BIRTH CONTROL: CONTRACEPTION
To rephrase the definition given at the beginning of the chapter, contraception may be described as any temporary method of birth control that permits sexual intercourse between a fertile man and a fertile woman but that prevents impregnation. This definition excludes abstinence, abortion, and sterilization (including castration), which are, obviously, forms of birth control, but which are distinctly not forms of contraception.
The efficacy of a specific method of contraception is determined by comparing its incidence of success with the incidence of pregnancy in couples who use no means of contraceptionthe latter assessed at 60 to 100 pregnancies in 100 years of coital experience.104 For example, if couples using condoms ("rubbers") as a contraceptive device show a pregnancy rate of 11 per 100 years (1200 months) of exposure, and if nonusers of any contraceptive methods show 100 pregnancies per 100 years of exposure, it is calculated that 89 out of 100 pregnancies were prevented by the use of the condom, and that its use as a contraceptive device is "89% effective."
Contraception serves five important purposes:
1. To aid early sexual adjustment in marriage. During the inevitable period of marital adjustment, sexual compatibility may be reached earlier and in a more satisfactory manner if fear of pregnancy is removed. It has also been shown that a wife's sexual responsiveness is directly related to the degree that both she and her husband are satisfied with their present method of contraception.2
To space pregnancies. Spacing the arrival of children allows a couple to give full consideration to the mother's health and to the family's economics. It has been claimed that when births are only one year apart, the death rate for babies is about 50% higher than when births are two years apart.150
To limit family size. Most couples prefer for many and various reasons to limit the size of their families. A primary consideration is that excessive childbearing can leave the mother with several undesirable physical conditions, such as high blood pressure, varicose veins, and relaxed vaginal tissue. Furthermore, after the birth of the second child, the chance of infant mortality increases with each additional child borne by the same mother.
Social factors also influence the number of children that individual couples want (only 10%, for instance, want more than four). Women are often reluctant to spend all their young and energetic adult lives being a mother to a baby or child. By limiting the number of children and by properly spacing them, they can frequently have their children during the first few years of marriage, leaving the latter years for a more leisurely life and, hopefully, a more meaningful one with regard to their commitment to a profession or to the community.
To avoid aggravation of existing illnesses or diseases. Many illnesses and diseasestuberculosis, heart and kidney disease, an advanced stage of diabetes (especially when complicated by damaged blood vessels), emotional disorders, nervous afflictions, recent surgery for cancerraise the question of the advisability of pregnancy.
To prevent the perpetuation of inherited diseases. Spread of inherited diseases, e.g., Huntington's chorea, can, obviously, be best controlled by preventing the pregnancy of an afflicted woman or a woman married to an afflicted man.
A study of the growth of the American family,110 in which 2700 white women between the childbearing ages of eighteen and thirty-nine were interviewed, revealed the following with regard to the practice of contraception:
70% of these women were practicing some form of contraception; 9% planned to do so later; 92% who had proved their fertility with the birth of at least one child, and who had been married for at least fifteen years, used contraceptives;
60% of those women who had never tried to prevent conception were relatively infertile in any event;
and with regard to religious groups:
57% of the Catholics in the study used some form of contraception, as did
75% of the Protestants, and 86% of the Jewish women.
After one child had been born, the percentages within religious groups using contraception were:
70% of the Catholic mothers,
83% of the Protestants, and
95% of the Jews.
The educational level of the couples was directly related to whether or not they used contraceptives: the higher the education received, the more likely the couples were to employ contraception. In 1955, seven in ten couples used some form of contraception, and by 1960 the number had risen to eight in ten.
Contraceptive measures currently offer a wide range of choice among medically approved devices and products.
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Men's Health Erectile Dysfunction