birth control
Family Planning and the religious issue.

Kats G.

PIP: The question of whether family planning is compatible with Islam is not a new issue. An eminent 11th century teacher declared that the earliest followers of the prophet practiced contraception with the knowledge of the prophet, who did not forbid it. The issue has always been controversial, but the usual attitude has been 1 of tolerance. The question has become more pressing in the past few decades with the increased urgency of controlling population growth. The success or failure of the birth control program will depend partly on the active support of the Islamic leadership. A 1982 survey showed that 19.5% of Egyptian men and women believed that family planning was somewhat or completely against their religious beliefs, and another 10.1% said they did not know. 38% of these people answered affirmatively to a question on whether anything in the religious books forbids birth control. In the mid-1930s, Egypt's Grand Mufti, the country's most authoritative interpretor of Islamic law, issued a religious decree permitting contraception, thus allowing establishment of birth control clinics in Egyptian citites. In 1964, Sheikh Hasan Ma'mun encouraged the use of contraception based on the changing needs of the Muslim people. Since 1980, religious leaders have played a major role in public education efforts of the State Information Service (SIS) by speaking out on the acceptability of birth control in the eyes of Islam. However, about 45,000 of Egypt's approximately 50,000 mosques are private and almost entirely immune from government control, and they have traditionally been a haven for critics of the Egyptian government. As the government has become more committed to family planning, their opposition has increased. The argument of some Sheikhs that birth control is a Western effort designed to weaken Egypt is countered by the SIS which points to the use of contraception in other countries: 87% in Belgium, 78% in England, 70% in the US, 6% in Bangladesh, and 2% in Nepal.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12339620&dopt=Abstract birth control



birth control
A model of fertility control in a Puerto Rican community.

Schensul SL, Borrero M, Barrera V, Backstrand J, Guarnaccia P.

PIP: This article examines the fertility control decision making of Puerto Rican women in Hartford, Connecticut a city that has a high sterilization rate among Puerto Rican heads or co-heads of households. Decisions regarding fertility are conceptualized as a result of a complex interaction among individual needs of women, factors influencing the family, the impact of religious institutions, accessibility of medical services, and socioeconomic resources of the household and the local community. A survey of 153 female household heads in Hartford conducted in 1978-79 by the Hispanic Health Council found that 79 (51.6%) had been sterilized. Further analysis was aimed at identifying the factors linked to sterilization in a subsample of the original respondents that included 3 categories: those using no birth control, those using the IUD or oral contraception, and those sterilized. The results indicate that Puerto Rican women begin their sexual activity with limited use of birth control, accept reversible methods primarily after the 2nd and 3rd births, become sterilized in significant numbers after their 3rd child, and have generally attaned sterilization after 5 births. Sterilization is the fertility control method most frequently selected at the point where women feel they have reached their desired family size. Since optimal family size is achieved quickly, many Puerto Rican women seek sterilization in their 20s. This widespread acceptance of sterilization in part reflects the effects of recent sterilization campaigns in Puerto Rico. It further reflects health care providers' expectation that Puerto Rican women will not be successful in their use of reversible methods. The major difference between higher and lower socioeconomic groups centers around the point in family size at which sterilization takes place, with women of higher socioeconomic status terminating childbearing after fewer births. It is concluded that interventions should aim to increase use of reversible methods of birth control, both for birth spacing and family size limitation, among Puerto Rican women of higher socioeconomic status and that a comprehensive approach, involving both socioeconomic factors and fertility control, should be directed toward those of lower socioeconomic status.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12339704&dopt=Abstract birth control



birth control
Motivations for childbearing and fertility behavior among urban and rural families of Iran.

Hekmat F, Kabacoff RI, Klein HE.

PIP: A sample of 384 husbands and wives were randomly selected and interviewed to investigate the implication of fertility norms and motivations for childbearing on fertility and family planning behavior among Iranian families in urban and rural areas of Iran, after the Islamic Revolution of 1979. The term "fertility behavior" refers to actual family size, which is defined as number of children the respondent has living at the time of the interview. "Family planning behavior" refers to the duration of time that the subject has used any birth control method(s). Rural families demonstrated larger actual and ideal family sizes than urban families. The rural sample had a median actual family size of 3.5 children and a median ideal family size of 4.7 children. For the urban sample these figures were 2.2 and 2.3, respectively. The median number of years married was 12.33 for rural and 13.91 for urban respondents. Urban respondents tended to emphasize the psychological and emotional benefits and liabilities associated with having children while rural respondents tended to emphasize both economic and security related motivations. Both groups endorsed infant mortality as a motivation for having more children. Male and female respondents were remarkably similar in their endorsed motivations. There was a significant positive correlation between desired and ideal family size. The correlations among ideal/desired family size and practicing birth control methods were the same and significant at the .001 level. The relationship between motivations for childbearing and years of practicing birth control methods was also significant at the .001 level. Stepwise regression analyses were performed to examine the important predictors of fertility and family planning behavior. For both actual family size and years on birth control, males and females were very similar in terms of predictor importance. Those respondents with less education and large ideal family size tended to have larger actual family size. Location (urban/rural) and parents, family size was weighted much more heavily for males than for females. Those respondents with greater education and who lived in an urban areas tended to have used birth control for longer periods of time. Ideal family size did not contribute significantly to this regression. Parents' family size and motivations for childbearing made marginal contributions to regressions on either dependent variable.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12339754&dopt=Abstract birth control



birth control
Male adolescent birth control behavior: the importance of developmental factors and sex differences.

