation of the uterus (less than 0.7%).[67][72] A previous model of the intrauterine
device (the Dalkon shield) was associated with an increased risk of pelvic inflammatory disease, however
the risk is not affected with current models in those without sexually transmitted infections around the time
of insertion.[73] IUDs appear to decrease the risk of ovarian cancer.[74]
Sterilization
Surgical sterilization is available in the form of tubal ligation for women and vasectomy for men.[2] Tubal
ligation decreases the risk of ovarian cancer.[2] Short term complications are twenty times less likely from a
vasectomy than a tubal ligation.[2][75] After a vasectomy, there may be swelling and pain of the scrotum
which usually resolves in one or two weeks.[76] Chronic scrotal pain associated with negative impact on
quality of life occurs after vasectomy in about 1-2% of men.[77] With tubal ligation, complications occur in
1 to 2 percent of procedures with serious complications usually due to the anesthesia.[78] Neither method
offers protection from sexually transmitted infections.[2] Sometimes, salpingectomy is also used for
sterilization in women.[79]
This decision may cause regret in some men and women. Of women who have undergone tubal ligation
after the age of 30, about 6% regret their decision, as compared with 20-24% of women who received
sterilization within one year of delivery and before turning 30, and 6% in nulliparous women sterilized
before the age of 30.[80] By contrast, less than 5% of men are likely to regret sterilization. Men who are
more likely to regret sterilization are younger, have young or no children, or have an unstable marriage.[81]
In a survey of biological parents, 9% stated they would not have had children if they were able to do it over
again.[82]
Although sterilization is considered a permanent procedure,[83] it is possible to attempt a tubal reversal to

reconnect the fallopian tubes or a vasectomy reversal to reconnect the vasa deferentia. In women, the desire
for a reversal is often associated with a change in spouse.[83] Pregnancy success rates after tubal reversal
are between 31 and 88 percent, with complications including an increased risk of ectopic pregnancy.[83]
The number of males who request reversal is between 2 and 6 percent.[84] Rates of success in fathering
another child after reversal are between 38 and 84 percent; with success being lower the longer the time
period between the vasectomy and the reversal.[84] Sperm extraction followed by in vitro fertilization may
also be an option in men.[85]
Behavioral
Behavioral methods involve regulating the timing or method of intercourse to prevent introduction of sperm
into the female reproductive tract, either altogether or when an egg may be present.[86] If used perfectly the
first-year failure rate may be around 3.4%, however if used poorly first-year failure rates may approach
85%.[87]
Fertility awareness
Fertility awareness methods involve determining the most fertile

