Birth control

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Birth control
Intervention
Package of birth control pills
A package of birth control pills
MeSH D003267

Birth control, also known as contraception and fertility control, are methods or devices used to prevent pregnancy.1 Planning, provision and use of birth control is called family planning.23 Safe sex, such as the use of male or female condoms, can also help prevent sexually transmitted infections.45 Birth control methods have been used since ancient times, but effective and safe methods only became available in the 20th century.6 Some cultures deliberately limit access to birth control because they consider it to be morally or politically undesirable.6

The most effective methods of birth control are sterilization by means of vasectomy in males and tubal ligation in females, intrauterine devices (IUDs) and implantable contraceptives. This is followed by a number of hormonal contraceptives including oral pills, patches, vaginal rings, and injections. Less effective methods include barriers such as condoms, diaphragms and contraceptive sponge and fertility awareness methods. The least effective methods are spermicides and withdrawal by the male before ejaculation. Sterilization, while highly effective, is not usually reversible; all other methods are reversible, most immediately upon stopping them.7 Emergency contraceptives can prevent pregnancy in the few days after unprotected sex. Some regard sexual abstinence as birth control, but abstinence-only sex education may increase teen pregnancies when offered without contraceptive education.89

In teenagers, pregnancies are at greater risk of poor outcomes. Comprehensive sex education and access to birth control decreases the rate of unwanted pregnancies in this age group.1011 While all forms of birth control may be used by young people,12 long-acting reversible birth control such as implants, IUDs, or vaginal rings are of particular benefit in reducing rates of teenage pregnancy.11 After the delivery of a child, a woman who is not exclusively breastfeeding may become pregnant again after as few as four to six weeks. Some methods of birth control can be started immediately following the birth, while others require a delay of up to six months. In those who are breast feeding progestin-only methods are preferred over combined oral contraceptives. In those who have reached menopause it is recommended that birth control be continued for one year after the last period.12

About 222 million women who want to avoid pregnancy in developing countries are not using a modern birth control method.1314 Birth control use in developing countries has decreased the number of maternal deaths by 40% (about 270,000 deaths prevented in 2008) and could prevent 70% if the full demand for birth control were met.1516 By lengthening the time between pregnancies, birth control can improve adult women's delivery outcomes and the survival of their children.15 In the developing world women's earnings, assets, weight, and their children's schooling and health all improve with greater access to birth control.17 Birth control increases economic growth because of fewer dependent children, more women participating in the workforce, and less consumption of scarce resources.1718

Methods

Chance of pregnancy during first year of use:1920
Method Typical use Perfect use
No birth control 85% 85%
Combination pill 9% 0.3%
Progestin-only pill 13% 1.1%
Sterilization (female) 0.5% 0.5%
Sterilization (male) 0.15% 0.10%
Condom (female) 21% 5%
Condom (male) 18% 2%
Copper IUD 0.8% 0.6%
Hormonal IUD 0.2% 0.2%
Patch 9% 0.3%
Vaginal ring 9% 0.3%
Depo Provera 6% 0.2%
Implant 0.05% 0.05%
Diaphragm and spermicide 12% 6%
Fertility awareness 24% 0.4–5%
Withdrawal 22% 4%
Lactational amenorrhea method
(6 months failure rate)
0-7.5%21 <2%22

Birth control methods include barrier methods, hormonal birth control, intrauterine devices (IUDs), sterilization, and behavioral methods. They are used before or during sex while emergency contraceptives are effective for up to a few days after sex. Effectiveness is generally expressed as the percentage of women who become pregnant using a given method during the first year23 and sometimes as a lifetime failure rate among methods with high effectiveness, such as tubal ligation.24

The most effective methods are those that are long acting and do not require ongoing health care visits.25 Surgical sterilization, implantable hormones, and intrauterine devices all have first-year failure rates of less than 1%.19 Hormonal contraceptive pills, patches or vaginal rings, and the lactational amenorrhea method (LAM), if used strictly, can also have first-year (or for LAM, first-6-month) failure rates of less than 1%.25 With typical use first-year failure rates are considerably high, at 9%, due to incorrect usage.19 Other methods such as fertility awareness, condoms, diaphragms, and spermicides have higher first-year failure rates even with perfect usage.25

While all methods of birth control have some potential adverse effects, the risk is less than that of pregnancy.25 After stopping or removing many methods of birth control, including oral contraceptives, IUDs, implants and injections, the rate of pregnancy during the subsequent year is the same as for those who used no birth control.26

In those with specific health problems, certain forms of birth control may require further investigations.27 For women who are otherwise healthy, many methods of birth control should not require a medical exam including birth control pills, injectable or implantable birth control, and condoms.28 Specifically, a pelvic exam, breast exam, or blood test before starting birth control pills do not appear to affect outcomes and therefore are not required.2930 The World Health Organization in 2009 published a detailed list of medical eligibility criteria for each type of birth control.27

Hormonal

Hormonal contraceptives work by inhibiting ovulation and fertilization.31 They are available in a number of different forms including oral pills, implants under the skin, injections, patches, IUDs and a vaginal ring. They are currently available only for women. There are two types of oral birth control, the combined oral contraceptive pill and the progestogen-only pill.32 If taken during pregnancy, they neither increase the risk of miscarriage nor cause birth defects.30

Combined hormonal contraceptives are associated with a slightly increased risk of venous and arterial blood clots.33 Venous clots, on average, increase from 2.8 to 9.8 per 10,000 women years34 which is still less than that associated with pregnancy.33 Due to this risk, they are not recommended in women over 35 years of age who continue to smoke.35 The effect on sexual desire is varied, with increase or decrease in some but with no effect in most.36 Combined oral contraceptives reduce the risk of ovarian cancer and endometrial cancer and do not change the risk of breast cancer.3738 They often reduce menstrual bleeding and painful menstruation cramps.30 The lower doses of estrogen found in the vaginal ring may reduce the risk of breast tenderness, nausea, and headache associated with higher dose estrogen products.37

Progestin-only pills, injections and intrauterine devices are not associated with an increased risk of blood clots and may be used by women with previous blood clots in their veins.3339 In those with a history of arterial blood clots, non-hormonal birth control or a progestin-only method other than the injectable version should be used.33 Progestin-only pills may improve menstrual symptoms and can be used by breastfeeding women as they do not affect milk production. Irregular bleeding may occur with progestin-only methods, with some users reporting no periods.40 The progestins, drospirenone and desogestrel minimize the androgenic side effects but increase the risks of blood clots and are thus not first line.41 The perfect use first-year failure rate of the injectable progestin, Depo-Provera, is 0.2%; the typical use first failure rate is 6%.19

Barrier

A rolled up male condom

Barrier contraceptives are devices that attempt to prevent pregnancy by physically preventing sperm from entering the uterus.42 They include male condoms, female condoms, cervical caps, diaphragms, and contraceptive sponges with spermicide.42

Globally, condoms are the most common method of birth control.43 Male condoms are put on a man's erect penis and physically block ejaculated sperm from entering the body of a sexual partner.44 Modern condoms are most often made from latex, but some are made from other materials such as polyurethane, or lamb's intestine.44 Female condoms are also available, most often made of nitrile, latex or polyurethane.45 Male condoms have the advantage of being inexpensive, easy to use, and have few adverse effects.46 Making condoms available to teenagers does not appear to affect the age of onset of sexual activity or its frequency.47 In Japan about 80% of couples who are using birth control use condoms, while in Germany this number is about 25%,48 and in the United States it is 18%.49

Male condoms and the diaphragm with spermicide have typical use first-year failure rates of 18% and 12%, respectively.19 With perfect use condoms are more effective with a 2% first-year failure rate versus a 6% first-year rate with the diaphragm.19 Condoms have the additional benefit of helping to prevent the spread of some sexually transmitted infections such as HIV/AIDS.7

Contraceptive sponges combine a barrier with a spermicide.25 Like diaphragms, they are inserted vaginally before intercourse and must be placed over the cervix to be effective.25 Typical failure rates during the first year depend on whether or not a woman has previously given birth, being 24% in those who have and 12% in those who have not.19 The sponge can be inserted up to 24 hours before intercourse and must be left in place for at least six hours afterward.25 Allergic reactions50 and more severe adverse effects such as toxic shock syndrome have been reported.51

