Birth Control FAQ

Becca Meuninck eleven years ago, at the helm, searching for whales, Robson Bight, British Columbia.

Becca, now 21 years old, is an Environmental Anthropology student at the School of Natural Resources and Environment, University of Michigan, Ann Arbor.  She is an environmental activist, lecturer and former author of the sex education web site at the University.

"The greatest pressure on our planet's finite resources is unabated growth of human population."                                   -Herbal Odyssey

World View of Women's Health

As compared to the rest of the world women in the United States rank 15th in life expectancy (80 years) and only 22nd in healthy lifespan (73 years).  Our health system ranks 37th in the world.  The best Health Care system is in France where people are fully protected and health care cost per capita is $2369 as compared to the $4187 per annum cost of an American.        Source:  World Health Organization 2001

Ninety one percent (91%) of Italian women use contraception.        Source  WHO 2001

 Postnatal Sex Taboo  

The history of contraceptives is a long and complicated one. Archeological excavations all over the world have turned up evidence of archaic human practices of birth control. The most ancient and perhaps most beneficial form of contraception (albeit not foolproof) is prolonged breast feeding.  Prolonged breast feeding prevents more pregnancies than all other methods combined, especially in Third World countries (19).  Referred to by anthropologists as the Post Natal Sex Taboo, a new mother who continues to breast feed may be chemically blocked from fertilization. Continued suckling may block ovulation for up to four years(19). Of course, continued breast feeding is good for both the infant and the mother, strengthening their immune systems and providing ample amounts of essential fatty acids for the developing brain of the child. 

Wild Plants as Contraceptives

Nature’s pharmacopoeia provides a broad array of potent contraceptives. The powdered seeds of Abrus precatorius L. (Jequerity) were used as an oral contraceptive in Central Africa tribes. A single dose of about 200mg was said to be effective for thirteen menstrual cycles. Dioscorea composita (Hemsl.) and other species of wild yam were used by Indios American people for hundreds of years to block fertilization. Wild yam contains sapogenins such as diosgenin a starter material for steroidal compounds used in human health. These building blocks of human sex hormone led to the development of oral contraceptives.(1) Dieffenbachia sequine (Jacq.) or dumbcane were used to induce temporary sterility by people in Central America, South America and Cuba. Nazi experimenters tested the expressed juice form dumbcane to induce sterility in both female and male rats. It is reported that German soldiers were ordered to chew a leaf of dumbcane daily while visiting concubinary recreation camps.  Research continues on a male contraceptive.  Of interest is Gossypium barbadense (L.), the Sea Island Cotton (gossypol) plant used to produce cotton fiber for clothing. Chinese researches are attempting to isolate and use the physiologically active chemical, gossypol, from Sea Island Cotton as a male contraceptive.  In Mexico, the Caribbean and Central America the root decoction of G. barbadense is reportedly used to induce abortion (abortifacient).  Caution: Extractions from cotton seeds and cotton roots are toxic and may be fatal.  Micmac and Malecite people of America used Chelone glabra L. to prevent pregancy.

Margaret Sanger’s Struggle for Birth Control In America

Birth control has been and continues to be a heated topic of argument. In the United States the dispute is most poignant. Is it human nature to control the child bearing process? One of the pioneers for the advancement of birth control in America is Margaret Sanger. Sanger, a nurse, began publishing magazines, pamphlets, and books in 1912 (3). During this time period, the Comstock Law made it illegal to distribute material classified as obscene, including information concerning contraception. Sanger was thrown into jail in 1914 for breaking this law. After imprisonment, Sanger continued to publish information on birth control. On October 16, 1916, Sanger and her partner Ethel Byrne set up a birth control clinic in Brooklyn, NY. This clinic was the first established in the United States. Once again, Sanger was placed in jail (15). During her lifetime, Sanger never succumbed to legal discouragement or threats. She fought for women’s reproductive rights her entire life. Sanger and women like her deserve credit for the reproductive freedom American women have today.

The Comstock law was passed in 1873. However, it wasn’t until 1936 that the law was revised to exclude birth control literature as obscene material. After revision, information on contraception was distributed across the country. The battle did not end with the amendment of the Comstock law. In 1965, the Supreme Court ruled that married people had the right to practice contraception without government intervention. This ruling covered less than half of the population. In 1972, unmarried people were granted the same right (3).

The struggle for the acceptance of birth control was a difficult battle in America. Today, lack of knowledge about contraception is blamed for the alarming teenage pregnancy rate in America. In fact, the United States has one of the highest teenage pregnancy rates among developed nations in the world. Comparative studies of Canada, Wales, England, The Netherlands, France, Sweden, and the United States, suggest that the American teenage pregnancy problem may be related to poor sex education in school and the lack of availability of birth control services and supplies (3). The opposing view of certain religious organizations and conservatives holds that sex-ed and the distribution of contraceptives to school-age children promotes sexual activity, therefore increasing the number of teenage pregnancies (16).