days of the menstrual cycle and avoiding unprotected
intercourse.[86] Techniques for determining fertility include
monitoring basal body temperature, cervical secretions, or the day
of the cycle.[86] They have typical first-year failure rates of 24%;
perfect use first-year failure rates depend on which method is used
and range from 0.4% to 5%.[23] The evidence on which these
estimates are based, however, is poor as the majority of people in A CycleBeads tool, used for
trials stop their use early.[86] Globally, they are used by about 3.6% estimating fertility based on days
of couples.[88] If based on both basal body temperature and since last menstruation
another primary sign, the method is referred to as symptothermal.
First-year failure rates of 20% overall and 0.4% for perfect use
have been reported in clinical studies of the symptothermal method.[89][23] A number of fertility tracking
apps are available, as of 2016, but they are more commonly designed to assist those trying to get pregnant
rather than prevent pregnancy.[90]
Withdrawal
The withdrawal method (also known as coitus interruptus) is the practice of ending intercourse ("pulling
out") before ejaculation.[91] The main risk of the withdrawal method is that the man may not perform the
maneuver correctly or in a timely manner.[91] First-year failure rates vary from 4% with perfect usage to
22% with typical usage.[23] It is not considered birth control by some medical professionals.[29]
There is little data regarding the sperm content of pre-ejaculatory fluid.[92] While some tentative research
did not find sperm,[92] one trial found sperm present in 10 out of 27 volunteers.[93] The withdrawal method
is used as birth control by about 3% of couples.[88]
Abstinence
Sexual abstinence may be used as a form of birth control, meaning either not engaging in any type of
sexual activity, or specifically not engaging in vaginal intercourse, while engaging in other forms of non-
vaginal sex.[94][95] Complete sexual abstinence is 100% effective in preventing pregnancy.[96][97]
However, among those who take a pledge to abstain from premarital sex, as many as 88% who engage in
sex, do so prior to marriage.[98] The choice to abstain from sex cannot protect against pregnancy as a result
of rape, and public health efforts emphasizing abstinence to reduce unwanted pregnancy may have limited
effectiveness, especially in developing countries and among disadvantaged groups.[99][100]
Deliberate non-penetrative sex without vaginal sex or deliberate oral sex without vaginal sex are also
sometimes considered birth control.[94] While this generally avoids pregnancy, pregnancy can still occur
with intercrural sex and other forms of penis-near-vagina sex (genital rubbing, and the penis exiting from
anal intercourse) where sperm can be deposited near the entrance to the vagina and can travel along the
vagina's lubricating fluids.[101][102]
Abstinence-only sex education does not reduce teenage pregnancy.[9][103] Teen pregnancy rates and STI
rates are generally the same or higher in states where students are given abstinence-only education, as
compared with comprehensive sex education.[103] Some authorities recommend that those using abstinence
as a primary method have backup methods available (such as condoms or emergency contraceptive
pills).[104]
Lactation
The lactational amenorrhea method involves the use of a woman's natural postpartum infertility which
occurs after delivery and may be extended by breastfeeding.[105] This usually requires the presence of no
periods, exclusively breastfeeding the infant, and a child younger than six months.[26] The World Health
Organization states that if breastfeeding is the infant's only source of nutrition, the failure rate is 2% in the
six months following delivery.[106] Six uncontrolled studies of lactational amenorrhea method users found
failure rates at 6 months postpartum between 0% and 7.5%.[107] Failure rates increase to 4–7% at one year
and 13% at two years.[108] Feeding formula, pumping instead of nursing, the use of a pacifier, and feeding
solids all increase its failure rate.[109] In those who are exclusively breastfeeding, about 10% begin having
periods before three months and 20% before six months.[108] In those who are not breastfeeding, fertility
may return four weeks after delivery.[108]
Emergency
Emergency contraceptive methods are medications (sometimes

misleadingly referred to as "morning-after pills")[110] or devices
used after unprotected sexual intercourse with the hope of
preventing pregnancy. Emergency contraceptives are often given
to victims of rape.[10] They work primarily by preventing
ovulation or fertilization.[2][111] They are unlikely to affect A split dose of two emergency
implantation, but this has not been completely excluded.[111] A contraceptive pills
number of options exist, including high dose birth control pills,
levonorgestrel, mifepristone, ulipristal and IUDs.[112] Providing
emergency contraceptive pills to women in advance does not affect rates of sexually transmitted infections,
condom use, pregnancy rates, or sexual risk-taking behavior.[113][114] All methods have minimal side
effects.[112]
Levonorgestrel pills, when used within 3 days, decrease the chance of pregnancy after a single episode of
unprotected sex or condom failure by 70% (resulting in a pregnancy rate of 2.2%).[10] Ulipristal, when
used within 5 days, decreases the chance of pregnancy by about 85% (pregnancy rate 1.4%) and is more
effective than levonorgestrel.[10][112][115] Mifepristone is also more effective than levonorgestrel, while
copper IUDs are the most effective method.[112] IUDs can be inserted up to five days after intercourse and
prevent about 99% of pregnancies after an episode of unprotected sex (pregnancy rate of 0.1 to
0.2%).[2][116] This makes them the most effective form of emergency contraceptive.[117] In those who are
overweight or obese, levonorgestrel is less effective and an IUD or ulipristal is recommended.[118]
Dual protection
Dual protection is the use of methods that prevent both sexually transmitted infections and pregnancy.[119]
This can be with condoms either alone or along with another birth control method or by the avoidance of
penetrative sex.[120][121]
If pregnancy is a high concern, using two methods at the same time is reasonable.[120] For example, two
forms of birth control are recommended in those taking the anti-acne drug isotretinoin or anti-epileptic
drugs like carbamazepine, due to the high risk of birth defects if taken during pregnancy.[122][123]
Effects
Health
Contraceptive use in developing countries is estimated