Intrauterine devices

The current intrauterine devices (IUD) are small devices, often 'T'-shaped, often containing either copper or levonorgestrel, which are inserted into the uterus. They are one form of long-acting reversible contraception which are the most effective types of reversible birth control.52 Failure rates with the copper IUD is about 0.8% while the levonorgestrel IUD has a failure rates of 0.2% in the first year of use.6 Among types of birth control, they along with birth control implants result in the greatest satisfaction among users.53 As of 2007, IUDs are the most widely used form of reversible contraception, with more than 180 million users worldwide.54

Evidence supports effectiveness and safety in adolescents53 and those who have and have not previously had children.55 IUDs do not affect breastfeeding and can be inserted immediately after delivery.56 They may also be used immediately after an abortion.57 Once removed, even after long term use, fertility returns to normal immediately.58

While copper IUDs may increase menstrual bleeding and result in more painful cramps59 hormonal IUDs may reduce menstrual bleeding or stop menstruation altogether.56 Cramping can be treated with NSAIDs.60 Other potential complications include expulsion (2–5%) and rarely perforation of the uterus (less than 0.7%).5660 A previous model of the intrauterine device (the Dalkon shield) was associated with an increased risk of pelvic inflammatory disease, however the risk is not affected with current models in those without sexually transmitted infections around the time of insertion.61

Sterilization

Surgical sterilization is available in the form of tubal ligation for women and vasectomy for men.6 There are no significant long-term side effects, and tubal ligation decreases the risk of ovarian cancer.6 Short term complications are twenty times less likely from a vasectomy than a tubal ligation.662 After a vasectomy, there may be swelling and pain of the scrotum which usually resolves in a week or two.63 With tubal ligation, complications occur in 1 to 2 percent of procedures with serious complications usually due to the anesthesia.64 Neither method offers protection from sexually transmitted infections.6

This decision may cause regret in some men and women. Of women aged over 30 who have undergone tubal ligation, about 5% regret their decision, as compared with 20% of women aged under 30.6 By contrast, less than 5% of men are likely to regret sterilization. Men more likely to regret sterilization are younger, have young or no children, or have an unstable marriage.65 In a survey of biological parents, 9% stated they would not have had children if they were able to do it over again.66

Although sterilization is considered a permanent procedure,67 it is possible to attempt a tubal reversal to reconnect the fallopian tubes or a vasectomy reversal to reconnect the vasa deferentia. In women the desire for a reversal is often associated with a change in spouse.67 Pregnancy success rates after tubal reversal are between 31 and 88%, with complications including an increased risk of ectopic pregnancy.67 The number of males who request reversal is between 2 and 6%.68 Rates of success in fathering another child after reversal are between 38 and 84%; with success being lower the longer the time period between the original procedure and the reversal.68 Sperm extraction followed by in vitro fertilization may also be an option in men.69

Behavioral

Behavioral methods involve regulating the timing or method of intercourse to prevent introduction of sperm into the female reproductive tract, either altogether or when an egg may be present.70 If used perfectly the first-year failure rate may be around 3.4%, however if used poorly first-year failure rates may approach 85%.71

Fertility awareness

Fertility awareness methods involve determining the most fertile days of the menstrual cycle and avoiding unprotected intercourse.70 Techniques for determining fertility include monitoring basal body temperature, cervical secretions, or the day of the cycle.70 They have typical first-year failure rates of 24%; perfect use first-year failure rates depend on which method is used and range from 0.4% to 5%.19 The evidence on which these estimates are based, however, is poor as the majority of people in trials stop their use early.70 Globally, they are used by about 3.6% of couples.72 If based on both basal body temperature and another primary sign, the method is referred to as symptothermal. Overall first-year failure rates of <2% to 20% have been reported in clinical studies of the symptothermal method.7374

Withdrawal

The withdrawal method (also known as coitus interruptus) is the practice of ending intercourse ("pulling out") before ejaculation.75 The main risk of the withdrawal method is that the man may not perform the maneuver correctly or in a timely manner.75 First-year failure rates vary from 4% with perfect usage to 22% with typical usage.19 It is not considered birth control by some medical professionals.25

There is little evidence regarding the sperm content of pre-ejaculatory fluid.76 While some tentative research did not find sperm,76 one trial found sperm present in 10 out of 27 volunteers.77 The withdrawal method is used as birth control by about 3% of couples.72

Abstinence

Though some groups advocate total sexual abstinence, by which they mean the avoidance of all sexual activity, in the context of birth control the term usually means abstinence from vaginal intercourse.7879 Abstinence is 100% effective in preventing pregnancy; however, not everyone who intends to be abstinent refrains from all sexual activity, and in many populations there is a significant risk of pregnancy from nonconsensual sex.8081

Abstinence-only sex education does not reduce teenage pregnancy.582 Teen pregnancy rates are higher in students given abstinence-only education, as compared with comprehensive sex education.8283 Some authorities recommend that those using abstinence as a primary method have backup method(s) available (such as condoms or emergency contraceptive pills).84 Deliberate non-penetrative sex without vaginal sex or deliberate oral sex without vaginal sex are also sometimes considered birth control.85 While this generally avoids pregnancy, pregnancy can still occur with intercrural sex and other forms of penis-near-vagina sex (genital rubbing, and the penis exiting from anal intercourse) where sperm can be deposited near the entrance to the vagina and can travel along the vagina's lubricating fluids.8687

Lactation

The lactational amenorrhea method involves the use of a woman's natural postpartum infertility which occurs after delivery and may be extended by breastfeeding.88 This usually requires the presence of no periods, exclusively breastfeeding the infant, and a child younger than six months.22 The World Health Organization states that if breastfeeding is the infant's only source of nutrition, the failure rate is 2% in the six months following delivery.89 Six uncontrolled studies of lactational amenorrhea method users found failure rates at 6 months postpartum between 0% and 7.5%.90 Failure rates increase to 4–7% at one year and 13% at two years.91 Feeding formula, pumping instead of nursing, the use of a pacifier, and feeding solids all increase its failure rate.92 In those who are exclusively breastfeeding, about 10% begin having periods before three months and 20% before six months.91 In those who are not breastfeeding, fertility may return four weeks after delivery.91

Emergency

Emergency contraceptive methods are medications (sometimes misleadingly referred to as "morning-after pills")93 or devices used after unprotected sexual intercourse with the hope of preventing pregnancy.94 They work primarily by preventing ovulation or fertilization.6 A number of options exist, including high dose birth control pills, levonorgestrel, mifepristone, ulipristal and IUDs.95 Levonorgestrel pills, when used within 3 days, decrease the chance of pregnancy after a single episode of unprotected sex or condom failure by 70% (resulting in a pregnancy rate of 2.2%).94 Ulipristal, when used within 5 days, decreases the chance of pregnancy by about 85% (pregnancy rate 1.4%) and might be a little more effective than levonorgestrel.949596 Mifepristone is also more effective than levonorgestrel while copper IUDs are the most effective method.95 IUDs can be inserted up to five days after intercourse and prevent about 99% of pregnancies after an episode of unprotected sex (pregnancy rate of 0.1 to 0.2%).697 This makes them the most effective form of emergency contraceptive.98 In those who are overweight or obese levonorgestrel is less effective and an IUD or ulipristal is recommended.99

Providing emergency contraceptive pills to women in advance does not affect rates of sexually transmitted infections, condom use, pregnancy rates, or sexual risk-taking behavior.100101 All methods have minimal side effects.95

Dual protection

Dual protection is the use of methods that prevent both sexually transmitted infections and pregnancy.102 This can be with condoms either alone or along with another birth control method or by the avoidance of penetrative sex.103104 If pregnancy is a high concern using two methods at the same time is reasonable,103 and two forms of birth control is recommended in those taking the anti-acne drug isotretinoin, due to the high risk of birth defects if taken during pregnancy.105

Effects

Health

maternal mortality rate map
Maternal mortality rate as of 2010106
Contraceptive use and total fertility rate by region

Contraceptive use in developing countries is estimated to have decreased the number of maternal deaths by 40% (about 270,000 deaths prevented in 2008) and could prevent 70% of deaths if the full demand for birth control were met.1516 These benefits are achieved by reducing the number of unplanned pregnancies that subsequently result in unsafe abortions and by preventing pregnancies in those at high risk.15

Birth control also improves child survival in the developing world by lengthening the time between pregnancies.15 In this population, outcomes are worse when a mother gets pregnant within eighteen months of a previous delivery.15107 Delaying another pregnancy after a miscarriage however does not appear to alter risk and women are advised to attempt pregnancy in this situation whenever they are ready.107

Teenage pregnancies, especially among younger teens, are at greater risk of adverse outcomes including early birth, low birth weight, and death of the infant.10 In the United States 82% of pregnancies in those between 15 and 19 are unplanned.60 Comprehensive sex education and access to birth control are effective in decreasing pregnancy rates in this age group.108

Finances

fertility rate map
Countries by fertility rate as of 2012.

