birth control
Men and family planning--a global view.

[No authors listed]

PIP: New research suggests that men have more interest in contraception and willingness to practice it than assumed. Recent experience also may indicate that family planning programs aimed at men can increase condom use and reliance on vasectomy. Recent studies in the U.S. indicate that the majority of men favor birth control and believe that men and women should share the responsibility for using it. A survey of Mexican men found that they believe in limiting family size. Preliminary results from studies in 5 Third World countries indicate that men have a greater interest in family planning than expected. Social and cultural constraints may explain the difference between attitudes and practice. Male contraceptives are still widely used; approximately 1/3 of the world's acceptors use male methods. Approximately 37 million men rely on condoms, 35 million have had vasectomies, and millions depend on withdrawal. Most people who rely on male contraceptives live in industrial countries. In France and Italy, withdrawal is the second most popular method of birth control; in Japan, 79% of the married couples use condoms; in the U.S., 10% rely on vasectomies. The number of couples using male contraception is likely to increase in the years ahead. 30% of U.S. men in the postwar baby boom are expected to have vasectomies. Male sterilizations are becoming more popular in Great Britain, China, and India. Clinical tests on hormonal contraceptives for men have begun and could be available within the next 2 decades. Few organized birth control programs are reaching men. However in Danfa, men are more conscientious birth control users and better family planning advocates than women and their acceptance rate has resulted in substantial fertility reductions. More social and monetary support should be allocated to encourage a responsible role in family planning among men. New male responsibility is already paying off in births averted, as documented in India and the Philippines and in the reduction of the spread of venereal disease in the U.S.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12338296&dopt=Abstract birth control



birth control
Family planning as preventive medicine.

[No authors listed]

PIP: A new compaign for offering and providing family planning services through the National Health Service in England is discussed. The campaign attempts to have contraception regarded as preventive medicines. The Abortion Act provided abortion reform, which has resulted in women receiving free abortions, but women in the lying-in wards who ask for contraception must pay for it. The Family Planning Association (FPA) is abandoning its domiciliary family planning approach because it is too expensive and difficult to deal with. This is the approach that the Minister of Health is encouraging, but he is discouraging giving birth control advice at maternity hospitals and welfare clinics. The FPA will never reach the working class properly for it relies on clients who can refer themselves to the clinic and who are prepared to pay an initial fee for advice and services plus the cost of their own supplies. A birth control campaign has been launched to try to bring about more effective family planning services. It is held that this birth control legislation should have been enacted before abortion reform.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12276405&dopt=Abstract birth control



birth control
The ideology and politics of birth control in inter-war England.

Lewis J.

PIP: Focus in this discussion is on the ideology and politics of birth control in inter-war England. Birth control ideology experienced considerable change in the immediate post World War 1 years. The working class birthrate began to significantly decline during this same period. The primary objective of birth controllers was to legitimize this trend by making birth control information freely available. World War 1 made discussion of birth control easier and physicians came to accept the use of the condom, primarily because of its use as a prophylactic in the fight against venereal disease. The war did not make the Malthusian League's case for birth control any more acceptable nor did it remove moral objections to birth control. Birth control needed a new approach, and this was provided by Marie Stopes. Stopes divorced herself totally from the League and worked to provide a strong scientific justification for birth control, rather than an economic one. She was also determined to come to terms with eugenic opposition to birth control. The scientific nature of her efforts had ideological purpose, and the Society of Constructive Birth Control and Racial Progress that she founded in 1921 reflected this. When other groups and individuals began to campaign for birth control in the mid and late 1920s, they all built their arguments on those of Stopes. During the decade of the 1920s the government refused to permit any access to birth control information through the public health service. In 1930 it decided to permit such information to be given to nursing and expectant mothers at maternal and child welfare clinics when further pregnancy was deemed to be detrimental to health. The 1930 decision was a critical first step and meant that birth control had achieved a degree of respectability. An attempt is made in the subsequent discussion to determine why and which parts of the argument formulated by Stopes appealed so widely to physicians, policymakers, and pressure groups and to examine why the official response was so limited and the implications this had for the relationship of women to welfare policy. When the government took the first steps toward granting access to birth control information, it did so on health grounds. No further liberalization of the law occurred and the argument that all women had the right of access to birth control information in order to space and limit the number of births was ignored. The population scare outweighted the case for birth control as a maternal and a racial measure by the mid 1930s.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12338472&dopt=Abstract birth control



birth control
Proxies for birth control. Comment on Kelly and Cutright, Sociological Focus, April 1983.