Types of Birth Control

Natural Family Planning

Natural family planning is perhaps the least invasive and least controversial type of birth control. This method, also known as fertility awareness or rhythm method, depends on sexual abstinence during the most fertile phase of a woman’s menstrual cycle. This interval usually ranges from five days before ovulation to two days after ovulation. The basal body temperature method requires the woman to take her temperature at the same time each morning before getting out of bed. On the day of ovulation the body temperature typically raises one degree and stays raised for several days afterward. Another technique is the cervical mucus method. In this approach the woman monitors the consistency of her cervical mucus. Fertility is indicated by mucus that is clear, wet, elastic or sticky. The effectiveness rate of natural family planning is about 81%, depending on the technique used. Unlike most forms of birth control, natural family planning is accepted by many religions (3).

Surgical Types of Contraception

Several cultures around the world have practiced extreme methods of birth control, including castration and female circumcision. Castration is the removal of the testes; without these the male is infertile. Prior to the invention of less drastic sterilization methods such as vasectomies, castration was used for family planning. For a long time, castration was used as a means of eugenics. Until the early 20th century, guards to women’s chambers and chamberlains, in China and the Middle East were castrated to prohibit them from impregnating women (4).

Female circumcision, know as female genital mutilation, is a social custom practiced in many countries in and around Africa. Three different types of female genital mutilation exist. Sunna circumcision removes the tip of the clitoris, its covering called the prepuce, or both. A clitoridectomy is when the entire clitoris, prepuce, and labia are removed. The final type is infibulation. Infibulation begins with a clitoridectomy, followed by sewing the vulva together. This operation leaves only a small hole for urine and menstrual blood to pass. It is customary that the woman’s husband cuts open her vulva on their wedding night. The side effects from such a procedure are numerous and dangerous. Many female circumcisions are preformed in less than sterile conditions, thus increasing the chance of infection. Female genital mutilation usually leaves the woman devoid of sexual pleasure, therefore decreasing the desire for premarital and adulterous sex. In the case of infibulation, the woman is unable to have intercourse unless her vulva is cut open. Unfortunately, 6,000 young girls are submitted to this barbaric ritual every day (9).

Conventional surgical methods of birth control are much less invasive compared to castration and female circumcision. Recent studies have shown that surgical sterilization is the most popular contraceptive, ranking ahead of both the condom and the birth control pill (17). Instead of removing the testes through castration men opt for a vasectomy as a form of surgical sterilization. The vas deferens are the tubes in the male body that carry the sperm out of the testes. These tubes are cut and tied off during a vasectomy. This prevents the sperm from being ejaculated with the other fluids in semen (4).

Tubal ligation is the surgical sterilization technique preformed on a woman. This method prevents the eggs from moving through the fallopian tubes to the uterus. It does so by cutting, blocking, or binding the fallopian tubes. If the egg does not travel through the fallopian tubes it will not become fertilized or implanted in the uterus. Surgical sterilization methods should be considered permanent, even though some operations have been successfully reversed (4). Tubal ligations are over 13% more popular than vasectomies. However, the popularity of both type of sterilization has been on the rise for 25 years. One possible reason for this is that most insurance companies cover these types of surgical sterilizations rather than reversible types of contraception (17).

Sterilization Poverty and Racial Prejudice

During the Sexual Revolution surgical sterilization was abused. Discrimination against minorities and those dependant on Welfare, influenced the government to sterilize women who were in need of federal assistance. In order to get the money and benefits they depended on, women gave up their right to sexual autonomy. In the early seventies, two young women of color were forcibly sterilized at a government funded clinic. Many other instances of such abuse took place in Aiken, South Carolina. The only physician in the town who delivered the children of Welfare mothers, required those with more than two children to agree to sterilization. During the Sexual Revolution it is estimated that between 100,000 to 200,000 women of color were forcibly sterilized by the government per year. The Sexual Revolution was not a time of sexual advancement for the victims of this abuse. In a time where wealthy and middle class Caucasian women were advancing, poor women of color were falling through the cracks (7).

The Intrauterine Device

The modern IUD was not conceived until the 20th century. However, the concept was developed long before that by ancient Turks and Arabs. To prevent their camels from getting pregnant during treks through the desert, nomads inserted smooth pebbles into the camels uterus (4). This method seems to have only been used for animals, although it is possible that desperate women may have emulated this process to avoid conception. If this method was reliable, women who wished to be infertile without their husbands consent may have tried it.

