CONTRACEPTION: HISTORY AND METHOD CONSIDERATIONS

Although many people believe that contraception is a modern invention, its origins ac­tually extend back to ancient times. We will now explore contraception throughout his­tory, both within the United States and cross-culturally.

Contraception in Ancient Times

People have always tried to invent ways to control fertility. The ancient Greeks used magic, superstition, herbs, and drugs to try and control their fertility, and the Egyptians tried fumigating the female genitalia with certain mixtures; inserting a tampon into the vagina that had been soaked in herbal liquid and honey; and inserting a mixture of croc­odile feces, sour milk, and honey (Dunham et al., 1992). Another strategy was to insert objects into the vagina that could entrap or block the sperm. Such objects include veg­etable seed pods (South Africa), a cervical plug of grass (Africa), sponges soaked with

Figure 13.1 The percentage of women who experience an unintended preg­nancy using each birth control method during first year of typical use. Source: Hatcher et al., 2004.
80
70
C <D 60 о
32%
20
16% 6% 15%
10
0
%
V %

alcohol (Persia), and empty pomegranate halves (Greece). These methods may sound far-fetched to us today, but they worked on many of the same principles as modern meth­ods. In the accompanying Human Sexuality in a Diverse World, “Herbal Lore and Contraception,” we discuss some of these methods.

Contraception in the United States: 1800s and Early 1900s

In the early 1800s, several groups in the United States wanted to control fertility in order to reduce poverty. However, contraception was considered a private affair, to be discussed only between partners in a relationship. As we learned in Chapter 1, Anthony Comstock worked with Congress in 1873 to pass the Comstock Laws, which prohibited the distribu­tion of all obscene material; this included contraceptive information and devices. Even medical doctors were not allowed to provide information about contraception (although a few still did). Margaret Sanger, the founder of Planned Parenthood, was one of the first people to publicly advocate the importance of contraception in the United States.

Contraception Outside the United States

Contraception throughout the world has always been affected by social and economic is­sues, knowledge levels, religion, and gender roles. For example, the high value placed on large family size in India has led to low rates of contraceptive usage (Nath & Nayar, 2004). This is in contrast to high contraceptive use in Hong Kong, where family planning groups urge couples to have only one or two children (Ng & Ma, 2004). Contraceptive misinfor-

mation and myths can also decrease contraceptive use. For ex­ample, in South Africa many believe that contraception is un­necessary if a person is engaging in sex infrequently (Nicholas, Daniels, & Hurwitz, 2004).

Contraceptive knowledge levels are also very important when it comes to contraceptive use. It is estimated that over 90% of teenage women in many countries in Asia, North Africa, Latin America, and the Caribbean report knowing about contraception, whereas women in sub-Saharan Africa have very low contraceptive knowledge levels (Blanc & Way, 1998).

Religion is another important factor when it comes to contraceptive use. Many predominantly Catholic regions and countries, such as Latin America, Ireland, France, and Poland, have limited contraceptive devices available. Many residents of these countries often do not agree with Church contraceptive teachings, however. One study in Brazil, which contains one of the highest concentrations of Catholics, found that 88% of participants did not follow the Church’s contraceptive teachings (de Freitas, 2004). Countries that do have strong religious affiliations often promote the use of nat­ural methods of contraception, such as withdrawal or natural family planning (Leyson, 2004).

Gender roles and power differentials also contribute to contraceptive use. Outside the United States, many women are often not involved in contraception decision making, and contraceptive use is thought to reduce a man’s masculinity. For example, in Israel, Jewish religious law teaches that men should not “spill their seed” and therefore opposes contraceptive methods that may damage sperm, such as vasectomy, with­drawal, condoms, or spermicides (Shtarkshall & Zemach,

2004) . Methods that do not harm sperm, such as oral contra­ceptives, IUDs, and even diaphragms are acceptable.

*This timeline does not include the oral contraceptive pills that followed the first pill that was available. A variety of different pills have been introduced with major im­provements including lower hormone levels.

**IUDs introduced after the Dalkon Shield are not included in this timeline.

Human Sexuality in a Diverse World