to have decreased the number of maternal deaths by
40% (about 270,000 deaths prevented in 2008) and
could prevent 70% of deaths if the full demand for birth
control were met.[19][20] These benefits are achieved by
reducing the number of unplanned pregnancies that
subsequently result in unsafe abortions and by
preventing pregnancies in those at high risk.[19] Maternal mortality rate as of 2010.[124]
Birth control also improves child survival in the

developing world by lengthening the time between
pregnancies.[19] In this population, outcomes are worse
when a mother gets pregnant within eighteen months of
a previous delivery.[19][125] Delaying another
pregnancy after a miscarriage however does not appear
to alter risk and women are advised to attempt
pregnancy in this situation whenever they are
ready.[125]
Birth control use and total fertility rate by region.
Teenage pregnancies, especially among younger teens,
are at greater risk of adverse outcomes including early
birth, low birth weight, and death of the infant.[14] In the United States 82% of pregnancies in those
between 15 and 19 are unplanned.[72] Comprehensive sex education and access to birth control are
effective in decreasing pregnancy rates in this age group.[126]
Finances
In the developing world, birth control increases economic growth due to there being fewer dependent
children and thus more women participating in or increased contribution to the workforce - as they are
usually the primary caregiver for children.[21] Women's earnings, assets, body mass index, and their
children's schooling and body mass index all improve with greater access to birth control.[21] Family
planning, via the use of modern birth control, is one of the most cost-effective health interventions.[127] For
every dollar spent, the United Nations estimates that two to six dollars are saved.[18] These cost savings are
related to preventing unplanned pregnancies and
decreasing the spread of sexually transmitted
illnesses.[127] While all methods are beneficial
financially, the use of copper IUDs resulted in the
greatest savings.[127]
The total medical cost for a pregnancy, delivery and

care of a newborn in the United States is on average
$21,000 for a vaginal delivery and $31,000 for a
Map of countries by fertility rate (2020)
caesarean delivery as of 2012.[128] In most other
countries, the cost is less than half.[128] For a child born
in 2011, an average US family will spend $235,000
over 17 years to raise them.[129]
Prevalence
Globally, as of 2009, approximately 60% of
those who are married and able to have
children use birth control.[131] How
frequently different methods are used varies
widely between countries.[131] The most
common method in the developed world is
condoms and oral contraceptives, while in
Africa it is oral contraceptives and in Latin
America and Asia it is sterilization.[131] In the
developing world overall, 35% of birth World map colored according to modern birth control use.
control is via female sterilization, 30% is via Each shading level represents a range of six percentage
IUDs, 12% is via oral contraceptives, 11% is points, with usage less than or equal to:
via condoms, and 4% is via male 6% 30% 66%
sterilization.[131] 12% 36% 78%
18% 48% 86%
While less used in the developed countries
than the developing world, the number of 24% 60% No data
women using IUDs as of 2007 was more than
180 million.[65] Avoiding sex when fertile is
used by about 3.6% of women of childbearing
age, with usage as high as 20% in areas of
South America.[132] As of 2005, 12% of
couples are using a male form of birth control
(either condoms or a vasectomy) with higher
rates in the developed world.[133] Usage of
male forms of birth control has decreased
between 1985 and 2009.[131] Contraceptive
use among women in Sub-Saharan Africa has
risen from about 5% in 1991 to about 30% in
2006.[134]
As of 2012, 57% of women of childbearing

