Human Sexuality and Gender/Contraception and Abortion

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Condoms

Origins of the Condom

Condoms have been around for a lot longer than we think. From as early as 1000 BC, Egyptians used a linen cloth, Chinese used oil-soaked silk paper, and the Japanese even went so far as to use turtle shells and horn. The oldest condoms found were discovered in 1640 in Birmingham, England, made of fish and animal intestine. Condoms made of animal intestines were popular in England at that time, but were very expensive and often reused. The mass production of latex condoms began in 1844, but at the time were as thick as bicycle inner tubes and had a seam down the side. Manufacturing improved in the 1930s, making the single-use condom almost as thin and inexpensive as condoms found today.

Condoms

Some people believe that condoms have disadvantages even though they provide protection from HIV/AIDS. For instance, one idea is that they may steal the passion and romance from sexual intercourse. Many college students claim the reason they do not use condoms is because it is not convenient at the time of sexual arousal. Crosby et al. (2003) surveyed 260 undergraduates (118 males, 142 females) that had reported using a condom in the past 3 months for at least one sexual encounter with a partner of the opposite sex. Of these 260 undergraduates, 44% reported not using condoms because the lack of availability. The findings of a different study focused on condom use by virgins from the age 16-20 suggested that if individuals do not use a condom during their first sexual experience they are more likely not use one in their future experiences. A similar study from Breakwell et al., could not correlate whether or not higher expected condom use from virgin females, opposed to males, was from a fear of pregnancy rather than AIDS. This study however, showed that females did link a greater fear of AIDS, then a males risky intentions.

College students do have reason to use condoms. Prevention of pregnancy and contraction of a sexually transmitted disease (STD) are both major concerns in today's society. For example, Murray, Steven, & Miller, Jessica (2000) examined the usage of effective birth control and STD prevention practiced by 105 undergraduate students (45 men; 60 women) both before and after an introductory health course. The results of the study found that more students were concerned with preventing pregnancy than the spread of STDs.

The Pill

Oral contraception is the most reversible and effective method of contraption available. It is known universally and heavily used among Canadian women. This is commonly known as “The Pill”. In the 1998 Canadian Contraception Study asked women that were familiar with oral contraceptives to rate on a 1-4 scale their opinion of the pill. One being very unfavorable and 4 meaning very favorable. They concentrated on what was the women’s opinion of the pill and if it has changed in the past year. The very favorable opinion was found throughout all educational groups ranging from 64% to 66%. All regions of Canada ranged from 62% to 67%. Current pill users who expressed a very favorable opinion were 84%. During this study 80% of the participants said that their opinion has not changed over the past year. For the ones who said that their view of the pill had changed to less favorable said that it was because of the pill’s side effects.

IUD

The fairly recent birth control method of the Intrauterine Device is very effective, with only .01-.08% women who use it becoming pregnant within the first year. The TCu-380A is the copper version, and boasts a failure rate of 3 to 8 out of 1,000 users. The LNG-IUD which releases hormones, is more effective with only 1 to 3 out of 1,000 users experiencing a failure. It can be used from 5 to 12 years, depending on the condition of the woman and the type chosen. This makes it more economically efficient, because the user only pays for it once, rather than once a month or several times a month with other methods. Along with the obvious monetary benefits and the convenience, it is easily reversible. Possible drawbacks include heavy menstrual bleeding and hormonal symptoms similar to the pill: breast tenderness, acne, etc.

Abstinence

When we hear the word contraception we normally think of Withdrawal, Barrier Methods, Hormonal Methods, and Spermicide Methods. The contraceptive that is the most widely known of but most often not used is abstinence. We all know what abstinence is, or do we? Planes et al (2009) surveyed seven-hundred and fifty college students (92% under age 26, 67.6% women) from Spain and compared them to surveys done by college students in Anglo-Saxon countries. Results showed that both groups of college students made similar errors in defining the word “abstinence”. Most students define abstinence as not having sex but also said oral sex was abstinent behavior. The true meaning of abstinence has been somewhat betrayed by all people, not only by college students. Abstinence is the best possible to way to prevent pregnancy and/or transmission of STD’s or AIDS. Although the theoretical failure rate of abstinence is exceptionally low, the typical use failure rate is extremely high because it only takes one time to fail at abstinence. Whereas with a condom or birth control you have a high percentage of it not failing each time you use them. The main issue that people have with abstinence is most of the time when you use abstinence as your “Plan A” contraceptive and you get into a situation, for example a party, you are not normally in the best mind frame, therefore making abstinence effortless to fail at.

New Male Contraceptives

Today, as there are many different types of female contraceptives, there are only few male contraceptives such as condoms or having a vasectomy. But in a research study by Thakur et al. (2010) examines several studies and trials being conducted to develop a wider range of male contraceptives. For example, Adjudin is a new prospective drug for male contraception which came from the existing drug Lonidamine which is an anti cancer medication that was also found to have contraceptive effects in clinical studies in the 1980s. Unfortunately this drug was later abandoned when it was discovered that high doses were potentially linked to kidney damage. As a result, reseachers in New York’s Population Council discovered several nontoxic components to Loniamaine including AF-2364 or Adjudin which is moving into clinical trials.

