birth control
Black women in double jeopardy: a perspective on birth control.

Gould KH.

PIP: The thesis that attitudes relating family planning to racism and genocide have historical roots in the birth control and the women's movements and that black women were the targets of racist and anti working class attitudes prevalent among the conservative forces in both movements is explored. The issue of genocide is limited to black women only, because the historical material on the genocide question and the findings of current studies on minorities are generally based on data collected from the black population. The 1st stage of the birth control movement failed to address any issues that were pertinent to black women. Early in the 20th century, with the advent of the 2nd stage of the birth control movement, a public controversy demonstrated the racist and anti working class attitudes that were dominant among feminists and advocates of birth control. The issue in question was "race suicide." Many viewpoints were advocated by those using this slogan, but the most pertinent was the fear that individuals of Yankeee stock, who had lower birth rates than other groups, would be numerically overwhelmed as a result of the fertility of immigrants, nonwhites, and the poor. The leaders of the birth control and women's movements failed to examine the facts that might have convinced them of the irrationality of their position. Overall, the beginning of this century saw birth control, a valuable tool, become a weapon with which to attack the poor and those who were nonwhite. In the 1920s the professionalization of the birth control movement finally crystallized the conservative trend, as women lost their leadership positions in the movement to men. This began the movement's 3rd stage. It set the pattern of physician-dominated clinic programs that still constitute the model for the delivery of birth control services. The stage was set for accusations concerning black genocide when the federal government's entry into the field of subsidized family planning services was tied to the coercive features of the 1967 amendments to the Social Security Act. Little empirical data exist on which segments of the black community agree with the genocide indictment. Steps social workers need to take in developing an appropriate response to clients' concerns are identified.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6724429&dopt=Abstract birth control



birth control
Ignorance of family planning methods in India: an important constraint on use.

Basu AM.

Interviews wih women in six villages in India and with educated, working women selected to be trained as interviewers in five states, and evidence from formal studies are discussed to support the conclusions that (1) the low overall rates of contraceptive use in India are at least partly due to low levels of knowledge about different methods of birth control, especially of the modern reversible methods; and (2) the low use of all methods except sterilization is a good proxy for lack of knowledge about these methods. It is suggested that, both in the interests of achieving demographic targets and in the interests of the clientele of the family planning program, much greater emphasis must be placed on spreading practical information about reversible contraception. The information dissemination activities of the program so far have tended to concentrate on the why of family planning and neglect the how, except in promoting sterilization.

PIP: Interviews with women in 6 villages in India and with educated, working women selected to be trained as interviewers and evidence from formal studies are discussed. Poor knowledge of family planning favors high fertility in India. The awareness and ever use of different birth control methods among married women, aged 15-49, are given. There is much ignorance and misinformation as shown by data on awareness of contraceptives in 1970 awareness of family planning methods among general responders and local leaders is also poor. Why is knowledge so low? Some reasons are socioeconomic development factors. Women reporting knowledge of various methods of contraception, by urban-rural residence and for urban sample, education and type of housing is given, as is of respondents who had heard of various contraceptive methods in Uttar Pradesh and Narangwal. Sterilization is fairly well accepted, however more knowledge is needed on reversible methods. The program needs to increase its level of IEC activities, and change the content of these activities by shifting the emphasis from why birth control is essential (most couples are now aware of the officially propagated advantages of small families) to how a small family can be achieved by methods less drastic than an operation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6740730&dopt=Abstract birth control



birth control
Chronic schizophrenic women's attitudes toward sex, pregnancy, birth control, and childrearing.

McEvoy JP, Hatcher A, Appelbaum PS, Abernethy V.

Interviews with 23 chronically institutionalized, schizophrenic women living on a chronic care unit indicated that the majority had a continuing interest in sex and engaged in sexual activity. Fourteen of the women wanted to become pregnant. Few seemed to recognize their limited potential to be adequate parents. Respondents often gave bizarre or inaccurate responses to the interview questions, indicating that their ideas about contraception, pregnancy, and childrearing were affected by psychopathology. The authors concede that the task of designing and implementing birth control programs for severely ill schizophrenic patients is formidable but encourage mental health professionals to openly discuss sex, birth control, and having children with their patients.