age want to avoid pregnancy (867 of Demand for family planning satisfied by modern methods
1,520 million).[135] About 222 million as of 2017.[130]
women however were not able to access birth
control, 53 million of whom were in sub-Saharan Africa and 97 million of whom were in Asia.[135] This
results in 54 million unplanned pregnancies and nearly 80,000 maternal deaths a year.[131] Part of the
reason that many women are without birth control is that many countries limit access due to religious or
political reasons,[2] while another contributor is poverty.[136] Due to restrictive abortion laws in Sub-
Saharan Africa, many women turn to unlicensed abortion providers for unintended pregnancy, resulting in
about 2–4% obtaining unsafe abortions each year.[136]
History
Early history
The Egyptian Ebers Papyrus from 1550 BC and the Kahun Papyrus from
1850 BC have within them some of the earliest documented descriptions
of birth control: the use of honey, acacia leaves and lint to be placed in
the vagina to block sperm.[137][138] Silphium, a species of giant fennel
native to north Africa, may have been used as birth control in ancient
Greece and the ancient Near East.[139][140] Due to its supposed
desirability, by the first century AD, it had become so rare that it was
worth more than its weight in silver and, by late antiquity, it was fully
extinct.[139] Most methods of birth control used in antiquity were Ancient silver coin from
probably ineffective.[141] Cyrene depicting a stalk of
silphium
The ancient Greek philosopher Aristotle (c. 384–322 BC) recommended
applying cedar oil to the womb before intercourse, a method which was
probably only effective on occasion.[141] A Hippocratic text On the Nature of Women recommended that a
woman drink a copper salt dissolved in water, which it claimed would prevent pregnancy for a year.[141]
This method was not only ineffective, but also dangerous, as the later medical writer Soranus of Ephesus
(c. 98–138 AD) pointed out.[141] Soranus attempted to list reliable methods of birth control based on
rational principles.[141] He rejected the use of superstition and amulets and instead prescribed mechanical
methods such as vaginal plugs and pessaries using wool as a base covered in oils or other gummy
substances.[141] Many of Soranus's methods were probably also ineffective.[141]
In medieval Europe, any effort to halt pregnancy was deemed immoral by the Catholic Church,[137]
although it is believed that women of the time still used a number of birth control measures, such as coitus
interruptus and inserting lily root and rue into the vagina.[142] Women in the Middle Ages were also
encouraged to tie weasel testicles around their thighs during sex to prevent pregnancy.[143] The oldest
condoms discovered to date were recovered in the ruins of Dudley Castle in England, and are dated back to
1640.[143] They were made of animal gut, and were most likely used to prevent the spread of sexually
transmitted diseases during the English Civil War.[143] Casanova, living in 18th century Italy, described the
use of a lambskin covering to prevent pregnancy; however, condoms only became widely available in the
20th century.[137]
Birth control movement
The birth control movement developed during the 19th and early 20th centuries.[144] The Malthusian
League, based on the ideas of Thomas Malthus, was established in 1877 in the United Kingdom to educate
the public about the importance of family planning and to advocate for getting rid of penalties for
promoting birth control.[145] It was founded during the "Knowlton trial" of Annie Besant and Charles
Bradlaugh, who were prosecuted for publishing on various methods of birth control.[146]
In the United States, Margaret Sanger and Otto Bobsein
popularized the phrase "birth control" in 1914.[147][148]
Sanger primarily advocated for birth control on the idea
that it would prevent women from seeking unsafe
abortions, but during her lifetime, she began to
campaign for it on the grounds that it would reduce
mental and physical defects.[149][150] She was mainly
active in the United States but had gained an
international reputation by the 1930s. At the time, under
the Comstock Law, distribution of birth control
"And the villain still pursues her", a satirical information was illegal. She jumped bail in 1914 after
Victorian era postcard her arrest for distributing birth control information and
left the United States for the United Kingdom.[151] In
the U.K., Sanger, influenced by Havelock Ellis, further
developed her arguments for birth control. She believed women needed to enjoy sex without fearing a