Sloan DG.

PIP: Kelly and Cutright (1983), using regression techniques, conclude that birth control is among the more important determinants of Swedish illegitimacy. To derive this conclusion, they use changes in the marital fertility of wives aged 35-39 as a proxy for birth control. They maintain that annual change in the marital fertility rate of wives aged 35-39 is not likely to be greatly influenced by annual change in factors other than birth control. The "argument" appears to derive from the "desired family size" model of childbearing--a basic assumption of social demography. In it simplest form it states that most couples do not practice birth control until they reach a preconceived goal, or desired family size. It thus implies that a change in family size preferences will most affect the birth control practices of the oldest reproductive age groups. The simple form of the model has been questioned by the failure of Western couples to reproductively compensate for a major proportion of their child deaths, by the proportions of Western couples who say they would have preferred larger families than they actually had, by the predictive inadequacy of family size preferences, and by suggestions that age may be the more important determinant of reproduction. As a result some demographers now concede its inadequacy. Others are trying to relax its assumptions, with as yet problematic success. Essentially every Western fertility decline to date has been characterized by an increasing concentration of childbearing in the youngest age groups. In discussing this pattern social demographers have maintained that it could only have come about by a decline in family size preferences. This then is the standard argument supporting Kelly and Cutright's proxy for birth control. The authorities who offer it generally ignore the difficulties with the desired family size model and simply assert without justification that couples do in fact conform to it. Data on the age patterns of chronic disease and on the reproductive effects of environmental stressors suggest that the modern age pattern of fertility could also be produced by a deteriorating environment. Kelly and Cutright are incorrect in asserting that factors other than voluntary birth control could not be responsible for changes in fertility at ages 35-39. At best they may argue that their proxy is uniquely definitive provided that the desired family size model can be saved and provided the health of Western populations has not been compromised by technological change. At issue is a debate between what Dunlap calls the human exemptionalist and the ecological world views.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12339404&dopt=Abstract birth control



birth control
Reply to Sloan [on proxies for birth control]

Kelly WR, Cutright P.

PIP: Sloan (1984) argues that annual changes in marital fertility of Swedish wives aged 35-39 between 1911 and 1974 is not a result of annual changes in the use of birth control, but is due to changes in health conditions that increase or decrease marital fertility. As evidence of the lack of effect of contraceptive practice on fertility Sloan cites a study published in 1916 whose author concluded that contraceptive use or nonuse had no effect on family size. Sloan is unaware of the shroud of ignorance that blinded such research in the distant past. There was no accepted methodology to determine contraceptive effectiveness until the 1930s, and scientists did not know key elemental facts about human reproduction. For example, the relationship of ovulation to the risk of pregnancy was unknown in 1916, and was to remain a mystery for more than a decade thereafter. Sloan's "declining health" explanation of low fertility in the West is merely a variant of an older attempt to explain low fertility as a result of high protein intake. Sloan's view that modern couples do not contracept to reach a desired family size and that changes in family size preference will not affect birth control practice among older (or younger it appears as well) couples seems to us to be an idiosyncratic view at best and directly opposed by all survey research. Couples do contracept most effectively when they are trying to prevent an additional birth. The view that failure of some Western couples to reproductively compensate for their child deaths as explained by poor reproductive health seems to assume that couples in non-Western population do so compensate, but this is wrong. The idea that such bereaved couples should have another child is so insensitive to tragedy as to defy further reply. Sloan's acceptance and use of reports that some couples say they wanted more children than they had ignores massive research findings of unwanted fertility among couples in populations with long histories of birth control practice. Further, it is difficult to have much faith in such responses since about 1/2 the couples in the Whelpton el al. study cited by Sloan also said they were fecund. These responses mean that couples may say that they want more than they actually had, but they deliberately did not have such a large and "ideal" family size because of other factors not considered by Sloan. Since it appears that Sloan was unable to find another authority, he cites a 3 page comment of his own in support of the hypothesis of deteriorating environment. He does not actually empirically link age patterns of chronic disease with fecundity loss; his view also ignores research indicating improved health conditions, at least among US women, after the mid-1930s that increased fecundity and then fertility. Thus, his argument that factors other than voluntary birth control could explain annual change in Swedish marital fertility among older couples is unsupported by empirical evidence. His remarks are also irrelevant to the use made in the author's article concerning marital fertility rates as a proxy for the use of annual birth control change among younger unmarried women. The marital rate varies, as does the illegitimacy rate. Annual increases in marital fertility are related to annual increases in illegitimacy; annual declines in marital rates to annual declines in illegitimacy. Sloan's hypothetical trends in fecundity have no bearing on our empirical study of annual change in Swedish illegitimacy rates. Finally, Sloan's claim that social demographers do not view a changing environment as problematic is unsupported and unjustified. author's modified