PIP: Interviews with 23 chronically institutionalized, schizophrenic women living on a chronic care unit and ranging in age from 20-58 years were interviewed to provide initial systematic data about the attitudes of chronic schizophrenic women toward sex, pregnancy, birth control, and childrearing. All of the subjects, patients at the Middle Tennessee Mental Health Institute, had been receiving neuroleptic medications for at least 3 months before they were interviewed. All had some outside grounds privileges allowing them to have unsupervised contact with male patients. Subjects had been continuously hospitalized for a minimum of 3 months. 2 of the women were married. 12 of the 23 women had borne children. The number of children ranged up to 9. At the time of the interview, 2 women were not using contraceptives, 9 were taking oral contraceptives (OCs), 1 had an IUD, and 2 had had tubal ligations. 1 women had had a hysterectomy, and 8 had already gone through menopause. Each patient was interviewed by the ward charge nurse (AH) who had become well acquainted with the patients during many months and even years of care. 13 of the 23 women reported they would like to have an active sex life. After describing the kind of man they would find attractive, 16 of the women reported they would not hesitate to have sex with such a man if the opportunity were available. 15 reported having had intercourse during the previous 3 months. The frequency of intercourse ranged from once during the entire 3 months to once a day during that period. The nursing staff who constantly worked with these women judged that 14 probably had been sexually active during the 3 months before the interview. 6 of the women reported they would currently like to become pregnant. 8 said they would like to become pregnant in the future. 9 reported no desire to become pregnant. 8 said they would currently like to have children or more children; 6 said they would not like to have more children now but would like to do so in the future. The 3 women who had been surgically sterilized all said they wanted to become pregnant and have more children. Despite the majority's accurate description of birth control, when the women were questioned about its advantages, only 10 understood that women could use birth control to avoid pregnancy. Psychopathology, manifested in unusual responses and inaccurate answers, often disrupted the reasoning of these patients and could potentially lead to illogical conclusions and imprudent activities.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6862399&dopt=Abstract birth control



birth control
Natural family planning: a birth control alternative.

Matis N.

PIP: There is currently a great need for a safe and reliable method of birth control in view of the medical hazards associated with the use of artificial contraceptives. The early natural methods of breastfeeding, calendar rhythm, and temperature have been superseded by 2 modern and highly effective methods: the ovulation method and the symptothermal method, which may be used to both achieve and avoid pregnancy. The ovulation method is based on a woman's observation of the behavior of her cervical mucus, which changes in character throughout the menstrual cycle. In addition to mucus observation, the symptothermal method includes temperature taking and cervical palpation. The results of several studies have found the natural methods to be comparable in effectiveness to contraceptive pills and the intrauterine device, although proper teaching and motivation of couples is required for their successful application. The periods of abstinence involved appear to engender improvements in the marriage. Knowledge of these methods is invaluable to midwifery. Various types of birth control methods including: combination estrogen/progestin pill; progestin only pill; intrauterine device; diaphragm (with cream, foam, or jelly); foam alone; cream or jelly alone; condom; female sterilization; male sterilization; calendar rhythm; basal body temperature; mucus; basal body temperature or mucus: postovulatory phase alone are compared for effectiveness (pregnancies per 100 woman years), and side effects/complications. author's modified

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6551435&dopt=Abstract birth control



birth control
The antecedents and prevention of unwanted pregnancy.

Gerrard M, McCann L, Geis BD.

