Birth control refers to anything which permits sexual intercourse while stopping the woman from conceiving. There are several ways to do this, some functional, some mechanical and some chemical or biological.
A common functional method is to withdraw the penis immediately before ejaculation, another is to have sexual intercourse only during times when the woman is unlikely to conceive based on the time an egg remains viable after release. Neither of these methods is very reliable in practice and both have a high failure rate, significantly higher than other methods.
There are also two surgical methods. For men a vasectomy involves cutting the vas deferens, the tubes down which sperm travel to mix with the semen. This effectively makes the man sterile and sperm are no longer found in the ejaculate. For women, a tubal ligation involves blocking off the fallopian tubes so an egg cannot reach the uterus when released from an ovary. The vasectomy is less invasive and simpler than the tubal ligation, but either method is completely effective with a negligible failure rate.
Mechanical methods refer to placing physical barriers between the penis and the cervix so sperm may not enter the uterus. The commonest is the condom, available in a bewildering array of forms and flavours. This is a tube, usually latex rubber and sealed at one end. It is rolled over the penis and traps the ejaculate in the sealed end.
For women, there are the cervical cap, a rubber cover which is placed over the cervix, and the diaphragm, a larger latex rubber dome with a sprung rim which seals off the end of the vagina, including the cervix. Both these barriers require insertion into the vagina before sexual intercourse and must remain for several hours after to ensure any sperm deposited are no longer viable. They are not as popular as the condom because they have to be inserted into a body cavity, which causes a significant break in the intimacy and thus more likely to lead to no birth control being used. Female barrier methods are also less effective than the condom.
A condom is by far the most convenient barrier method, taking just a few seconds to put on and can even become part of the foreplay. For that reason, it has become one of the standard and most used birth control methods. The success rate for the condom is very high, but not as high as a vasectomy or tubal ligation. It is certainly high enough to be considered a very reliable method.
One further advantage of a condom is that it provides a physical barrier against infectious agents. Most venereal disease organism are introduced into the body through physical abrasions during intercourse and the latex of the condom protects these abrasions from bacterial infection. Except in the case of stable relationships between partners who restrict themselves to each other, it is recommended that a condom be used as a protection against infection even if another birth control method, such as the pill, is also being used.
Chemical birth control consists of spermicidal creams, hormones to suppress ovulation and medications which stop implantation of a fertilised egg into the uterine wall.
Spermicides are not recommended for use alone as the force of the ejaculate may move them away from the cervix and permit viable sperm to enter. They are considered more effective when used in conjunction with other methods, such as a cervical cap or diaphragm when the sperm are trapped outside the cervix in the vagina and the spermicide has time to act. On the other hand, if no other method is available it is better than using none.
One of the most common methods of birth control are hormones to suppress ovulation, i.e. birth control pills. They are effective immediately they are taken and allow for sexual relations at any time without fear of pregnancy. These pills are responsible for enabling more than one generation of women to express themselves fully in sexual matters and are a great benefit to society. For some reason, even today, they are obtainable only by prescription from a doctor. In the past there have been attempts to link them with various medical conditions, including breast cancer, but the incidence is either too low to be significant or has been shown to be incorrect.
Another type of hormone pill is often referred to as the “morning after pill”, since it is used as an emergency contraceptive after unprotected intercourse has taken place. It was originally thought that these pills stopped implantation of a fertilised egg so the fetus could not develop, but it is now known that they actually suppress or delay ovulation so there is no egg to fertilise. The criticism that they cause an extremely early abortion is based on this misplaced belief that fertilisation takes place, but since the large hormonal dose actually inhibits egg release there is no early abortion. These pills are most effective if taken as soon after intercourse as possible, not necessarily waiting for the next morning.
The biological means of birth control is the intrauterine device (IUD). Placing one of these devices into the uterine endometrium causes a fertilised egg to fail to implant, thus stopping pregnancy. These also have been criticised on the basis that they really cause an early abortion, but the evidence for this is not clear and they may work by inhibiting ovulation or fertilisation. In addition, there have been reports of medical problems developing either as a reaction to the device or because the device has moved after insertion. For those reasons it has not become as popular as it was once thought it might. Its advantage is that once inserted it remains active for several months without further attention.
The wide diversity of methods available for birth control means that almost everyone can find a method that would be satisfactory for them. The exception would be those who adhere to any religion which forbids birth control entirely and insists that each occasion of intercourse must allow for conception to be possible. This insistence is often based on the belief that god arranged for sexual intercourse as a means of increasing the population of humans and not as a means of personal pleasure which improves the bonding between couples.