In the developing world, birth control increases economic growth due to there being fewer dependent children and thus more women participating in the workforce.17 Women's earnings, assets, body mass index, and their children's schooling and body mass index all improve with greater access to birth control.17 Family planning via the use of modern birth control is one of the most cost-effective health interventions.109 For every dollar spent, the United Nations estimates that two to six dollars are saved.110 These cost savings are related to preventing unplanned pregnancies and decreasing the spread of sexually transmitted illnesses.109 While all methods are beneficial financially, the use of copper IUDs resulted in the greatest savings.109

The total medical cost for a pregnancy, delivery and care of a newborn in the United States is on average $21,000 for a vaginal delivery and $31,000 for a Caesarean section as of 2012.111 In most other countries the cost is less than half.111 For a child born in 2011, an average US family will spend $235,000 over 17 years to raise them.112

Prevalence

prevalence of modern birth control map
Percentage of women using modern birth control as of 2010.

Globally, as of 2009, approximately 60% of those who are married and able to have children use birth control.113 How frequently different methods are used varies widely between countries.113 The most common method in the developed world is condoms and oral contraceptives, while in Africa it is oral contraceptives and in Latin America and Asia it is sterilization.113 In the developing world overall, 35% of birth control is via female sterilization, 30% is via IUDs, 12% is via oral contraceptives, 11% is via condoms, and 4% is via male sterilization.113

While less used in the developed countries than the developing world, the number of women using IUDs as of 2007 was more than 180 million.54 Avoiding sex when fertile is used by about 3.6% of women of childbearing age, with usage as high as 20% in areas of South America.114 As of 2005, 12% of couples are using a male form of birth control (either condoms or a vasectomy) with higher rates in the developed world.115 Usage of male forms of birth control has decreased between 1985 and 2009.113 Contraceptive use among women in Sub-Saharan Africa has risen from about 5% in 1991 to about 30% in 2006.116

As of 2012, 57% of women of childbearing age want to avoid pregnancy (867 of 1520 million).117 About 222 million women however were not able to access birth control, 53 million of whom were in sub-Saharan Africa and 97 million of whom were in Asia.117 This results in 54 million unplanned pregnancies and nearly 80,000 maternal deaths a year.113 Part of the reason that many women are without birth control is that many countries limit access due to religious or political reasons,6 while another contributor is poverty.118 Due to restrictive abortion laws in Sub-Saharan Africa, many women turn to unlicensed abortion providers for unintended pregnancy, resulting in about 2–4% obtaining unsafe abortions each year.118

History

Early history

ancient coin depicting silphium
Ancient silver coin from Cyrene depicting a stalk of silphium

The Egyptian Ebers Papyrus from 1550 BCE and the Kahun Papyrus from 1850 BCE have within them some of the earliest documented descriptions of birth control: the use of honey, acacia leaves and lint to be placed in the vagina to block sperm.119120 It is believed that in Ancient Greece silphium was used as birth control which, due to its effectiveness and thus desirability, was harvested into extinction.121

In medieval Europe, any effort to halt pregnancy was deemed immoral by the Catholic Church,119 although it is believed that women of the time still used a number of birth control measures, such as coitus interruptus and inserting lily root and rue into the vagina.122 Casanova, living in 18th century Italy, described the use of a lambskin covering to prevent pregnancy; however, condoms only became widely available in the 20th century.119

Birth control movement

a cartoon of a woman being chased by a stork with a baby
"And the villain still pursues her", a satirical Victorian era postcard

The birth control movement developed during the 19th and early 20th centuries.123 The Malthusian League, based on the ideas of Thomas Malthus, was established in 1877 to educate the public about the importance of family planning and to advocate for getting rid of penalties for promoting birth control.124 It was founded during the "Knowlton trial" of Annie Besant and Charles Bradlaugh, who were prosecuted for publishing on various methods of birth control.125

In the United States, Margaret Sanger and Otto Bobsein popularized the phrase "birth control" in 1914.126127 Sanger was mainly active in the United States but had gained an international reputation by the 1930s. Sanger established a short-lived birth-control clinic in 1916, which was shut down after eleven days and resulted in her arrest.128 The publicity surrounding the arrest, trial, and appeal sparked birth control activism across the United States.129

The first permanent birth-control clinic was established in Britain in 1921 by Marie Stopes working with the Malthusian League.130 The clinic, run by midwives and supported by visiting doctors,131 offered mothers birth-control advice and taught them the use of a cervical cap. Her clinic made contraception acceptable during the 1920s by presenting it in scientific terms. Throughout the 1920s, Stopes and other feminist pioneers, including Dora Russell and Stella Browne, played a major role in breaking down taboos about sex. In April 1930 the Birth Control Conference assembled 700 delegates and was successful in bringing birth control and abortion into the political sphere - three months later, the Ministry of Health, in the United Kingdom, allowed local authorities to give birth-control advice in welfare centers.132

Modern methods

In 1909, Richard Richter developed the first intrauterine device made from silkworm gut, which was further developed and marketed in Germany by Ernst Gräfenberg in the late 1920s.133 Gregory Pincus and John Rock with help from the Planned Parenthood Federation of America developed the first birth control pills in the 1950s, such as mestranol/norethynodrel, which became publicly available in the 1960s.134 Medical abortion became an alternative to surgical abortion with the availability of prostaglandin analogs in the 1970s and mifepristone in the 1980s.135

Society and culture

Legal positions

Human rights agreements require most governments to provide family planning and contraceptive information and services. These include the requirement to create a national plan for family planning services, remove laws that limit access to family planning, ensure that a wide variety of safe and effective birth control methods are available including emergency contraceptives, make sure there are appropriately trained healthcare providers and facilities at an affordable price, and create a process to review the programs implemented. If governments fail to do the above it may put them in breach of binding international treaty obligations.136

In 2010, the United Nations launched the Every Woman Every Child movement to assess the progress toward meeting women's contraceptive needs. The initiative has set a goal of increasing the number of users of modern birth control by 120 million women in the world's 69 poorest countries by the year 2020. Additionally, they aim to eradicate discrimination against girls and young women who seek contraceptives.137138

Religious views

Religions vary widely in their views of the ethics of birth control.139 The Roman Catholic Church officially only accepts natural family planning in certain cases,140 although large numbers of Catholics in developed countries accept and use modern methods of birth control.141142143 Among Protestants there is a wide range of views from supporting none to allowing all methods of birth control.144 Views in Judaism range from the stricter Orthodox sect to the more relaxed Reform sect.145 Hindus may use both natural and artificial contraceptives.146 A common Buddhist view is that preventing conception is acceptable, while intervening after conception has occurred is not.147

In Islam, contraceptives are allowed if they do not threaten health, although their use is discouraged by some.148 The Quran does not make any explicit statements about the morality of birth control, but contains statements encouraging having children. Prophet Muhammad also is reported to have said "marry and procreate".149

World Contraception Day

The 26th of September is World Contraception Day, devoted to raising awareness and improving education about sexual and reproductive health, with a vision of a world where every pregnancy is wanted.150 It is supported by a group of governments and international NGOs, including the Asian Pacific Council on Contraception, Centro Latinamericano Salud y Mujer, the European Society of Contraception and Reproductive Health, the German Foundation for World Population, the International Federation of Pediatric and Adolescent Gynecology, International Planned Parenthood Federation, the Marie Stopes International, Population Services International, the Population Council, the United States Agency for International Development (USAID), and Women Deliver.150