PIP: Much of the research on the antecedents and consequences of birth control has focused on teenagers and members of racial minority groups, but the trends in contraceptive use indicate that the danger of unwanted pregnancy exists for most women throughout the childbearing ages of 14-45, for white and middle class women as well as minority women and women from the lower socioeconomic status levels. There are basically 4 choices open to the unmarried woman who conceives: giving the child up for adoption, keeping the child without marrying, and marriage. There are little data on the mental health consequences of giving a child up for adoption, but there is no question that the experience at the very least upsetting and may cause longterm trauma. Induced abortion is less traumatic, both physically and psychologically, than carrying a pregnancy to term, however, many women suffer from longterm depression following the procedure. The social, economic, and psychological consequences of single motherhood are clearly documented for both teenagers and older women. The most frequently cited problems are delayed or truncated emotional and social activities, unemployment, and role overload resulting from the responsibility of caring for a child without the support of a spouse. The pregnant teenager who does marry has a 50% probability of divorce within 4 years, and even if the couple does stay married they suffer some adverse consequences. In 1978 Zelnick and Kantner estimated that it would be possible to reduce the number of premarital pregnancies and presumably their psychological and economic consequences by at least 40% if all sexually active young women were to use a contraceptive method and to use it consistently. If the majority of all sexually active women were to use the most reliable methods of contraception, the unwanted pregnancy rate would be reduced even more markedly. Yet, reliable contraceptive behavior involves a complex sequence of psychological and behavioral events including awareness of the risk of becoming pregnant, obtaining adequate information about contraception, making decisions about contraceptive use, acquiring contraception, and regular and consistent use of a reliable contraceptive method. The literature on the psychological antecedents of contraceptive behavior clearly characterize ineffective female contraceptors as being unaccepting of their own sexuality and having negative attitudes toward most matters pertaining to sex. Their attitudes and emotions include irrational fears about specific contraceptives, conflicting attitude and belief systems about birth control in general, and guilt. Implicit in this profile is an inability to think rationally about the high probability that unprotected sex will result in conception and an inability to engage in rational decision making about birth control. Yet, review of the prevention programs currently available reveals that the vast majority are designed to serve the self-motivated women. Given that these programs already have been demonstrated to be effective, it is time to direct attention to exploring ways to reach those women who will not adequate precautions without first experiencing changes in their attitudinal and emotional responses to sex.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6569048&dopt=Abstract birth control



birth control
Adolescents' communication styles for learning about birth control from mass media.

De Pietro R, Clark N.

This article is an exploratory study to identify discrete factors which predict the way in which adolescents are likely to communicate about birth control after receiving information from a mass medium is described. First, we discuss styles of interacting with others regarding information from mass media which have been described in previous research. Five styles are identified: media-oriented, peer-oriented, home-oriented, professionally-oriented, and multi-source oriented. Next, we discuss categories of factors which theoretically should distinguish among the five communication styles. These factors are drawn from theories and previous research in communication and social learning. Using data collected from a random sample of 100 adolescents, we then test the predictive ability of categories of factors. Discriminant analysis is used to determine which factors within categories are most predictive of style and which best discriminate between styles. Eight factors are identified which predict 75% of all communication styles. The factors are sex, race, giving advice about sex, seeking information about birth control, dating rules regarding where one can go, dating rules regarding behavior on dates, feelings of pride, and feelings of popularity. Finally, we discuss the significance for practitioners of study findings and of predicting adolescents' communication styles.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6671899&dopt=Abstract birth control



birth control
Unwanted pregnancies amongst teenagers.

Francome C.

PIP: This article discusses the conflicting positions on the effectiveness of sex education and availability of birth control facilities in lowering the rate of teenage pregnancies. It provides evidence of a drop in the rate of teenage births, only 1/3 of which can be accounted for by the rise in abortions. It concludes that teenagers must have been using birth control more effectively than in the early 1970s. The evidence from Britain does not support the concern expressed in some quarters that birth control education for teenagers leads to more pregnancies. Evidence from Australia seems to point in a similar direction. Age specific birth rates for women in Great Britain during the years 1971-80 show that the number of live births for teenagers aged 15-19 years has declined from 51/thousand in 1971 to only 31/thousand in 1980. For the 16-19 year age group there has been an absolute decrease of over 20/thousand births and 2 births for every abortion. In the under 16 age group there has been no absolute fall in the number of births and for every birth there are more than 2 abortions. author's modified

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6841377&dopt=Abstract birth control