Birth control
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Birth control, also known family planning, is the practice of taking steps to prevent pregnancy or childbirth as a result of sexual activity. Birth control is often used synonymously with contraception, although some of the practices discussed on this page (such as abortion or abstinence) are not contraceptive, although they can still be classed as birth control since they prevent a possible birth.
Some forms of contraception, such as the condom, can also help prevent transmission of STDs.
There are several broad groups of birth control methods, including barrier methods, hormonal suppression of ovulation, surgical sterilization, and wishful thinking. Methods are listed here in order of decreasing approximate effectiveness at preventing pregnancy or birth.
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[edit] Methods and effectiveness
[edit] Almost perfect
| For those of you in the mood, RationalWiki has a fun article about Birth Control. |
Abstinence (voluntary or involuntary) is completely refraining from sexual intercourse. It works by depositing no sperm within the vagina to fertilize the egg cell. This method is almost 100% effective in preventing pregnancy, with a few exceptions in mythology. Generally, abstinence carries no risks, but may cause a degree of psychological frustration and short sightedness. This method also may lead to more pregnancies since abstinence only education, most often supported by the religious right, provides no education regarding preventing pregnancy or disease if passion unexpectedly gets the upper hand.[1] These "education" programs often actively discourage the use of contraception that is known to be effective, particularly by twisting or quote mining the data on effectiveness or even by outright lying about it. Other sex education programs, ones which aren't endorsed by the religious right, teach abstinence in combination with conventional contraceptives and disease prevention methods.
However, saying that abstinence is 100% effective in preventing pregnancy is a bit like saying that condoms are 100% effective when they do not fail. When abstinence does fail (which happens a lot, due to human nature), there is absolutely nothing preventing pregnancy or STDs - unless some form of contraception is used, which it often isn't due to the narrow scope of sex education provided within abstinence movements.
Abortion is not a form of contraception, since it is carried out in response to a pregnancy rather than to prevent one, but is still a highly effective method of preventing a live birth, although in a few exceptionally rare cases, a child aborted late in a pregnancy has survived. Abortion laws and methods vary around the world, as do social and ethical attitudes towards abortion. In a few countries, such as Russia, Turkey and parts of Eastern Europe, use of abortion as a form of birth control is almost as common as contraception, and in China abortions are often mandated to enforce the one-child rule. In most other countries, it is used as an option for terminating an unwanted pregnancy, rather than as a chosen alternative to other means of birth control.
Vasectomy is a procedure in which the vas deferens (the ducts that carry sperm from the testes to the prostate gland in the male) are cut, a small section removed, and the resulting ends sealed off with small stainless steel clips. It is nearly 100% effective. This method prevents sperm from entering the semen, but carries the obvious risk of (usually) irreversible sterility. If performed by a completely incompetent doctor, however, sperm can still reach the prostate, and thus escape the male's body to potentially impregnate a woman.
Tubal Ligation is a similar method of sterilization for females. The oviducts are cut and sealed, preventing eggs from reaching the uterus. Although having nearly a 100% effectiveness, as with a vasectomy, if performed incorrectly, an egg can still pass through. This is harder to test for than a failed vasectomy. Tubal ligation is also an invasive abdominal surgery, with higher risk factors, while vasectomy is a much simpler and cheaper outpatient procedure.
[edit] Highly effective
Oral contraception is a hormone-based pill taken by the woman. The hormones prevent the anterior pituitary from releasing follicle stimulation hormones, and the ovary does not get prepared to release an egg. When the woman stops taking the medicine, there is a possibility of irregular periods for a while. This method is around 99% effective if the medication is taken as prescribed (important note: it clashes with some antibiotics, rendering it ineffective). Furthermore, you may have to shell out like 300 bucks for mifepristone if this shit doesn't work.
Depo Provera is a series of four injections of a progesterone-like steroid for women, repeated annually, which functions like the other hormonal methods mentioned above. This method is about 99% effective.
Emergency contraceptive pills (ECPs), also known as the "morning after pill" or the "Plan B pill" are pills women take to reduce the chance of pregnancy after they have unprotected sex.[2] It acts to prevent both the fertilization and implantation of the embryo. It is distinct from abortion as abortions are performed after implantation. Examples of these pills include levonorgestrel (progestin) which are 89% effective, and mifepristone (These are used only at selected countries as ECPs) which are about 83% effective at ECP dosage (10 mg).[3]
Contraceptive implants are tubes of progestin implanted into the ovary surgically. This functions similarly to oral contraception, but without the need for daily pill ingestion. This procedure, however, carries with it the normal risks of surgery. This is generally about 90% effective.