Misconceptions

There are a number of common misconceptions regarding sex and pregnancy.151 Douching after sexual intercourse is not an effective form of birth control.152 Additionally, it is associated with a number of health problems and thus is not recommended.153 Women can become pregnant the first time they have sexual intercourse154 and in any sexual position.155 It is possible, although not very likely, to become pregnant during menstruation.156

Research directions

Females

Improvements of existing birth control methods are needed, as around half of those who get pregnant unintentionally are using birth control at the time.25 A number of alterations of existing contraceptive methods are being studied, including a better female condom, an improved diaphragm, a patch containing only progestin, and a vaginal ring containing long-acting progesterone.157 This vaginal ring appears to be effective for three or four months and is currently available in some areas of the world.157

A number of methods to perform sterilization via the cervix are being studied. One involves putting quinacrine in the uterus which causes scarring and infertility. While the procedure is inexpensive and does not require surgical skills, there are concerns regarding long-term side effects.158 Another substance, polidocanol, which functions in the same manner is being looked at.157 A device called Essure, which expands when placed in the fallopian tubes and blocks them, was approved in the United States in 2002.158

Males

Methods of male birth control include condoms, vasectomies and withdrawal.159160 Between 25 and 75% of males who are sexually active would use hormonal birth control if it was available for them.115159 A number of hormonal and non-hormonal methods are in trials,115 and there is some research looking at the possibility of contraceptive vaccines.161

A reversible surgical method under investigation is reversible inhibition of sperm under guidance (RISUG) which consists of injecting a polymer gel, styrene maleic anhydride in dimethyl sulfoxide, into the vas deferens. An injection with sodium bicarbonate washes out the substance and restores fertility. Another is an intravas device which involves putting a urethane plug into the vas deferens to block it. A combination of an androgen and a progestin seems promising, as do selective androgen receptor modulators.115 Ultrasound and methods to heat the testicles have undergone preliminary studies.162

Other animals

Neutering or spaying, which involves removing some of the reproductive organs, is often carried out as a method of birth control in household pets. Many animal shelters require these procedures as part of adoption agreements.163 In large animals the surgery is known as castration.164 Birth control is also being considered as an alternative to hunting as a means of controlling overpopulation in wild animals.165 Contraceptive vaccines have been found to be effective in a number of different animal populations.166167

