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Contraception: Then and Now
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Women (and men) seem to have always wanted to limit the number of children they give birth to. Various methods have been used for thousands of years. Some very effective and safe and some not so effective, or safe. The following is a brief overview of some of the methods women and men have used to limit their family size.
Behavioral Contraception
There have been many ways people have avoided getting pregnant that involved behavioral changes. Some of these have included abstinence within a marriage and withdrawal. There are two kinds of withdrawal: coitus interruptus and coitus reservatus. Coitus interruptus is withdrawal with ejaculation afterwards and coitus reservatus is withdrawal without ejaculation.
In China and India in ancient times coitus reservatus was popular because many people believed that men lost ‘yang’ when ejaculating. In the middle ages it was taught by the church that the pleasure of ejaculation was sinful so coitus reservatus was considered to be sinless. Many women have also spaced their pregnancies further apart by breast feeding for extended periods of time.
Barrier Methods
Barrier methods include condoms and sponges. There is a cave painting in France that is 12,000 to 15,000 years old that shows a man using a condom. They were also known to be used in England at least as early as 1640 and were made from animal gut. Later, around 1943, rubber condoms became mass produced after Charles Goodyear figured out how to vulcanize rubber. In 1994, Reality, a female condom became available in the U.S.
Women around the world have also used numerous things to block their uterus and avoid getting pregnant. In Africa seedpods, plugs of grass and roots were used for this purpose. In the far east seaweed, moss and bamboo were used. In Greece halves of empty pomegranates were used to block semen from entering the uterus. The French used sponges soaked with brandy in the 17th century and British women used sponges wetted with olive oil early in the 20th century. Other substances used include tissue paper, beeswax and silver.
Foams, creams and various sorts of jellies were also in an attempt to kill and/or block sperm. These include cedar rosin combined with myrtle, lead, alum, or wine, tampons soaked in the fermented juice of acacia plants and even honey.
Hormonal Methods
In Northern Africa a plant called silphium use to grow which had good contraceptive properties. It was in high demand and by the 4th century had become extinct. Descendants of the Aztecs in Mexico used to eat the Barbasco root as a contraceptive. Progestin from this plant was eventually used to make the first birth control pills. Birth control pills now have lower levels of hormones than the original ones and have been tested for safety more than any other medicine in history.
Depot Medroxyprogesterone Acetate or DMPA was first available in 1969. It was first approved by the FDA in 1992 as Depo-Provera and is a long lasting injectable progestin contraceptive (but has some possible health risks). A hormonal implanted contraceptive called Norplant was approved in the US in 1990, but is no longer being made, a similar product, Jadelle will eventually be made available.
Additional hormonal methods include a patch called Ortho Evra which used synthetic estrogen and progestin. NuvaRing is a small and flexible ring that is put into the vagina once a month and also uses synthetic estrogen and progestin.
Emergency contraceptive methods include those to induce menstruation before fertilization or implantation and have been around since at least ancient Greece. In 1999 the FDA approved Plan B, a progestin only method using levonorgestrel. It is available in the United Kingdom as Levonelle and in France as NorLevo.
IUD’s or Intrauterine Device are also a type of emergency contraceptive as well as a primary contraception method. It is used by being placed in the uterus by a medical professional and is one of the most popular methods of birth control. As early as the 9th century Persian physicians suggested putting paper with ginger water into the uterus to prevent pregnancy. In the early 20th century IUD’s were made from gold and silver but infections were a serious problem with the method. In the 1960’s IUD’s were popular for a while until problems with the Dalkon Shield became known. Today only a small percent of the population uses IUD’s in the US, but in some parts of the world they are still quite popular.
In the U.S. the birth control pill is the most used form of reversible contraception, worldwide however the IUD in the most common.
Tubal ligations are a used as a permanent form of contraception. Overall in the U.S. it is the most popular form of birth control with 27% of women who use contraception using this method.
In the past many of the contraceptive methods available to wome were not so safe or effective. Many centuries ago Chinese women would sometimes drink lead or mercury to keep from having children which was very dangerous and sometimes ended in death. Of course at that time childbirth itself was very risky and many women died giving birth. We are lucky today to have so many safe options available to us.
For learn more about the history of contraception Planned Parenthood has a very comprehensive article about the History of Birth Control Methods and Wikipedia also has a nice overview of various methods of birth control.
(Technorati Tags: contraception, birth control, condom, coitus interruptus, coitus reservatus, Plan B, IUD)
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