The intrauterine device, or IUD, is essentially a plastic-and-copper coil inserted into the uterus by a doctor, triggering an immune system response that prevents implantation of any fertilized eggs. As with contraceptive implants, this procedure carries a risk of uterine infections, and is about 99% successful in preventing pregnancy.
[edit] Reasonably effective
Another female method for preventing pregnancy is the diaphragm, which is a latex cover inserted into the vagina before intercourse, covering the cervix. The diaphragm prevents sperm from entering the uterus. Combined with an application of spermicidal jelly, mentioned later, the effectiveness is around 90%. An oddity worth mentioning is that lemons were used in the 1700's as a diaphragm, and modern science has discovered they are effective at killing sperm and the HIV virus.[4] However, other studies have concluded that lemon juice can damage vaginal tissue, and this is not a studied method.
Taking the diaphragm a step further is the cervical cap, which is a cap held by suction to the cervix, also buttressed with use of a spermicide. This 85% efficient method has a possible link to cancer of the cervix, owing to the application of cell destroying chemicals right onto the cervix.
The most well-known form of contraception is the condom, which is a latex (or "lambskin", or other synthetic plastic) sheath rolled over an erect penis, which traps sperm before it can reach the vagina, as well as most bacteria and viruses. The previous statement only applies to latex condoms. The usage of sheepskin condoms, although still effective at preventing sperm from reaching the vagina, have pores large enough to allow viruses, such as HIV, to pass through. This method carries around an 85% success rate, with no presently known risks provided the sheath is not torn or broken.
The female condom is a liner fitted into the vagina before intercourse which prevents the sperm from progressing past the cervix. This method carries the benefit of preventing STDs, but as mentioned above, only latex works effectively in disease prevention. This is not to be used in conjunction with a male condom, as the two latex surfaces will stick together and possibly tear, removing the protection. As with a male condom, this method carries about an 85% success rate.
[edit] Less effective
Withdrawal of the penis before ejaculation, also known as coitus interruptus, is self-explanatory, preventing sperm from even entering the vagina. The main problem this method runs into is that, even before ejaculation, some sperm is pre-ejaculated due to stimulation, which could still be enough to allow for pregnancy to occur, leading to a failure rate of 18-19%.[5] This method also depends on good timing on the part of the male at a moment when he is least likely to be thinking about timing. The withdrawal method is often jokingly associated with Catholicism, although in fact the Catholic Church regard it as a mortal sin (See Onanism). Apart from its problems as a birth control method, withdrawal may also detract somewhat from the joy of the occasion (unless you're a bukkake enthusiast).
Spermicides, as mentioned above, are products designed to create a hostile environment for sperm, which kills a large enough number to prevent the egg from being fertilized. Presently, there is no significant risk known, save for the aforementioned possible link to cervical cancer. Spermicides are usually used in conjunction with the various barrier methods such as condoms and diaphragms.
The rhythm method (a.k.a. "Vatican roulette") involves keeping track of the day of ovulation, and limiting intercourse to certain days of the month. It is the only method other than abstinence that is approved by the Catholic Church. The problem this method runs into is that sperm can survive within the fallopian tubes for up to five days, and in some cases, up to seven. Not to mention cases where people think "rhythm method" means something totally different. This is about 70% effective.
[edit] Almost useless
A douche is a method of washing out the vagina and uterus with water or other substances after intercourse, and is the least effective method of birth control, if it can even be considered a method at all. By inserting a liquid medium into the vagina, you have actually propelled the sperm closer to their target. Although this does remove some sperm, not enough is removed to make this a useful form of birth control. Alternatively if the aim is prevent implantation of the embryo into the womb, it may have to be continued for prolonged periods of time.[6] Douching is less than 60% effective.
Herbal contraception is worth mentioning, more for historical interest than practical use. Various herbs, fruits and vegetables, including pomegrate, neem oil, marijuana, and wild carrot seeds are known to lower male or female fertility to some extent, and have been used for contraceptive purposes in the past, or in societies which do not have access to modern birth control products. However, their effectiveness is highly unreliable and does not compare favourably with modern contraceptive methods.[7]
In the Hunter Davies novel Here We Go 'Round the Mulberry Bush, it was suggested that the radioactivity from a luminous watch placed by the testes for several hours would kill any sperm, and thus prevent conception. Unfortunately, modern luminous watches are no longer radioactive -- and even if they were, hanging a lump of radioactive material around one's genitals would not be recommended.