References

  1. ^ "Definition of Birth control". MedicineNet. Retrieved 9 August 2012. 
  2. ^ Oxford English Dictionary. Oxford University Press. June 2012 (online). 
  3. ^ World Health Organization (WHO). "Family planning". Health topics. World Health Organization (WHO). 
  4. ^ Taliaferro, L. A.; Sieving, R.; Brady, S. S.; Bearinger, L. H. (2011). "We have the evidence to enhance adolescent sexual and reproductive health--do we have the will?". Adolescent medicine: state of the art reviews 22 (3): 521–543, xii. PMID 22423463. 
  5. ^ a b Chin, H. B.; Sipe, T. A.; Elder, R.; Mercer, S. L.; Chattopadhyay, S. K.; Jacob, V.; Wethington, H. R.; Kirby, D.; Elliston, D. B. (2012). "The Effectiveness of Group-Based Comprehensive Risk-Reduction and Abstinence Education Interventions to Prevent or Reduce the Risk of Adolescent Pregnancy, Human Immunodeficiency Virus, and Sexually Transmitted Infections". American Journal of Preventive Medicine 42 (3): 272–294. doi:10.1016/j.amepre.2011.11.006. PMID 22341164. 
  6. ^ a b c d e f g h i j k Hanson, S.J.; Burke, Anne E. (21 December 2010). "Fertility control: contraception, sterilization, and abortion". In Hurt, K. Joseph; Guile, Matthew W.; Bienstock, Jessica L.; Fox, Harold E.; Wallach, Edward E. The Johns Hopkins manual of gynecology and obstetrics (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 382–395. ISBN 978-1-60547-433-5. 
  7. ^ a b Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration. (Rev. and Updated ed. ed.). Geneva, Switzerland: WHO and Center for Communication Programs. 2011. ISBN 978-0-9788563-7-3. 
  8. ^ DiCenso A, Guyatt G, Willan A, Griffith L (June 2002). "Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials". BMJ 324 (7351): 1426. PMC 115855. PMID 12065267. 
  9. ^ Duffy, K.; Lynch, D. A.; Santinelli, J. (2008). "Government Support for Abstinence-Only-Until-Marriage Education". Clinical Pharmacology & Therapeutics 84 (6): 746–748. doi:10.1038/clpt.2008.188. PMID 18923389. 
  10. ^ a b Black, A. Y.; Fleming, N. A.; Rome, E. S. (2012). "Pregnancy in adolescents". Adolescent medicine: state of the art reviews 23 (1): 123–138, xi. PMID 22764559. 
  11. ^ a b Rowan, S. P.; Someshwar, J.; Murray, P. (2012). "Contraception for primary care providers". Adolescent medicine: state of the art reviews 23 (1): 95–110, x–xi. PMID 22764557. 
  12. ^ a b Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration. (Rev. and Updated ed. ed.). Geneva, Switzerland: WHO and Center for Communication Programs. 2011. pp. 260–300. ISBN 978-0-9788563-7-3. 
  13. ^ "Costs and Benefits of Contraceptive Services: Estimates for 2012" (pdf). United Nations Population Fund. June 2012. p. 1. 
  14. ^ Carr, B.; Gates, M. F.; Mitchell, A.; Shah, R. (2012). "Giving women the power to plan their families". The Lancet 380 (9837): 80–82. doi:10.1016/S0140-6736(12)60905-2. PMID 22784540. 
  15. ^ a b c d e f Cleland, J; Conde-Agudelo, A; Peterson, H; Ross, J; Tsui, A (Jul 14, 2012). "Contraception and health.". Lancet 380 (9837): 149–56. doi:10.1016/S0140-6736(12)60609-6. PMID 22784533. 
  16. ^ a b Ahmed, S.; Li, Q.; Liu, L.; Tsui, A. O. (2012). "Maternal deaths averted by contraceptive use: An analysis of 172 countries". The Lancet 380 (9837): 111–125. doi:10.1016/S0140-6736(12)60478-4. PMID 22784531. 
  17. ^ a b c d Canning, D.; Schultz, T. P. (2012). "The economic consequences of reproductive health and family planning". The Lancet 380 (9837): 165–171. doi:10.1016/S0140-6736(12)60827-7. PMID 22784535. 
  18. ^ Van Braeckel, D.; Temmerman, M.; Roelens, K.; Degomme, O. (2012). "Slowing population growth for wellbeing and development". The Lancet 380 (9837): 84–85. doi:10.1016/S0140-6736(12)60902-7. PMID 22784542. 
  19. ^ a b c d e f g h i Trussell, James (May 2011). "Contraceptive failure in the United States". Contraception 83 (5): 397–404. doi:10.1016/j.contraception.2011.01.021. PMC 3638209. PMID 21477680. 
    Trussell, James (1 November 2011). "Contraceptive efficacy". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. 
  20. ^ Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC) (21 June 2013). "U.S. Selected practice recommendations for contraceptive use, 2013: adapted from the World Health Organization Selected practice recommendations for contraceptive use, 2nd edition". MMWR Recommendations and Reports 62 (5): 1–60. PMID 23784109. 
  21. ^ Van der Wijden, C; Kleijnen, J; Van den Berk, T (2003). "Lactational amenorrhea for family planning.". Cochrane Database of Systematic Reviews (4): CD001329. doi:10.1002/14651858.CD001329. PMID 14583931. 
  22. ^ a b Blenning, CE; Paladine, H (Dec 15, 2005). "An approach to the postpartum office visit.". American family physician 72 (12): 2491–6. PMID 16370405. 
  23. ^ Brown, Gordon Edlin, Eric Golanty, Kelli McCormack (2000). Essentials for health and wellness (2nd ed. ed.). Sudbury, Mass.: Jones and Bartlett. p. 161. ISBN 9780763709099. 
  24. ^ Edmonds, edited by D. Keith (2012). Dewhurst's textbook of obstetrics & gynaecology (8th ed. ed.). Chichester, West Sussex: Wiley-Blackwell. p. 508. ISBN 9780470654576. 
  25. ^ a b c d e f g h i Cunningham, F. Gary; Stuart, Gretchen S. (12 April 2012). "Contraception and sterilization". In Hoffman, Barbara; Schorge, John O.; Schaffer, Joseph I.; Halvorson, Lisa M.; Bradshaw, Karen D.; Cunningham, F. Gary. Williams gynecology (2nd ed.). New York: McGraw-Hill Medical. pp. 132–169. ISBN 978-0-07-171672-7. 
  26. ^ Mansour, D; Gemzell-Danielsson, K; Inki, P; Jensen, JT (November 2011). "Fertility after discontinuation of contraception: a comprehensive review of the literature". Contraception 84 (5): 465–77. doi:10.1016/j.contraception.2011.04.002. PMID 22018120. 
  27. ^ a b Organization, World Health (2009). Medical eligibility criteria for contraceptive use (4th ed. ed.). Geneva: Reproductive Health and Research, World Health Organization. pp. 1–10. ISBN 9789241563888. 
  28. ^ Department of Reproductive Health and Research, Family and Community (2004). Selected practice recommendations for contraceptive use. (2 ed. ed.). Geneva: World Health Organization. p. Chapter 31. ISBN 9241562846. 
  29. ^ Tepper, NK; Curtis, KM; Steenland, MW; Marchbanks, PA (May 2013). "Physical examination prior to initiating hormonal contraception: a systematic review.". Contraception 87 (5): 650–4. doi:10.1016/j.contraception.2012.08.010. PMID 23121820. 
  30. ^ a b c Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration. (Rev. and Updated ed. ed.). Geneva, Switzerland: WHO and Center for Communication Programs. 2011. pp. 1–10. ISBN 978-0-9788563-7-3. 
  31. ^ Nelson, Anita L.; Cwiak, Carrie (2011). "Combined oral contraceptives (COCs)". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 249–341. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. 
  32. ^ Ammer, Christine (2009). "oral contraceptive". The encyclopedia of women's health (6th ed.). New York: Facts On File. pp. 312–315. ISBN 978-0-8160-7407-5. 
  33. ^ a b c d Brito, MB; Nobre, F, Vieira, CS (April 2011). "Hormonal contraception and cardiovascular system". Arquivos brasileiros de cardiologia 96 (4): e81–9. doi:10.1590/S0066-782X2011005000022. PMID 21359483. 
  34. ^ Stegeman, BH; de Bastos, M; Rosendaal, FR; van Hylckama Vlieg, A; Helmerhorst, FM; Stijnen, T; Dekkers, OM (Sep 12, 2013). "Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis.". BMJ (Clinical research ed.) 347: f5298. PMID 24030561. 
  35. ^ Kurver, Carla L.; van der Wijden; Burgers, Jako (4 October 2012). "Samenvatting van de NHG-standaard ‘Anticonceptie’ [Summary of the Dutch College of General Practitioners' practice guideline 'Contraception']". Nederlands Tijdschrift voor Geneeskunde (in Dutch) 156 (41): A5083. PMID 23062257. 
  36. ^ Burrows, LJ; Basha, M; Goldstein, AT (September 2012). "The effects of hormonal contraceptives on female sexuality: a review.". The journal of sexual medicine 9 (9): 2213–23. doi:10.1111/j.1743-6109.2012.02848.x. PMID 22788250. 
  37. ^ a b Shulman, LP (October 2011). "The state of hormonal contraception today: benefits and risks of hormonal contraceptives: combined estrogen and progestin contraceptives.". American journal of obstetrics and gynecology 205 (4 Suppl): S9–13. doi:10.1016/j.ajog.2011.06.057. PMID 21961825. 