Those who wish to adhere to such dogma are, of course, free to do so, but saying that intercourse is primarily to increase the population is not necessarily true. It is true that in a narrow, biological sense it is the mechanism to bring about a pregnancy, but it is not true in a wider sense. Among humans sexual intercourse fills the two other purposes of personal pleasure and pair bonding between mates. Pair bonding, in particular, is important since, even at their most precocious, human young take ten to fifteen years or longer to reach an age at which they can reasonably be expected to survive without parental help. Sexual pair bonding assists in this as the man is far more likely to remain and help the woman raise the children. In other words, evolution has developed the family as a stable unit among humans to ensure a suitable environment for children to be brought to maturity. Sexual pleasure is a major component of that bonding and could well explain why humans do not have sexual relations only at specific times of the year, as so many animals do. That means evolution has used the pre-existing mechanism of sexual intercourse to increase the attachment of human males to their partners through the provision of frequent sexual pleasure thus retaining their assistance in raising the children as a consequence. Sexual intercourse is not only, nor primarily, for conception. It is primarily to ensure the male assists in raising his children. To see the truth in this, compare the one time resulting in conception with the 1,000 times over the first ten years of the child‘s life.
This also explains why couples without children, whether heterosexual or otherwise, live in stable, family partnerships. Although the ability or desire to conceive may be missing, the desire for long term pair bonding still remains and the pleasure in the sexual basis for it is still sufficient to keep them together. It should also be mentioned that sexual pleasure is not the only component of pair bonding. Liking each other, loving each other and having respect for each other are also major influences, as is societal pressure to remain a family.
This long term bonding in times past often led to numerous pregnancies. It was not unknown for a women to have a newborn almost every year. The stress on undernourished individuals sometimes led to an early death, leaving the children without the support they needed. Over many centuries methods to decrease the likelihood of a pregnancy were tried with varying degrees of success but they usually had a high failure rate. Invention of the condom changed that, and was a successful and very effective method of contraception. It remains so to this day. Condoms may be purchased in many stores, including pharmacies, grocery stores and supermarkets. They are quite freely available at minimal cost. That is a good thing, but I question why one method of birth control should be so freely available yet other methods of birth control should be deliberately restricted.
When the birth control pill first became available it required a prescription from a medical doctor and was usually prescribed only to married women. Sometimes, progressive doctors found ways to avoid the restrictions and provided prescriptions for regulation of menstrual periods, which happen to employ the same pills, thus making birth control available to many more women. Blind eyes were often turned to this practice, but why should that be necessary? If one method of birth control is freely available, surely every method of birth control should be freely available.
With hormone pill methods the objection to making them more easily available is that they may pose a danger to the woman‘s health. They have now been available to millions of women for more than fifty years, yet no clear cut correlation exists between these pills and serious illnesses. If there were such a clear association surely it would have been identified by now. I strongly suspect that limiting their availability by prescription is a holdover from a more sexually restrictive time based on an attitude that women should not be sexually active unless married. There may be a very small minority of women who should not be using them, but the vast majority of women experience no problems of any kind. Why should these women not be able to purchase them in the same places as condoms are sold? Why do adult women require a doctor‘s permission as to what birth control method they should use? It is worth noting that some men and women, likely more than are negatively affected by the pill, are allergic to latex and cannot use condoms but there is no suggestion that condoms should only be available by prescription so as to ensure that a minority of users who develop allergic reactions can be spared. The present approach makes no sense except in a paternalistic society with an undercurrent which says that women are unable to make rational decisions about their own health and reproduction.
The undercurrent surrounding the availability of birth control pills, and other birth control methods in general, is fundamentally moralistic, and based on religious concepts of sexual propriety. Women are not supposed to enjoy sexual intercourse and are fundamentally viewed as the vessel to carry the man‘s seed to fruition. Intercourse is viewed as a means to that end only, instead of being a mechanism to bond people to each other and provide a loving family to raise children. Making methods of birth control freely available would remove most of the risk of a pregnancy and that alone would increase the pleasure of those engaging in the activity allowing for a fuller expression of the love bond they have between them. Since it is that love bond which stabilises families to promote healthy child rearing, society should have a significant interest in promoting anything which may improve it, including making birth control more freely available to any who want to use it.
Married people are not the only ones who are sexually active, of course. Many unmarried people are, of all ages and types. Sexual pleasure is still a major driving force in human activities among those not in a partnership, and it will undoubtedly remain so. There is no point in decrying this. It will continue to happen simply because it is a basic human drive. Rather than trying to stop what is, after all, a normal human activity, it would be more sensible to remain neutral, that is, not to condemn nor to criticise, but to make birth control more easily available so the people involved can avoid a pregnancy. The age of those involved is largely irrelevant and young people have as much right to these materials as anybody else. If a female is able to conceive, she should have the right to access birth control. It is far better to avoid a pregnancy than to deal with the trauma of a 13 year old girl giving birth or having an abortion. The same should apply to boys who produce sperm. It is better that they should have access to birth control than to become a father at 13.
I am, of course, not talking about the sexual exploitation of underage children and young women by older men. Yet even in those cases, it should be self evident that birth control should be available as a pregnancy would just intensify the emotional damage done to them.
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