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For other uses, see Birth control (disambiguation).

A family planning centre in Kuala Terengganu,Malaysia.

Birth control is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of pregnancy or childbirth.[citation needed] There are three main routes to preventing or ending pregnancy; the prevention of fertilization of theovum by sperm cells (“contraception“), the prevention of implantation of the blastocyst (“contragestion“), and the chemical or surgical induction of abortion of the developing embryo or, later, fetus. In common usage, term “contraception” is often used for both contraception and contragestion.

Birth control is commonly used as part of family planning.

The history of birth control began with the discovery of the connection between coitus and pregnancy. The oldest forms of birth control included coitus interruptuspessaries, and the ingestion of herbs that were believed to be contraceptive or abortifacient. The earliest record of birth control use is an ancient Egyptian set of instructions on creating a contraceptive pessary.

Different methods of birth control have varying characteristicsCondoms, for example, are the only methods that provide significant protection from sexually transmitted diseases. Cultural and religious attitudes on birth control vary significantly.

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“And the villain still pursues her.” Satirical Victorian era postcard.

Probably the oldest methods of contraception (aside from avoiding vaginal intercourse) are coitus interruptus, lactational, certain barrier methods, and herbal methods (emmenagogues and abortifacients).

In Germany, during the reign of Hitler, and before World War II, in 1935, birth control information was readily available to outcast groups including Jews, Gypsies, Slavs, and mentally or physically disabled people. When it came to women that were classified as Aryan, they were forbidden to receive information after the Nuremberg Laws were implemented. In Russia to faciliate social equality between men and women, Russia made birth control readily available. Aleksandra Kollontai (1872-1952), was the commissar for public welfare during this time, promoted birth control education for adults as well. When it came to birth control in France, women were working for reproductive rights and they helped end the nation’s ban on birth control in 1965. Finally in 1970, in Catholic Italy, feminists won the right to gain access to birth control information.[1]

Much earlier than this, satirical English author Daniel Defoe wrote Conjugal Lewdness. The full original title of this 1727 essay was “Conjugal Lewdness or, Matrimonial Whoredom”, though he was later asked to rename it for the sake of propriety. The modified title became “A Treatise Concerning the Use and Abuse of the Marriage Bed”. The essay dealt primarily with contraception, comparing it directly with infanticide. Defoe accomplished this through anecdotes, such as a conversation between two women in which the right-minded chides the other for asking for “recipes” that might prevent pregnancy. In the essay, he further referred to contraception as “the diabolical practice of attempting to prevent childbearing by physical preparations.”

Coitus interruptus (withdrawal of the penis from the vagina prior to ejaculation) probably predates any other form of birth control. This is not a particularly reliable method of contraception, as few men have the self-control to correctly practice the method at every single act of sexual intercourse.[2] Although it is commonly believed that pre-ejaculate fluid can cause pregnancy, modern research has shown that pre-ejaculate fluid does not contain viable sperm.[3][4]

There are historic records of Egyptian women using a pessary (a vaginal suppository) made of various acidic substances and lubricated with honey or oil, which may have been somewhat effective at killing sperm.[5] However, it is important to note that the sperm cell was not discovered until Anton van Leeuwenhoek invented the microscope in the late 17th century, so barrier methods employed prior to that time could not know of the details of conception. Asian women may have used oiled paper as a cervical cap, and Europeans may have used beeswax for this purpose. The condom appeared sometime in the 17th century, initially made of a length of animal intestine. It was not particularly popular, nor as effective as modern latex condoms, but was employed both as a means of contraception and in the hopes of avoiding syphilis, which was greatly feared and devastating prior to the discovery of antibiotic drugs.

Various abortifacients have been used throughout human history in attempts to terminate undesired pregnancy. Some of them were effective, some were not; those that were most effective also had major side effects. One abortifacient reported to have low levels of side effects—silphium—was harvested to extinction around the 1st century.[6] The ingestion of certain poisonsby the female can disrupt the reproductive system; women have drunk solutions containing mercuryarsenic, or other toxic substances for this purpose. The Greek gynaecologist Soranusin the 2nd century suggested that women drink water that blacksmiths had used to cool metal. The herbs tansy and pennyroyal are well-known in folklore as abortive agents, but these also “work” by poisoning the woman. Levels of the active chemicals in these herbs that will induce a miscarriage are high enough to perilously damage the liverkidneys, and other organs. However, in those times where risk of maternal death from postpartum complications was high, the risks and side effects of toxic medicines may have seemed less onerous. Someherbalists claim that black cohosh tea will also be effective in certain cases as an abortifacient.[7]

Aside from abortifacients, herbal contraceptives in folklore have also included a few preventative measures. Hibiscus rosa-sinensis, known in Ayurveda as a contraceptive, may have antiestrogenic properties.[8] Papaya seeds, rumored to be a male contraceptive, have recently been studied for their azoospermic effect on monkeys.[9]

During the medieval periodphysicians in the Islamic world listed many birth control substances in their medical encyclopedias. Avicenna listing 20 in The Canon of Medicine (1025) andMuhammad ibn Zakariya ar-Razi listing 176 in his Hawi (10th century). This was unparalleled in European medicine until the 19th century.[10]

The fact that various effective methods of birth control were known in the ancient world sharply contrasts with a seeming ignorance of these methods in wide segments of the population of early modern Christian Europe. This ignorance continued far into the 20th century, and was paralleled by eminently high birth rates in European countries during the 18th and 19th centuries.[11] Some historians have attributed this to a series of coercive measures enacted by the emerging modern state, in an effort to repopulate Europe after the population catastrophe of the Black Death, starting in 1348. According to this view, the witch hunts were the first measure the modern state took in an attempt to eliminate knowledge about birth control within the population, and monopolize it in the hands of state-employed male medical specialists (gynecologists). Prior to the witch hunts, male specialists were unheard of, because birth control was naturally a female domain.[12]

Presenters at a family planning conference told a tale of Arab traders inserting small stones into the uteruses of their camels in order to prevent pregnancy, a concept very similar to the modern IUD. Although the story has been repeated as truth, it has no basis in history and was meant only for entertainment purposes.[13] The first interuterine devices (which occupied both the vagina and the uterus) were first marketed around 1900. The first modern intrauterine device (contained entirely in the uterus) was described in a German publication in 1909. TheGräfenberg ring, the first IUD that was used by a significant number of women, was introduced in 1928.[14]

The rhythm method (with a rather high method failure rate of ten percent per year)[citation needed] was developed in the early 20th century, as researchers discovered that a woman only ovulates once per menstrual cycle. Not until the 1950s, when scientists better understood the functioning of the menstrual cycle and the hormones that controlled it, were methods ofhormonal contraception and modern methods of fertility awareness (also called natural family planning) developed.

Margaret Sanger was an American birth control activist and the founder of the American Birth Control League (which eventually became Planned Parenthood). She was instrumental in opening the way to access birth control.

In 1960 the FDA approved the first form of hormonal birth control, the combined oral contraceptive pill.

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