  38. ^ Havrilesky, LJ; Moorman, PG; Lowery, WJ; Gierisch, JM; Coeytaux, RR; Urrutia, RP; Dinan, M; McBroom, AJ; Hasselblad, V; Sanders, GD; Myers, ER (July 2013). "Oral Contraceptive Pills as Primary Prevention for Ovarian Cancer: A Systematic Review and Meta-analysis.". Obstetrics and gynecology 122 (1): 139–147. doi:10.1097/AOG.0b013e318291c235. PMID 23743450. 
  39. ^ Mantha, S.; Karp, R.; Raghavan, V.; Terrin, N.; Bauer, K. A.; Zwicker, J. I. (7 August 2012). "Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis". BMJ 345 (aug07 2): e4944–e4944. doi:10.1136/bmj.e4944. PMC 3413580. PMID 22872710. 
  40. ^ Burke, AE (October 2011). "The state of hormonal contraception today: benefits and risks of hormonal contraceptives: progestin-only contraceptives.". American journal of obstetrics and gynecology 205 (4 Suppl): S14–7. doi:10.1016/j.ajog.2011.04.033. PMID 21961819. 
  41. ^ Rott, H (August 2012). "Thrombotic risks of oral contraceptives.". Current Opinion in Obstetrics and Gynecology 24 (4): 235–40. doi:10.1097/GCO.0b013e328355871d. PMID 22729096. 
  42. ^ a b Neinstein, Lawrence (2008). Adolescent health care : a practical guide (5th ed. ed.). Philadelphia: Lippincott Williams & Wilkins. p. 624. ISBN 9780781792561. 
  43. ^ Chaudhuri (2007). Practice Of Fertility Control: A Comprehensive Manual (7th ed.). Elsevier India. p. 88. ISBN 9788131211502. 
  44. ^ a b Hamilton, Richard (2012). Pharmacology for nursing care (8th ed. ed.). St. Louis, Mo.: Elsevier/Saunders. p. 799. ISBN 9781437735826. 
  45. ^ Facts for life (4th ed. ed.). New York: United Nations Children's Fund. 2010. p. 141. ISBN 9789280644661. 
  46. ^ Pray, Walter Steven (2005). Nonprescription product therapeutics (2nd ed. ed.). Philadelphia: Lippincott Williams & Wilkins. p. 414. ISBN 9780781734981. 
  47. ^ "Condom Use by Adolescents". PEDIATRICS 132 (5): 973–981. 28 October 2013. doi:10.1542/peds.2013-2821. 
  48. ^ Eberhard, Nieschlag, (2010). Andrology Male Reproductive Health and Dysfunction (3rd ed. ed.). [S.l.]: Springer-Verlag Berlin Heidelberg. p. 563. ISBN 9783540783558. 
  49. ^ Barbieri, Jerome F. (2009). Yen and Jaffe's reproductive endocrinology : physiology, pathophysiology, and clinical management (6th ed. ed.). Philadelphia, PA: Saunders/Elsevier. p. 873. ISBN 9781416049074. 
  50. ^ Kuyoh, MA; Toroitich-Ruto, C; Grimes, DA; Schulz, KF; Gallo, MF (January 2003). "Sponge versus diaphragm for contraception: a Cochrane review.". Contraception 67 (1): 15–8. PMID 12521652. 
  51. ^ Organization, World Health (2009). Medical eligibility criteria for contraceptive use (4th ed. ed.). Geneva: Reproductive Health and Research, World Health Organization. p. 88. ISBN 9789241563888. 
  52. ^ Winner, B; Peipert, JF; Zhao, Q; Buckel, C; Madden, T; Allsworth, JE; Secura, GM. (2012). "Effectiveness of Long-Acting Reversible Contraception". New England Journal of Medicine 366 (21): 1998–2007. doi:10.1056/NEJMoa1110855. PMID 22621627. 
  53. ^ a b Committee on Adolescent Health Care Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and, Gynecologists (October 2012). "Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices.". Obstetrics and gynecology 120 (4): 983–8. doi:10.1097/AOG.0b013e3182723b7d. PMID 22996129. 
  54. ^ a b Darney, Leon Speroff, Philip D. (2010). A clinical guide for contraception (5th ed. ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. pp. 242–243. ISBN 9781608316106. 
  55. ^ Black, K; Lotke, P; Buhling, KJ; Zite, NB; Intrauterine contraception for Nulliparous women: Translating Research into Action (INTRA), group (October 2012). "A review of barriers and myths preventing the more widespread use of intrauterine contraception in nulliparous women.". The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception 17 (5): 340–50. doi:10.3109/13625187.2012.700744. PMID 22834648. 
  56. ^ a b c Gabbe, Steven (2012). Obstetrics: Normal and Problem Pregnancies. Elsevier Health Sciences. p. 527. ISBN 9781455733958. 
  57. ^ Steenland, MW; Tepper, NK; Curtis, KM; Kapp, N (November 2011). "Intrauterine contraceptive insertion postabortion: a systematic review.". Contraception 84 (5): 447–64. doi:10.1016/j.contraception.2011.03.007. PMID 22018119. 
  58. ^ Hurd, [edited by] Tommaso Falcone, William W. (2007). Clinical reproductive medicine and surgery. Philadelphia: Mosby. p. 409. ISBN 9780323033091. 
  59. ^ Grimes, D.A., MD (2007). ""Intrauterine Devices (IUDs)" In:Hatcher, RA; Nelson, TJ; Guest, F; Kowal, D". Contraceptive Technology 19th ed. (New York: Ardent Media). 
  60. ^ a b c Marnach, ML; Long, ME; Casey, PM (March 2013). "Current issues in contraception.". Mayo Clinic proceedings. Mayo Clinic 88 (3): 295–9. doi:10.1016/j.mayocp.2013.01.007. PMID 23489454. 
  61. ^ "Popularity Disparity: Attitudes About the IUD in Europe and the United States". Published by Policy Review Published Fall 2007. Retrieved 2010-04-27. 
  62. ^ Adams CE, Wald M (August 2009). "Risks and complications of vasectomy". Urol. Clin. North Am. 36 (3): 331–6. doi:10.1016/j.ucl.2009.05.009. PMID 19643235. 
  63. ^ Hillard, Paula Adams (2008). The 5-minute obstetrics and gynecology consult. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 265. ISBN 0-7817-6942-6. 
  64. ^ Hillard, Paula Adams (2008). The 5-minute obstetrics and gynecology consult. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 549. ISBN 0-7817-6942-6. 
  65. ^ Hatcher, Robert (2008). Contraceptive technology (19th ed. ed.). New York, N.Y.: Ardent Media. p. 390. ISBN 9781597080019. 
  66. ^ Moore, David S. (2010). The basic practice of statistics (5th ed. ed.). New York: Freeman. p. 25. ISBN 9781429224260. 
  67. ^ a b c Deffieux, X; Morin Surroca, M; Faivre, E; Pages, F; Fernandez, H; Gervaise, A (May 2011). "Tubal anastomosis after tubal sterilization: a review.". Archives of gynecology and obstetrics 283 (5): 1149–58. doi:10.1007/s00404-011-1858-1. PMID 21331539. 
  68. ^ a b Shridharani, A; Sandlow, JI (November 2010). "Vasectomy reversal versus IVF with sperm retrieval: which is better?". Current Opinion in Urology 20 (6): 503–9. doi:10.1097/MOU.0b013e32833f1b35. PMID 20852426. 
  69. ^ Nagler, HM; Jung, H (August 2009). "Factors predicting successful microsurgical vasectomy reversal.". The Urologic clinics of North America 36 (3): 383–90. doi:10.1016/j.ucl.2009.05.010. PMID 19643240. 
  70. ^ a b c d Grimes, DA; Gallo, MF; Grigorieva, V; Nanda, K; Schulz, KF (Oct 18, 2004). "Fertility awareness-based methods for contraception.". Cochrane Database of Systematic Reviews (4): CD004860. doi:10.1002/14651858.CD004860.pub2. PMID 15495128. 
  71. ^ Lawrence, Ruth (2010). Breastfeeding : a guide for the medical professional. (7th ed. ed.). Philadelphia, Pa.: Saunders. p. 673. ISBN 9781437707885. 
  72. ^ a b Freundl, G; Sivin, I; Batár, I (April 2010). "State-of-the-art of non-hormonal methods of contraception: IV. Natural family planning.". The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception 15 (2): 113–23. doi:10.3109/13625180903545302. PMID 20141492. 
  73. ^ Jennings, Victoria H.; Burke, Anne E. (1 November 2011). "Fertility awareness-based methods". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 417–434. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. 
  74. ^ Frank-Herrmann, Petra; Heil, Jörg; Gnoth, Christian; Toledo, Estefania; Baur, Siegfried; Pyper, Cecilia; Jenetzky, Ekkehart; Strowitzki, Thomas; Freundl, Günter (May 2007). "The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study". Human Reproduction 22 (5): 1310–1319. doi:10.1093/humrep/dem003. PMID 17314078. 
  75. ^ a b Organization, World Health (2009). Medical eligibility criteria for contraceptive use (4th ed. ed.). Geneva: Reproductive Health and Research, World Health Organization. pp. 91–100. ISBN 9789241563888. 
  76. ^ a b Jones, RK; Fennell, J; Higgins, JA; Blanchard, K (June 2009). "Better than nothing or savvy risk-reduction practice? The importance of withdrawal.". Contraception 79 (6): 407–10. doi:10.1016/j.contraception.2008.12.008. PMID 19442773. 