pregnancy. During her time abroad, Sanger also saw a more flexible diaphragm in a Dutch clinic, which
she thought was a better form of contraceptive.[150] Once Sanger returned to the United States, she
established a short-lived birth-control clinic with the help of her sister, Ethel Bryne, based in the Brownville
section of Brooklyn, New York[152] in 1916. It was shut down after eleven days and resulted in her
arrest.[153] The publicity surrounding the arrest, trial, and appeal sparked birth control activism across the
United States.[154] Besides her sister, Sanger was helped in the movement by her first husband, William
Sanger, who distributed copies of “Family Limitation.” Sanger's second husband, James Noah H. Slee,
would also later become involved in the movement, acting as its main funder.[150]
The increased use of birth control was seen by some as a form of social decay.[155] A decrease of fertility
was seen as a negative. Throughout the Progressive Era (1890-1920), there was an increase of voluntary
associations aiding the contraceptive movement.[155] These organizations failed to enlist more than 100,000
women because the use of birth control was often compared to eugenics;[155] however, there were women
seeking a community with like-minded women. The ideology that surrounded birth control started to gain
traction during the Progressive Era due to voluntary associations establishing community. Birth control was
unlike the Victorian Era because women wanted to manage their sexuality. The use of birth control was
another form of self-interest women clung to. This was seen as women began to gravitate towards strong
figures, like the Gibson girl.[156]
The first permanent birth-control clinic was established in Britain in 1921 by Marie Stopes working with
the Malthusian League.[157] The clinic, run by midwives and supported by visiting doctors,[158] offered
women's birth-control advice and taught them the use of a cervical cap. Her clinic made contraception
acceptable during the 1920s by presenting it in scientific terms. In 1921, Sanger founded the American
Birth Control League, which later became the Planned Parenthood Federation of America.[159] In 1924 the
Society for the Provision of Birth Control Clinics was founded to campaign for municipal clinics; this led to
the opening of a second clinic in Greengate, Salford in 1926.[160] Throughout the 1920s, Stopes and other
feminist pioneers, including Dora Russell and Stella Browne, played a major role in breaking down taboos
about sex. In April 1930 the Birth Control Conference assembled 700 delegates and was successful in
bringing birth control and abortion into the political sphere – three months later, the Ministry of Health, in
the United Kingdom, allowed local authorities to give birth-control advice in welfare centres.[161]
The National Birth Control Association was founded in Britain in 1931, and became the Family Planning
Association eight years later. The Association amalgamated several British birth control-focused groups
into 'a central organisation' for administering and overseeing birth control in Britain. The group
incorporated the Birth Control Investigation Committee, a collective of physicians and scientists that was
founded to investigate scientific and medical aspects of contraception with 'neutrality and impartiality'.[162]
Subsequently, the Association effected a series of 'pure' and 'applied' product and safety standards that
manufacturers must meet to ensure their contraceptives could be prescribed as part of the Association's
standard two-part-technique combining ‘a rubber appliance to protect the mouth of the womb’ with a
‘chemical preparation capable of destroying... sperm’.[163] Between 1931 and 1959, the Association
founded and funded a series of tests to assess chemical efficacy and safety and rubber quality.[164] These
tests became the basis for the Association's Approved List of contraceptives, which was launched in 1937,
and went on to become an annual publication that the expanding network of FPA clinics relied upon as a
means to 'establish facts [about contraceptives] and to publish these facts as a basis on which a sound public
and scientific opinion can be built'.[165]
In 1936, the United States Court of Appeals for the Second Circuit ruled in United States v. One Package
of Japanese Pessaries that medically prescribing contraception to save a person's life or well-being was not
illegal under the Comstock Laws. Following this decision, the American Medical Association Committee