[edit] Opposition to contraception
The prohibition on most methods of birth control by the Roman Catholic Church is based on a faulty understanding of human biology which dates back to the Middle Ages. It was once believed that male seed contained a complete (but microscopic) human being, and the only contribution of the woman was to provide fertile ground to allow it to grow to the size of an infant. The Church no longer holds this to be true, but opposition to the practice remains due to inertia.
The Protestant "quiverfull" movement maintains that God should be the only judge of when conception happens, and hence shares this position on contraception making lots of babies. The obvious point one can raise in response to this is that if God is all-powerful, he could just make someone get pregnant anyway[8], regardless of contraception. He could also prevent someone from using it. He could also make an abortion not work, etc.
[edit] With respect to natural selection
Regarding[9] natural selection and evolution, birth control seems like a very bad idea. Preventing the spreading of human genes seems like the most unnatural thing in the world. Yet people still are happy with doing it. Evolutionary biologist Richard Dawkins suggests that contraception is fine (from a memetic and genetic view) because evolution has "built in" the desire for sexual lust and not the desire for children. As a result, birth control may seem unnatural from a Darwinian point of view, but it doesn't go against what evolution has programmed the human race to do.
Rejecting birth control, however, highlights one of the principles of natural selection. That is that fast breeders can, in some circumstances, out-compete those that are most suitable for the environment. This is because natural selection preserves those "most fit for reproduction" and not those necessarily "most fit for survival". Therefore those throwing out babies constantly (such as the Quiverfull movement), or at increasingly younger ages, will generate more offspring than those with good physical or mental characteristics who would be happy to delay, restrict, or entirely stop having children for the sake of their career and personal development (namely by using birth control). Cynically put, stupidity - at least with respect to fucking everything in sight - reigns supreme in the world of natural selection.
[edit] Diversionary techniques
Masturbation is giving oneself sexual pleasure through the stimulation of one's own genitalia. Like abstinence, it is almost 100% effective in preventing pregnancy. Risks of blindness and hairy palms have been greatly exaggerated. (Please be sure to dispose of your batteries in an environmentally friendly manner.) It should be noted that masturbation is not exclusively a solo activity, and it is possible to stimulate another person's genitalia. When two or more more people stimulate each other with this method, it is called "mutual masturbation"
Oral sex is the simulation of the genitalia of another person (or, for the incredibly flexible, oneself). It is nearly 100% effective in preventing pregnancy; however, like abstinence, passions can spin out of control, causing the couple to actually do the deed without a proper means of artificial contraception.
Anal sex is the insertion of a penis or dildo into the anus. It is almost 100% effective, but there is a theoretical possibility (when the receptive partner is female)[10] that the sperm will migrate out of the woman's anus and into her vagina. Also, it's really painful the first few times. Or so we've heard. Anal sex is riskier than vaginal sex because of the thinner, capillary-rich, walls of the anus, compared to the thick muscular walls of the vagina. This increases the likelihood of disease transmission when unprotected. If you do engage in anal sex, make sure to wash before engaging in vaginal sex to prevent possible infection of the vagina with rectal flora or fauna. Also note that unlike the vagina, the anus cannot produce its own lubrication, you must provide this yourself with appropriate products.
It should be noted that both oral and anal sex can be performed with a male condom to minimise the likelihood of disease transmission.
[edit] See also
[edit] Footnotes
- ↑ (see Johnston, Levi)
- ↑ See the Wikipedia article on Emergency contraception.
- ↑ Planned Parenthood on emergency contraception
- ↑ http://articles.mercola.com/sites/articles/archive/2002/10/26/lemons.aspx
- ↑ American pregnancy association
- ↑ Perhaps in terms of several 24-hour days, continuously.
- ↑ See Herbal Contraception for more information, but please don't consider this as a serious contraceptive option!
- ↑ It has allegedly been done, even without the sexual act
- ↑ copyright ♥ K e n D o l l ♥
- ↑ If you don't know why this qualification is necessary, read Myra Breckinridge, or just see Wikipedia's article on pegging. "I don't want to hurt you; I only want to teach you..."