  77. ^ Killick, SR; Leary, C; Trussell, J; Guthrie, KA (March 2011). "Sperm content of pre-ejaculatory fluid.". Human fertility (Cambridge, England) 14 (1): 48–52. doi:10.3109/14647273.2010.520798. PMC 3564677. PMID 21155689. 
  78. ^ "Abstinence". Planned Parenthood. 2009. Retrieved 2009-09-09. 
  79. ^ Murthy, Amitasrigowri S; Harwood, Bryna (2007). Contraception Update (2nd ed.). New York: Springer. pp. Abstract. doi:10.1007/978-0-387-32328-2_12. ISBN 978-0-387-32327-5. 
  80. ^ Fortenberry, J. Dennis (2005). "The limits of abstinence-only in preventing sexually transmitted infections". Journal of Adolescent Health 36 (4): 269–70. doi:10.1016/j.jadohealth.2005.02.001. PMID 15780781. , which cites:
    Brückner, Hannah; Bearman, Peter (2005). "After the promise: The STD consequences of adolescent virginity pledges". Journal of Adolescent Health 36 (4): 271–8. doi:10.1016/j.jadohealth.2005.01.005. PMID 15780782. 
  81. ^ Kim Best (2005). "Nonconsensual Sex Undermines Sexual Health". Network 23 (4). 
  82. ^ a b Ott, MA; Santelli, JS (October 2007). "Abstinence and abstinence-only education". Current Opinion in Obstetrics and Gynecology 19 (5): 446–52. doi:10.1097/GCO.0b013e3282efdc0b. PMID 17885460. 
  83. ^ Duffy, K; Lynch, DA; Santelli, J (December 2008). "Government support for abstinence-only-until-marriage education.". Clinical pharmacology and therapeutics 84 (6): 746–8. doi:10.1038/clpt.2008.188. PMID 18923389. 
  84. ^ Kowal D (2007). "Abstinence and the Range of Sexual Expression". In Hatcher, Robert A., et al. Contraceptive Technology (19th rev. ed.). New York: Ardent Media. pp. 81–86. ISBN 0-9664902-0-7. 
  85. ^ Feldmann, J.; Middleman, A. B. (2002). "Adolescent sexuality and sexual behavior". Current Opinion in Obstetrics and Gynecology 14 (5): 489–493. PMID 12401976. 
  86. ^ Thomas, R. Murray (2009). Sex and the American teenager seeing through the myths and confronting the issues. Lanham, Md.: Rowman & Littlefield Education. p. 81. ISBN 9781607090182. 
  87. ^ Edlin, Gordon (2012). Health & Wellness.. Jones & Bartlett Learning. p. 213. ISBN 9781449636470. 
  88. ^ Blackburn, Susan Tucker (2007). Maternal, fetal, & neonatal physiology : a clinical perspective (3rd ed. ed.). St. Louis, Mo.: Saunders Elsevier. p. 157. ISBN 9781416029441. 
  89. ^ "WHO 10 facts on breastfeeding". World Health Organization. April 2005. 
  90. ^ Van der Wijden, Carla; Brown, Julie; Kleijnen, Jos (8 October 2008). "Lactational amenorrhea for family planning". Cochrane Database of Systematic Reviews (4): CD001329. doi:10.1002/14651858.CD001329. PMID 14583931. 
  91. ^ a b c Fritz, Marc (2012). Clinical Gynecologic Endocrinology and Infertility. pp. 1007–1008. ISBN 9781451148473. 
  92. ^ Swisher, Judith Lauwers, Anna. Counseling the nursing mother a lactation consultant's guide (5th ed. ed.). Sudbury, MA: Jones & Bartlett Learning. pp. 465–466. ISBN 9781449619480. 
  93. ^ Office of Population Research; Association of Reproductive Health Professionals (31 July 2013). "What is the difference between emergency contraception, the 'morning after pill', and the 'day after pill'?". Princeton: Princeton University. Retrieved 7 September 2013. 
  94. ^ a b c Gizzo, S; Fanelli, T; Di Gangi, S; Saccardi, C; Patrelli, TS; Zambon, A; Omar, A; D'Antona, D; Nardelli, GB (October 2012). "Nowadays which emergency contraception? Comparison between past and present: latest news in terms of clinical efficacy, side effects and contraindications.". Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 28 (10): 758–63. doi:10.3109/09513590.2012.662546. PMID 22390259. 
  95. ^ a b c d Cheng, L; Che, Y; Gülmezoglu, AM (Aug 15, 2012). "Interventions for emergency contraception.". Cochrane Database of Systematic Reviews 8: CD001324. doi:10.1002/14651858.CD001324.pub4. PMID 22895920. 
  96. ^ Richardson, AR; Maltz, FN (January 2012). "Ulipristal acetate: review of the efficacy and safety of a newly approved agent for emergency contraception.". Clinical therapeutics 34 (1): 24–36. doi:10.1016/j.clinthera.2011.11.012. PMID 22154199. 
  97. ^ "Update on Emergency Contraception". Association of Reproductive Health Professionals. March 2011. Retrieved 20 May 2013. 
  98. ^ Cleland K, Zhu H, Goldstruck N, Cheng L, Trussel T (2012). "The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience". Human Reproduction 27 (7): 1994–2000. doi:10.1093/humrep/des140. PMID 22570193. 
  99. ^ Glasier, A; Cameron, ST; Blithe, D; Scherrer, B; Mathe, H; Levy, D; Gainer, E; Ulmann, A (Oct 2011). "Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel.". Contraception 84 (4): 363–7. doi:10.1016/j.contraception.2011.02.009. PMID 21920190. 
  100. ^ Kripke C (September 2007). "Advance provision for emergency oral contraception". Am Fam Physician 76 (5): 654. PMID 17894132. 
  101. ^ Shrader SP, Hall LN, Ragucci KR, Rafie S (September 2011). "Updates in hormonal emergency contraception". Pharmacotherapy 31 (9): 887–95. doi:10.1592/phco.31.9.887. PMID 21923590. 
  102. ^ "Dual protection against unwanted pregnancy and HIV / STDs". Sex Health Exch (3): 8. 1998. PMID 12294688. 
  103. ^ a b Cates, W., Steiner, M. J. (2002). "Dual Protection Against Unintended Pregnancy and Sexually Transmitted Infections: What Is the Best Contraceptive Approach?". Sexually Transmitted Diseases 29 (3): 168–174. doi:10.1097/00007435-200203000-00007. PMID 11875378. 
  104. ^ "Statement on Dual Protection against Unwanted Pregnancy and Sexually Transmitted Infections, including HIV" (PDF). International Planned Parenthood Federation. May 2000. 
  105. ^ Gupta, Ramesh C. (2011-02-25). Reproductive and Developmental Toxicology. Academic Press. p. 105. ISBN 978-0-12-382032-7. 
  106. ^ Country Comparison: Maternal Mortality Rate in The CIA World Factbook
  107. ^ a b Sholapurkar, SL (February 2010). "Is there an ideal interpregnancy interval after a live birth, miscarriage or other adverse pregnancy outcomes?". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 30 (2): 107–10. doi:10.3109/01443610903470288. PMID 20143964. 
  108. ^ Lavin, C; Cox, JE (August 2012). "Teen pregnancy prevention: current perspectives.". Current Opinion in Pediatrics 24 (4): 462–9. doi:10.1097/MOP.0b013e3283555bee. PMID 22790099. 
  109. ^ a b c Tsui AO, McDonald-Mosley R, Burke AE (April 2010). "Family planning and the burden of unintended pregnancies". Epidemiol Rev 32 (1): 152–74. doi:10.1093/epirev/mxq012. PMC 3115338. PMID 20570955. 
  110. ^ Carr, B; Gates, MF; Mitchell, A; Shah, R (Jul 14, 2012). "Giving women the power to plan their families.". Lancet 380 (9837): 80–2. doi:10.1016/S0140-6736(12)60905-2. PMID 22784540. 
  111. ^ a b Rosenthal, Elisabeth (June 30, 2013). "American Way of Birth, Costliest in the World". New York Times. 
  112. ^ "Expenditures on Children by Families, 2011". United States Department of Agriculture, Center for Nutrition Policy and Promotion. 
  113. ^ a b c d e f Darroch, JE (March 2013). "Trends in contraceptive use.". Contraception 87 (3): 259–63. doi:10.1016/j.contraception.2012.08.029. PMID 23040137. 
  114. ^ Darney, Leon Speroff, Philip D. (2010). A clinical guide for contraception (5th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 315. ISBN 1-60831-610-6. 
  115. ^ a b c d Naz, RK; Rowan, S (June 2009). "Update on male contraception.". Current Opinion in Obstetrics and Gynecology 21 (3): 265–9. PMID 19469045. 
  116. ^ Cleland, JG; Ndugwa, RP; Zulu, EM (Feb 1, 2011). "Family planning in sub-Saharan Africa: progress or stagnation?". Bulletin of the World Health Organization 89 (2): 137–43. doi:10.2471/BLT.10.077925. PMC 3040375. PMID 21346925. 
  117. ^ a b Darroch, JE; Singh, S (May 18, 2013). "Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys.". Lancet 381 (9879): 1756–1762. doi:10.1016/S0140-6736(13)60597-8. PMID 23683642. 
  118. ^ a b Rasch, V (July 2011). "Unsafe abortion and postabortion care -an overview.". Acta obstetricia et gynecologica Scandinavica 90 (7): 692–700. doi:10.1111/j.1600-0412.2011.01165.x. PMID 21542813. 
  119. ^ a b c Cuomo, Amy (2010). "Birth control". In O'Reilly, Andrea. Encyclopedia of motherhood. Thousand Oaks, Calif.: Sage Publications. pp. 121–126. ISBN 9781412968461. 