on Contraception revoked its 1936 statement condemning birth control. A national survey in 1937 showed
71 percent of the adult population supported the use of contraception. By 1938, 347 birth control clinics
were running in the United States despite their advertisement still being illegal. First Lady Eleanor
Roosevelt publicly supported birth control and family planning.[166] The restrictions on birth control in the
Comstock laws were effectively rendered null and void by Supreme Court decisions Griswold v.
Connecticut (1965)[167] and Eisenstadt v. Baird (1972).[168] In 1966, President Lyndon B. Johnson started
endorsing public funding for family planning services, and the Federal Government began subsidizing birth
control services for low-income families.[169] The Affordable Care Act, passed into law on March 23,
2010, under President Barack Obama, requires all plans in the Health Insurance Marketplace to cover
contraceptive methods. These include barrier methods, hormonal methods, implanted devices, emergency
contraceptives, and sterilization procedures.[170]
Modern methods
In 1909, Richard Richter developed the first intrauterine device made from silkworm gut, which was
further developed and marketed in Germany by Ernst Gräfenberg in the late 1920s.[171] In 1951, an
Austrian-born American chemist, named Carl Djerassi at Syntex in Mexico City made the hormones in
progesterone pills using Mexican yams (Dioscorea mexicana).[172] Djerassi had chemically created the pill
but was not equipped to distribute it to patients. Meanwhile, Gregory Pincus and John Rock with help from
the Planned Parenthood Federation of America developed the first birth control pills in the 1950s, such as
mestranol/noretynodrel, which became publicly available in the 1960s through the Food and Drug
Administration under the name Enovid.[159][173] Medical abortion became an alternative to surgical
abortion with the availability of prostaglandin analogs in the 1970s and mifepristone in the 1980s.[174]
Society and culture
Legal positions
Human rights agreements require most governments to provide family planning and contraceptive
information and services. These include the requirement to create a national plan for family planning
services, remove laws that limit access to family planning, ensure that a wide variety of safe and effective
birth control methods are available including emergency contraceptives, make sure there are appropriately
trained healthcare providers and facilities at an affordable price, and create a process to review the programs
implemented. If governments fail to do the above it may put them in breach of binding international treaty
obligations.[175]
In the United States, the 1965 Supreme Court decision Griswold v. Connecticut overturned a state law
prohibiting dissemination of contraception information based on a constitutional right to privacy for marital
relationships. In 1971, Eisenstadt v. Baird extended this right to privacy to single people.[176]
In 2010, the United Nations launched the Every Woman Every Child movement to assess the progress
toward meeting women's contraceptive needs. The initiative has set a goal of increasing the number of
users of modern birth control by 120 million women in the world's 69 poorest countries by the year 2020.
Additionally, they aim to eradicate discrimination against girls and young women who seek
contraceptives.[177] The American Congress of Obstetricians and Gynecologists (ACOG) recommended in
2014 that oral birth control pills should be over the counter medications.[178]
Since at least the 1870s, American religious, medical, legislative, and legal commentators have debated
contraception laws. Ana Garner and Angela Michel have found that in these discussions men often attach
reproductive rights to moral and political matters, as part of an ongoing attempt to regulate human bodies.
In press coverage between 1873 and 2013 they found a divide between institutional ideology and real-life
experiences of women.[179]
Religious views
Religions vary widely in their views of the ethics of birth control.[180] The Roman Catholic Church re-
affirmed its rejection of artificial contraception in 1968 and only accepts natural family planning,[181]
although large numbers of Catholics in developed countries accept and use modern methods of birth
control.[182][183][184] Among Protestants, there is a wide range of views from supporting none, such as in
the Quiverfull movement, to allowing all methods of birth control.[185] Views in Judaism range from the