Cohen DD, Rose RD.

PIP: A survey of sex and birth control behavior of 51 male adolescents aged 15-17 was conducted utilizing a structured interview protocol. The sample was drawn from 3 community agencies. The respondents resided in a major northeastern metropolitan part of Pennsylvania. The purpose of the study was to describe male adolescent birth control behavior incorporating developmental issues, and to interpret the findings in light of what is known about female birth control behavior. Based on research with teenage females, 3 social influences were examined for their possible impact on male birth control behavior. An interview schedule was undertaken to form the basis of the demographic items, the description of the social network, history of sex and birth control behavior, pregnancy history and communication about sex and birth control. A questionnaire, designed to measure the influence of significant others on females' birth control behavior, formed the basis of the items concerning the expectations of others about contraceptive behavior. Thirdly, questions on perceived power relations with girlfriends were used to determin the influence of teenage females' self-perceptions of power in dyadic relationships on their own contraceptive usage. A new operational definition of male effective birth control usage involving the effectiveness of the method and the consistency of its usage was developed. Findings similar to those obtained in the research on females suggest that adolescent sexual partners may be the only direct social influence on adolescents' birth control usage. Results indicating differences from research with females suggest that in general: male birth control behavior is primarily self-oriented, males are more likely to be effective contraceptors with casual partners than with girlfriends, males are more likely to communicate about sex and birth control with similar age peers than with family members and/or other adults, and that teen males view sex and birth control decisions as female decisions. Only 35.3% of the males showed a full understanding of how pregnancy occurs. For coitally active subjects, the more the topic of communication was specifically sexual in content, the more likely it was for the subject to speak to similar-aged people and friends than to adults.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12339898&dopt=Abstract birth control



birth control
Marketing of birth control in LDCs: with special references to India.

Dholakia RR, Kindra GS, Pangotra P.

The authors outline a marketing approach for family planning programs in developing countries, with references to experiences in India. Following an overview of types of population programs, suggestions for strengthening program efforts are offered, and a framework for marketing birth control is described. "This approach was based on the recognition that acceptance of a small family norm is interwoven with the freedom to make that choice....This framework suggests that marketing plans should be aimed at the three-dimensional goal of increasing the population's desire, ability, and capability toward acceptance of the small family norm and the practice of birth control [and] that in consideration of the wide geographical variations in population growth, per capita income, and the level of development in general, programs should be designed in a segmented manner to suit the socio-economic nature of each group." excerpt

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12340764&dopt=Abstract birth control



birth control
The future of male birth control.

Goldstein M.

PIP: Current forms of non-surgical birth control for men are neither effective nor convenient, despite the demand for non-permanent male birth control. After drugs like thalidomide came onto the European market too quickly, the US Food and Drug Administration has been slow to approve new methods. Although a male pill is a distant reality, research into hormonal supression of sperm production, maturation, and transport continues. With an understanding of how the testes/pituitary/hypothalmus network functions, supression of spermatogenesis should be possible in several ways. Androgens could ideally suppress some hormone production by the pituitary, diminishing testosterone production in the testes, and causing spermatogenesis to cease. But androgens must be injected, do not always produce a complete absence of sperm, and can cause side effects, e.g. heart disease; kidney damage. Another hormone treatment can cause libido loss. A new approach in the 1st research stages lowers follicle stimulating hormone production and can theroretically slow or stop spermatogenesis. Gossypol and certain other spermatogenesis suppressants have undesireable side effects and toxicity. Substances that interfere with sperm maturation in the epididymis have associated risks of toxicity and gonadal damage, as indicated by animal experiments. Vas valves, developed in the 1970s, have not been as promising as 1st believed. Switching them on and off is a problem; surgical implant sites are subject to leakage and granulomas; and sperm buildup in the epididymis can cause infertility. Research continues on surgical vasectomy reversal. A Chinese development: injection of cyanoacrylate and phenol into the vas, holds promise. Freezing technics used in sperm banking do not adequately guarantee sperm viability.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12340896&dopt=Abstract birth control



birth control
[Applying information to improve family planning in Gaoping County]

[Article in Chinese]

Zhang Y.

PIP: The scientific management method of improving family planning through information has produced a low birth rate and natural increase rate in Gaoping County, China, since 1976. In order to promote good family planning, Gaoping County incorporated the scientific management method with the establishment of an information network that included information banks, files, and newspaper columns. The officials of Gaoping County focused their efforts on women most susceptible to unplanned childbirth, e.g., women uneducated in birth control and prenatal care. The women were divided into groups according to their educational needs, e.g., women who were hesitant toward birth control, women who used birth control, women who never reproduced, and women who were newly married. By educating these women to the aspects of planned childbirth, prenatal testing, prenatal care, and contraceptives, Gaoping County effectively promoted good family planning in the areas of birth control and family health. The following statistics are the results of incorporating the scientific management system in family planning of Gaoping County. In 1983, the birth rate in Gaoping County was 11.3%, a 2.8% decline from 1982; the mortality rate decreased 0.2% to a rate of 7.6%; and the natural increase rate decreased 2.6% to a rate of 3.7%. The planned birth rate in 1983 was 90.1% and the rate of 1 child per couple was 91%. This was an increase from the 1982 rates of 21.3% and 25.2%, respectively. From January 1984 to June 1984 the planned birth rate reached 97.2%. These statistics are evidence of the positive results in using information in family planning.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12341115&dopt=Abstract birth control