Like its predecessor, the modern IUD is inserted into the uterus. IUDs are small plastic devices that may contain a progesterone insert, or partial copper covering. The IUD works by either thickening the lining of the uterus so that a fertilized egg cannot become implanted or by not allowing the sperm to fertilize the egg in the first place. The IUD was invented during the American Sexual Revolution. This device allowed women of the time more control of there reproductive system. This new sexual freedom fueled the fires for other types of female liberation. Unfortunately, the IUD did not turn out to be the bed of roses as it was originally portrayed. New sexual freedom also meant new sexual pressure. Men expected women to take advantage of their new infertility by engaging in sexual activity (13). The Dalkon Shield, one of the first IUDs, was pulled off the market in 1975 because it increased the rates of pelvic infection and sterility. The Dalkon Shield had a multi strand filament which bacteria in the vagina used to climb up into the uterus. Today, IUDs have a single strand tail and are much smaller to insure that they fit easily into the uterus (18).

Heat Method of Contraception

In 1946, Dr. M. Voegeli reported that wet heat applied to the testes would induce temporary infertility in males. Dr. Voegeli tested his method for more than ten years on nine male volunteers. The men were temporarily sterilized by sitting in a shallow bath of 116 degrees Fahrenheit for forty-five minutes daily for three weeks. The result of this treatment is six months sterility. After a six month period without the treatment the male was once again able to sire children. This method was taught by Voegeli to Indian men during the famines between 1930 and 1950 in India. No substantial side effects were reported by the doctor throughout the duration of that period (12).

Barrier Methods

Condoms have had a vibrant history. Colorful penis coverings were used by the Egyptians. However, it is unclear whether their function was contraceptive or simply decorative. In 16th century Italy, anatomist, Fallopius recounted linen sheaths that protected the users from contracting syphilis. Casanova referred to condoms as "English riding coats" (4). These "riding coats," were developed out of sheep intestines by a physician in the court of King Charles II of England. In 1844 the vulcanization of rubber was the turning point for prophylactics. Vulcanized rubber condoms protected not only against pregnancy, but STDs as well. In light of this, condoms became a widely used contraceptive (4).

Today there are many different options for those who rely on condoms as contraception. In 1994 the female condom was developed (4). The female condom is made out a elongated polyurethane sheath with two rings. The smaller inside ring is used to insert the female condom into the vagina; here it serves as a receptacle for semen. The large outer ring lies outside of the body and protects the vagina and perineum from coming in contact with the penis or scrotum. People who are allergic to latex can use the female condom since it is made of polyurethane. Female condoms are packaged with lubrication, however, many people add more inside so the penis moves in and out with ease. Those who frequently engage in sexual activity may not find the female condom to be cost effective at a price of $2.50 each. On the other hand what is too much to pay for birth control method with a 95% success rate, that also protects against STDs?

Another contraceptive was created following the vulcanization of rubber. A German physician invented the modern diaphragm in 1838. A diaphragm is a shallow molded rubber cup that fits into the vagina over the cervix. It is held in place by the vaginal muscles. Like women, the diaphragm comes in many different sizes. In order to insure a good fit one must have a physician examine and measure the vagina. The diaphragm is designed to be used along with a spermicide so that if any semen seeps into the cervix it will contain only dead sperm. With typical use it is approximately 83% effective. As long as the users are not allergic to rubber or spermicide, there are very few side effects (4).

Twenty-two years after the discovery of the diaphragm, the cervical cap was developed. The cervical cap struggled for a long time to gain acceptance in the United States. It was not until the1980s that the FDA approved it. Wide spread use of the cervical cap in Europe was quite contrary to the lack to consumption of the product in America. Like the diaphragm, the cervical cap is to be used with spermicide. A cervical cap is much smaller then a diaphragm, and is held directly in the cervix by suction. The cervical cap must also be fitted by a health care professional (4).

Spermicides

Ancient Egyptians realized the importance of contraception. One of the first written records of contraception is found in the Ebers Medical Papyrus. This medical guide was written by the Egyptians between 1550 and 1500 BC. It details the preparation of a tampon immersed in an herbal mixture of acacia, dates, colocynth, and honey, that supposedly prevented the sperm from fertilizing the egg. When fermented this mixture produces lactic acid. Modern research shows that lactic acid is a spermicide. Another option for the women of ancient Egypt was a vaginal suppository of honey and dried crocodile dung to prevent pregnancy (4).

The most commonly used spermicide on today’s market is nonoxynol-9. This is the type of spermicide used in vaginal lubricants like KY-Jelly Plus, and on many brands of spermicidal condoms. These lubricants can be used alone, or for added protection with a condom, diaphragm, or cervical cap. Spermicide comes in many different forms. There are sperm-killing jellies, creams, foams, films, suppositories, and tablets. Spermicide is easy to obtain, because it can be purchased without a prescription. Resent studies showed that certain STD organisms are killed by spermicide. They are effective about 70% of the time if inserted into the vagina, and as long as the woman does not douche for six to eight hours after intercourse (3).