stricter Orthodox sect, which prohibits all methods of birth control, to the more relaxed Reform sect, which
allows most.[186] Hindus may use both natural and modern contraceptives.[187] A common Buddhist view
is that preventing conception is acceptable, while intervening after conception has occurred is not.[188] In
Islam, contraceptives are allowed if they do not threaten health, although their use is discouraged by
some.[189]
World Contraception Day
September 26 is World Contraception Day, devoted to raising awareness and improving education about
sexual and reproductive health, with a vision of a world where every pregnancy is wanted.[190] It is
supported by a group of governments and international NGOs, including the Office of Population Affairs,
the Asian Pacific Council on Contraception, Centro Latinamericano Salud y Mujer, the European Society
of Contraception and Reproductive Health, the German Foundation for World Population, the International
Federation of Pediatric and Adolescent Gynecology, International Planned Parenthood Federation, the
Marie Stopes International, Population Services International, the Population Council, the United States
Agency for International Development (USAID), and Women Deliver.[190]
Misconceptions
There are a number of common misconceptions regarding sex and pregnancy.[191] Douching after sexual
intercourse is not an effective form of birth control.[192] Additionally, it is associated with a number of
health problems and thus is not recommended.[193] Women can become pregnant the first time they have
sexual intercourse[194] and in any sexual position.[195] It is possible, although not very likely, to become
pregnant during menstruation.[196] Contraceptive use regardless of its duration and type does not have a
negative effect on the ability of women to conceive following termination of use and it doesn't significantly
delay fertility. Women who use oral contraceptives for a longer duration may have a slightly lower rate of
pregnancy than do women using oral contraceptives for a shorter period of time, possibly due to fertility
decreasing with age.[197]
Accessibility
Access to birth control may be affected by finances and the laws within a region or country.[198] In the
United States African American, Hispanic, and young women are disproportionately affected by limited
access to birth control, as a result of financial disparity.[199][200] For example, Hispanic and African
American women often lack insurance coverage and are more often poor.[201] New immigrants in the
United States are not offered preventive care such as birth control.[202]
Research directions
Females
Improvements of existing birth control methods are needed, as around half of those who get pregnant
unintentionally are using birth control at the time.[29] A number of alterations of existing contraceptive
methods are being studied, including a better female condom, an improved diaphragm, a patch containing
only progestin, and a vaginal ring containing long-acting progesterone.[203] This vaginal ring appears to be
effective for three or four months and is currently available in some areas of the world.[203] For women
who rarely have sex, the taking of the hormonal birth control levonorgestrel around the time of sex looks
promising.[204]
A number of methods to perform sterilization via the cervix are being studied. One involves putting
quinacrine in the uterus which causes scarring and infertility. While the procedure is inexpensive and does
not require surgical skills, there are concerns regarding long-term side effects.[205] Another substance,
polidocanol, which functions in the same manner is being looked at.[203] A device called Essure, which
expands when placed in the fallopian tubes and blocks them, was approved in the United States in
2002.[205] In 2016, a black boxed warning regarding potentially serious side effects was added,[206][207]
and in 2018, the device was discontinued.[208]
Males
Methods of male birth control include condoms, vasectomies and withdrawal.[209][210] Between 25 and
75% of males who are sexually active would use hormonal birth control if it was available for
them.[133][209] A number of hormonal and non-hormonal methods are in trials,[133] and there is some
research looking at the possibility of contraceptive vaccines.[211]
A reversible surgical method under investigation is reversible inhibition of sperm under guidance (RISUG)
which consists of injecting a polymer gel, styrene maleic anhydride in dimethyl sulfoxide, into the vas
deferens. An injection with sodium bicarbonate washes out the substance and restores fertility. Another is