Another new type of male contraception America could be seeing soon is male birth control pills. Men will have at their arsenal the same things women use for their birth control usage; oral pills, patches, injections, and even implants. The male birth control would supply doses of testosterone and effectively stop the sperm from reaching the egg. None of these options have been approved yet, as most men are worried of side effects. However, scientists proclaim the drugs will be safe and expect them to be on the market in the next three to five years. Schieszer, John. "Male Birth Control soon a reality." msnbc. MSNBC, 01.10.2010. Web. 1 May 2011. <http://www.msnbc.msn.com/id/3543478/>.

Birth Control in Cambodia and Other Low Income Areas

When looking at the cultural perspectives regarding conception and birth control used by women in a Cambodian refugee camp, the amount of times the women got pregnant depended on how much education they received. For example, Journal of Community Health Nursing (1988), showed that Cambodian women in refugee camps that had 1-11 years of education had only 0-4 pregnancies versus women who had 0-2 years of education that had 2-13 pregnancies. There are multiple forms of birth control that are able to fit the lifestyle of many women. For example Clarke et al. (1998) reviewed a study that a family planning clinic in Florida participated, surveying clients who were administered the Norplant, Depo Provo. The participants involved in the study and used this form of contraceptive were generally younger than thirty, having the ethnicity of African American, single, unemployed, having low educational levels, and had no risk factors or previous abortions.

Abortion

The court case Roe v. Wade (1973), “established a national policy recognizing the right of a woman to terminate an unwanted pregnancy” (Bond and Johnson, 1982). Bond and Johnson examined the hospital abortion services after Roe v. Wade. They found that community preferences, incentives and disincentives, and organizational norms were all directly related. The findings showed that certain types of hospitals are more responsive to external considerations, making organizational norms the most important factor influencing the hospitals regulations. Roe vs. Wade created changes in the policies of the hospitals depending on the way the community, doctors and nurses, and administration viewed abortion policies.

Bond R., and Johnson A. (1982) Implementing a Permissive Policy: Hospital Abortion Services after Roe v. Wade, American Journal of Political Science, 26(1), 1-24, 1982.

In Bond and Johnson, 1982 they explain that abortion is more than just a non-issue they measured the economic needs of hospitals which coincide with the Houston study (kemp et al., 1978). They believe abortion can actually help hospitals stand on their feet bringing in more money. Competition in the medical market place actually encourages abortion clinics to open, which in turn helped to change policies in hospitals.

Legalization?

There are many speculations as to why abortion should be illegal, all of them being legitimate reasons. It is generally looked down upon by societies, one reason being that people believe that it is a violation of the fourteenth amendment which states, "...nor shall any State deprive any person of life, liberty, or property, law; nor deny to any person within its jurisdiction the equal protection of the laws" (Roland 85). Some people believe this translates abortion into murder, but then there is the question of whether or not a fetus in the womb is an actual person. In the case, Roe v. Wade, the Supreme Court decision was that the Constitution does not recognize a child in the womb of a mother as a "person" entitled to the protection of the due process clause of the Fourteenth Amendment (Roe v. Wade 156). Weighing these options, no one can come up with an entirely moral reason that abortion is right. But, whe we think of a world without legal abortions, what should we picture? Making abortion illegal "does not not increase the woman's shame about seeking an abortion." The need for abortions would not end with an abolishment of it's legality, but illegal abortions would make a comeback. According to Ricky Solinger in his abortion research novel, women who admitted to having illegal abortions reported "medical complications afterward including excessive hemorrhaging, infection, and serility." Most risk death of not just the infant, but the mother due to complications that may arise in a non-professional procedure. The major impact of abortion being illegal is that it is, "ultimately dangerous". There is no way to prove that abortion is right, but there is proof that women with unwanted pregnancies can be saved from consequences as serous as death through the legalization of safe abortion (Solinger 361).

Roland, Jon. (2000) JOURNAL OF THE JOINT COMMITTEE at 85. Intent of the Fourteenth Amendment was to Protect All Rights

Roe v. Wade 410. (1983) U.S. Supreme Court 113. 156-57

Solinger, Rickie. (1998) Abortion wars: a half century of struggle, 1950-2000. University o California Press, LA. 361

Contraceptive Failure Rates

The failure rate of contraceptive use depends on the use or absence of some sort of contraceptive and if the product is being correctly used. There are three categories to contraceptives the barrier contraceptives, hormonal contraceptives, and other methods. Failure rate for each method is the number of women who become pregnant if 100 women used the method for one year. Barrier Methods Failure Rate: Condoms- 11%, Female Condom- 21%, Diaphragm- 17%, Cervical Cap- 17% to 23%, Cervical Shield- 15%, Contraceptive Sponge- 14% to 28%, Intrauterine Device (IUD) - <1%, Spermicides- 20% to 50% Hormonal Contraceptive Failure Rates: Birth Control- 1% to 2%, Minipills (POPs)- 2%, Contraceptive Patch- 1% to 2%, Contraceptive Ring – 1% to 2%, Contraceptive Injections (Depo shot) - <1%, Hormonal Releasing IUDs- <1%, Morning After Pill- 11% to 25% Other Methods: Natural Family Planning (Rhythmic Planning)- >20%, Withdrawal- 4% to 19%, Sterilization- <1%, Abstinence- 0%