  120. ^ Lipsey, Richard G.; Carlaw, Kenneth; Bekar, Clifford (2005). "Historical Record on the Control of Family Size". Economic Transformations: General Purpose Technologies and Long-Term Economic Growth. Oxford University Press. pp. 335–40. ISBN 978-0-19-928564-8. 
  121. ^ unspecified (2001). "Herbal contraceptives and abortifacients". In Bullough, Vern L. Encyclopedia of birth control. Santa Barbara, Calif.: ABC-CLIO. pp. 125–128. ISBN 9781576071816. 
  122. ^ McTavish, Lianne (2007). "Contraception and birth control". In Robin, Diana. Encyclopedia of women in the Renaissance : Italy, France, and England. Santa Barbara, Calif.: ABC-CLIO. pp. 91–92. ISBN 9781851097722. 
  123. ^ Hartmann, B (1997). "Population control I: Birth of an ideology.". International journal of health services : planning, administration, evaluation 27 (3): 523–40. PMID 9285280. 
  124. ^ Simms, Madeleine (27 January 1977). "Review: A History of the Malthusian League 1877-1927". New Scientist. 
  125. ^ d'Arcy, F (Nov 1977). "The Malthusian League and the resistance to birth control propaganda in late Victorian Britain.". Population studies 31 (3): 429–48. PMID 11630505. 
  126. ^ Wilkinson Meyer, Jimmy Elaine (2004). Any friend of the movement: networking for birth control, 1920–1940. Ohio State University Press. p. 184. ISBN 978-0-8142-0954-7. 
  127. ^ Galvin, Rachel (1998). "Margaret Sanger's "Deeds of Terrible Virtue"". National Endowment for the Humanities. 
  128. ^ Baker, Jean H. (2012). Margaret Sanger : a life of passion (First pbk. edition. ed.). pp. 115–117. ISBN 9781429968973. 
  129. ^ McCann, Carole Ruth (2010). "Women as Leaders in the Contraceptive Movement". In Karen O'Connor. Gender and Women's Leadership: A Reference Handbook. SAGE. p. 751. OCLC 568741234. 
  130. ^ Hall, Ruth (1977). Passionate Crusader. Harcourt, Brace, Jovanovich. p. 186. 
  131. ^ Marie Carmichael Stopes (1925). The First Five Thousand. London: John Bale, Sons & Danielsson. p. 9. OCLC 12690936. 
  132. ^ Hall, Lesley (2011). The life and times of Stella Browne : feminist and free spirit. London: I. B. Tauris. p. 173. ISBN 9781848855830. 
  133. ^ Fritz, Marc A.; Speroff, Leon (2011). "Intrauterine contraception". Clinical gynecologic endocrinology and infertility (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 1095–1098. ISBN 978-0-7817-7968-5. 
  134. ^ Poston, Dudley (2010). Population and Society: An Introduction to Demography. Cambridge University Press. p. 98. ISBN 9781139489386. 
  135. ^ Kulier, Regina; Kapp, Nathalie; Gülmezoglu, A. Metin; Hofmeyr, G. Justus; Cheng, Linan; Campana, Aldo (November 9, 2011). "Medical methods for first trimester abortion". Cochrane Database of Systematic Reviews (11): CD002855. doi:10.1002/14651858.CD002855.pub4. PMID 22071804. 
  136. ^ Cottingham J., Germain A., Hunt P. (2012). "Use of human rights to meet the unmet need for family planning". The Lancet 380 (9837): 172–180. doi:10.1016/S0140-6736(12)60732-6. PMID 22784536. 
  137. ^ Susheela Singh; Jacqueline E. Darroch (June 2012). "Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012" (PDF). Guttmacher Institute and United Nations Population Fund (UNFPA), 201. 
  138. ^ "About Every Woman Every Child". United Nations Foundation. Retrieved 21 September 2013. 
  139. ^ Srikanthan, A; Reid, RL (February 2008). "Religious and cultural influences on contraception". Journal of obstetrics and gynaecology Canada – Journal d'obstetrique et gynecologie du Canada (JOGC) 30 (2): 129–37. PMID 18254994. 
  140. ^ Pope Paul VI (1968-07-25). "Humanae Vitae: Encyclical of Pope Paul VI on the Regulation of Birth". Vatican. Retrieved 2006-10-01. 
  141. ^ Rosemary Radford Ruether (2006). "Women in North American Catholicism". In Rosemary Skinner Keller. Encyclopedia of women and religion in North America. Bloomington, Ind. [u.a.]: Indiana Univ. Press. p. 132. ISBN 978-0-253-34686-5. 
  142. ^ Bob Digby et.al. (2001). Bob Digby, ed. Heinemann 16-19 Geography: Global Challenges Student Book 2nd Edition. Heinemann. p. 158. ISBN 978-0-435-35249-3. 
  143. ^ Rengel, Marian (2000). Encyclopedia of birth control. Phoenix, Ariz: Oryx Press. p. 202. ISBN 978-1-57356-255-3. 
  144. ^ Bennett, Jana Marguerite (2008). Water is thicker than blood : an Augustinian theology of marriage and singleness. Oxford: Oxford University Press. p. 178. ISBN 978-0-19-531543-1. 
  145. ^ Feldman, David M. (1998). Birth Control in Jewish Law. Lanham, MD: Jason Aronson. ISBN 0-7657-6058-4. 
  146. ^ "Hindu Beliefs and Practices Affecting Health Care". University of Virginia Health System. Archived from the original on 2007-05-15. Retrieved 2006-10-06. 
  147. ^ "More Questions & Answers on Buddhism: Birth Control and Abortion". Alan Khoo. Retrieved 2008-06-14. 
  148. ^ Khalid Farooq Akbar. "Family Planning and Islam: A Review". Hamdard Islamicus XVII (3). 
  149. ^ Yusuf Al-Qaradawi, Muhammad Saleh Al-Munajjid. "Contraception: Permissible?,"IslamOnline.
  150. ^ a b "World Contraception Day". 
  151. ^ Hutcherson, Hilda (2002). What your mother never told you about s.e.x (1st Perigee ed. ed.). New York: Perigee Book. p. 201. ISBN 9780399528538. 
  152. ^ Rengel, Marian (2000). Encyclopedia of birth control. Phoenix, Ariz: Oryx Press. p. 65. ISBN 9781573562553. 
  153. ^ Cottrell, BH (Mar–Apr 2010). "An updated review of of evidence to discourage douching.". MCN. The American journal of maternal child nursing 35 (2): 102–7; quiz 108–9. doi:10.1097/NMC.0b013e3181cae9da. PMID 20215951. 
  154. ^ Alexander, William (2013). New Dimensions In Women's Health - Book Alone (6th ed.). Jones & Bartlett Publishers. p. 105. ISBN 9781449683757. 
  155. ^ Sharkey, Harriet (2013). Need to Know Fertility and Conception and Pregnancy. HarperCollins. p. 17. ISBN 9780007516865. 
  156. ^ Strange, Mary (2011). Encyclopedia of women in today's world. Thousand Oaks, Calif.: Sage Reference. p. 928. ISBN 9781412976855. 
  157. ^ a b c Jensen, JT (October 2011). "The future of contraception: innovations in contraceptive agents: tomorrow's hormonal contraceptive agents and their clinical implications.". American journal of obstetrics and gynecology 205 (4 Suppl): S21–5. doi:10.1016/j.ajog.2011.06.055. PMID 21961821. 
  158. ^ a b Castaño, PM; Adekunle, L (March 2010). "Transcervical sterilization.". Seminars in reproductive medicine 28 (2): 103–9. doi:10.1055/s-0030-1248134. PMID 20352559. 
  159. ^ a b Glasier, A (November 2010). "Acceptability of contraception for men: a review.". Contraception 82 (5): 453–6. doi:10.1016/j.contraception.2010.03.016. PMID 20933119. 
  160. ^ Kogan, P; Wald, M (Feb 2014). "Male contraception: history and development.". The Urologic clinics of North America 41 (1): 145–61. doi:10.1016/j.ucl.2013.08.012. PMID 24286773. 
  161. ^ Naz, RK (July 2011). "Antisperm contraceptive vaccines: where we are and where we are going?". American journal of reproductive immunology (New York, N.Y. : 1989) 66 (1): 5–12. doi:10.1111/j.1600-0897.2011.01000.x. PMID 21481057. 
  162. ^ Ojeda, edited by Willaim J. Kovacs, Sergio R. (2011). Textbook of endocrine physiology (6th ed. ed.). Oxford: Oxford University Press. p. 262. ISBN 9780199744121. 
  163. ^ Millar, Lila (2011). Infectious Disease Management in Animal Shelters. John Wiley & Sons. ISBN 9781119949459. 
  164. ^ Ackerman, [edited by] Lowell (2007). Blackwell's five-minute veterinary practice management consult (1st ed. ed.). Ames, Iowa: Blackwell Pub. p. 80. ISBN 9780781759847. 
  165. ^ Boyle, Rebecca (March 3, 2009). "Birth control for animals: a scientific approach to limiting the wildlife population explosion". Popular Science. New York: PopSci.com. 
  166. ^ Kirkpatrick, JF; Lyda, RO; Frank, KM (July 2011). "Contraceptive vaccines for wildlife: a review.". American journal of reproductive immunology (New York, N.Y. : 1989) 66 (1): 40–50. doi:10.1111/j.1600-0897.2011.01003.x. PMID 21501279. 
  167. ^ Levy, JK (July 2011). "Contraceptive vaccines for the humane control of community cat populations.". American journal of reproductive immunology (New York, N.Y. : 1989) 66 (1): 63–70. doi:10.1111/j.1600-0897.2011.01005.x. PMID 21501281. 

Further reading

External links








Creative Commons License