an intravas device which involves putting a urethane plug into the vas deferens to block it. A combination
of an androgen and a progestin seems promising, as do selective androgen receptor modulators.[133]
Ultrasound and methods to heat the testicles have undergone preliminary studies.[212]
Other animals
Neutering or spaying, which involves removing some of the reproductive organs, is often carried out as a
method of birth control in household pets. Many animal shelters require these procedures as part of
adoption agreements.[213] In large animals the surgery is known as castration.[214]
Birth control is also being considered as an alternative to hunting as a means of controlling overpopulation
in wild animals.[215] Contraceptive vaccines have been found to be effective in a number of different
animal populations.[216][217] Kenyan goat herders fix a skirt, called an olor, to male goats to prevent them
from impregnating female goats.[218]
See also
Human population planning
Immunocontraception
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Further reading
Speroff L, Darney PD (2010). A clinical guide for contraception (https://books.google.com/bo
oks?id=f5XJtYkiJ0YC&pg=PT1) (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
pp. 242–43. ISBN 978-1-60831-610-6. Archived (https://web.archive.org/web/20160506220
517/https://books.google.com/books?id=f5XJtYkiJ0YC&pg=PT1) from the original on May 6,
2016.
Stubblefield PG, Roncari DM (2011). "Family Planning" (https://books.google.com/books?id
=P3erI0J8tEQC&q=editions%3AytqC2tqT5BIC&pg=PA247). In Berek JS (ed.). Berek &
Novak's Gynecology (15th ed.). Philadelphia: Lippincott Williams & Wilkins. pp. 211–69.
ISBN 978-1-4511-1433-1.
Jensen JT, Mishell Jr DR (March 2012). "Family Planning: Contraception, Sterilization, and
Pregnancy Termination" (https://books.google.com/books?id=X5KT_w6Nye8C&pg=PA215).
In Lentz GM, Lobo RA, Gershenson DM, Katz VL (eds.). Comprehensive Gynecology
(6th ed.). Philadelphia: Mosby Elsevier. pp. 215–72. ISBN 978-0-323-06986-1.
Gavin L, Moskosky S, Carter M, Curtis K, Glass E, Godfrey E, et al. (Division of Reproductive
Health, National Center for Chronic Disease Prevention and Health Promotion, CDC) (April
2014). "Providing quality family planning services: Recommendations of CDC and the U.S.
Office of Population Affairs". MMWR. Recommendations and Reports. 63 (RR-04): 1–54.
World Health Organization Department of Reproductive Health and Research and Johns
Hopkins Bloomberg School of Public Health (2011). Family planning: A global handbook for
providers: Evidence-based guidance developed through worldwide collaboration (http://ww
w.fphandbook.org/sites/default/files/hb_english_2012.pdf) (PDF) (Rev. and Updated ed.).
Geneva: WHO and Center for Communication Programs. ISBN 978-0-9788563-7-3.
Curtis KM, Jatlaoui TC, Tepper NK, Zapata LB, Horton LG, Jamieson DJ, Whiteman MK
(July 2016). "U.S. Selected Practice Recommendations for Contraceptive Use, 2016" (http
s://doi.org/10.15585%2Fmmwr.rr6504a1). MMWR. Recommendations and Reports. 65 (4):
1–66. doi:10.15585/mmwr.rr6504a1 (https://doi.org/10.15585%2Fmmwr.rr6504a1).
External links
Birth control (https://curlie.org/Health/Reproductive_Health/Birth_Control/) at Curlie
"WHO Fact Sheet" (https://www.who.int/mediacentre/factsheets/fs351/en/). July 2017.
Retrieved July 23, 2017.
"Birth Control Comparison Chart" (http://www.birth-control-comparison.info/). Cedar River
Clinics.
Bulk procurement of birth control (https://www.who.int/rhem/procurement/en/) by the World
Health Organization
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Birth control

Birth control, also known as contraception,

The World Health Organization and United States Centers

Three varieties of Birth control pills A transdermal A NuvaRing vaginal

A rolled up male An unrolled male A polyurethane A diaphragm

Although sterilization is considered a permanent procedure,[83] it is possible to attempt a tubal reversal to

Fertility awareness methods involve determining the most fertile

Emergency contraceptive methods are medications (sometimes

Contraceptive use in developing countries is estimated

Birth control also improves child survival in the

The total medical cost for a pregnancy, delivery and

As of 2012, 57% of women of childbearing

Birth control movement

Society and culture

World Contraception Day

Retrieved from "https://en.wikipedia.org/w/index.php?title=Birth_control&oldid=1052042907"

This page was last edited on 27 October 2021, at 01:38 (UTC).

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