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12339405&dopt=Abstract birth control



birth control
Adolescent contraceptive risk-taking behavior: a social psychological model of females' use of and compliance with birth control.

Durant RH, Sanders Jm Jr, Jay S, Levinson R.

PIP: Assuming that contraceptives are readily available and affordable to most adolescents, but that insufficient contraceptive use and high pregnancy rates stem from adolescent female risk-taking, a multivariate model of adolescent female contraceptive risk-taking behavior is described. Derived from behavioral science theory and empirical research, the model postulates direct and indirect associations between relevant variables. It also assumes behavior is comprised of deciding to initiate birth control, choosing a contraceptive method, complying with the method, and deciding to change methods or discontinue birth control. Premarital sexual standards and experiences, length of sexual relationship, religiosity and traditional values, and physical and sexual development are discussed as variables that directly affect the frequency of sexual intercourse. The frequency of sexual intercourse and perceived risk of pregnancy, and the perceived probability of pregnancy and outcome experiences of sexual activity are also examined. Variables that mediate the impact of coital frequency on contraceptive risk-taking include the cognitive assessment of pregnancy and contraception, support by significant others, personality development, and experience with contraceptives. Empirical tests of the model are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12317634&dopt=Abstract birth control



birth control
Population legislation: a preliminary study.

Zou P.

PIP: Legislation on birth and population control has received increased attention in China where a scientific approach is sought based on Marxist principles and the realities of the country. There are 6 categories of lawmaking: 1) a bill is drafted when conditions call for it, 2) the bill is passed in part when conditions are ripe, 3) the bill is adopted on a trial basis, 4) the State Council issues tentative rules and regulations, 5) administrative rules and local ordinances are issued, and 6) government policies take the place of missing laws and regulations. The Marriage Act of 1950 was tried based on the principle of ripe conditions, and it proved to be appropriate. Delegates to the National People's Congress and members of the Political Consultative Conference solicited the enactment of laws on birth control. Regarding the legislative process one opinion is to hold off until conditions are ripe, another view deems birth control too complex for lawmaking to enforce, and still another holds that the dynamics of demography makes frequent changes necessary with an effect on the stability of any law. This latter view ought to consider that the Chinese Constitution has been revised 4 times in the last 30 years without affecting its stability. Still another position is the recommendation of local rules and regulations before promulgating a national birth control act. The requirements of population legislation entail coordination between various population laws, norms, executive orders, regulations, and local rules. The provisions have to be consistent with agreement between form and content (bigamy is prohibited by the Marriage Law and punished under the penal code). Technical requirements mandate clear and precise language and avoidance of repetition of clauses.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12317648&dopt=Abstract birth control