Hormonal Methods of Birth Control: The Pill

From ancient times until the advent of the modern birth control pill, women consumed many substances to prevent pregnancy or induce miscarriage. These folk remedies often proved to be dangerous and even fatal. For example, the seeds of Queen Anne’s lace, pennyroyal and giant fennel were all poisons used for contraception (4). Toxic chemicals found in some wild yams have been used by people living in the tropics as a method of contraception (Heiser 151). It is important to remember that these former methods of contraception have not been approved by modern practitioners or the FDA, and should not be self-prescribed.

During the Sexual Revolution of the 1960s and 70s researchers developed a very reliable form of hormonal contraception. This new drug was a mixture of synthetic estrogen and progesterone in the form of a pill. Several years later a progesterone only pill was adapted. The birth control pill was given the title "The Pill," suggesting that it was some sort of God. In a sense it was a God to the millions of women seeking sexual freedom. "The Pill" made it possible for women to be sexually active without the worries of unplanned pregnancy. The new "swinging singles" in the sexual revolution enjoyed the freedom it gave them from conventional methods of birth control like condoms. No longer did women have to rely on their male partner to remember and agree to use a condom.

The media during the Sexual Revolution portrayed the glamour of the single life. Sexual freedom and promiscuity were no longer look down upon. "The Pill" got rid of the dangers of pregnancy that young women from previous generations faced. Unfortunately, this brought on new sexual pressure. Women during the Sexual Revolution were beginning to lose the right to say "no" that the 19th century feminists struggled to obtain. (7).

After the birth control pill was developed there was a drop in prophylactic use. This created a rise in the prevalence of STDs. Health organizations alerted the public that "the pill" did not protect against STDs. It was too late for many young people. STDs claimed the fertility and sexual health of many sexually active people. Today, those who contracted STDs struggle to conceive children and maintain their reproductive health. To avoid repeating their mistakes sexually active youth must be made aware of the dangers of STDs and the safer sex options available.

The rise in sexual activity brought on by reliable contraceptives, changed the face of the American university. Students around the country campaigned to end visiting hours in the dorms. To appease their students some school instituted coed dorms. This was not enough for some students, girls began to break the rules by moving off campus with their boyfriends. University Health Services were criticized for not distributing oral contraceptive to unmarried students. The older generation soon realized that little could be done to stop this new sexual freedom (7).

New methods of contraception changed the lives of married couples as well. During the mid-1960s, three out of four married couples relied on "the pill," the IUD, or sterilization. Couple began having children later in life ( 6). One cause of this was the fact that more women were entering the work force. Contraceptives, like "the pill," made it possible for women to plan when they wanted children and how many they would have. As a result, there was a drastic decrease in population growth from the 1950s to the1970s (6).

Nearly 30 years ago, an injectable contraceptive called Depo-Provera was introduced. This contraceptive, given every three months, is 99.7% effective in preventing pregnancy. Depo-Provera is composed of a synthetic hormone, medroxyprogesterone acetate, which is a derivative of the natural female hormone progesterone. The shot of Depo-Provera is given in the buttock or upper arm. Since it is only administered four times a year Depo-Provera is very convenient. The shot causes the ovaries to go into a resting state. Sometimes a woman will cease to menstruate while using this contraceptive. The average cost of it is between $30 and $65 every three months. Depo-Provera must be given by a health care professional. It is available at family planning clinics like Planned Parenthood, and through private practices. Certain side effects may be experienced while on Depo-Provera. These may include weight gain, irregular menstrual bleeding, and cession of menstruation (8).

Following in the footsteps of Depo-Provera was Norplant, a long term yet reversible contraceptive. Norplant became commercially available in 1991 after it was approved by the FDA. Six match-sized capsules are inserted into the woman’s arm, over a five year period these capsules release small amounts of progestin. Norplant is an extremely effective contraceptive with a failure rate of less than one percent. The side effects of Norplant are similar to those of DepoProvera or the birth control pill. Women using Norplant can have it removed by their doctor if they wish to get pregnant before the five year time period is over. For those seeking long term contraception that is reversible Norplant is ideal. Unlike tubal ligations which are only sometimes reversible, a woman on Norplant can conceive almost as soon as the capsules are removed. If the woman does not wish to undergo surgery, she can wait for five years until the capsules become ineffective (14).

Unfortunately, Norplant has been abused by our government. Since it is easy to monitor and may not be removed by anyone other than a physician the government has tried to use it as a type of punishment. In several states female child abusers were given the choice to serve jail time or have Norplant inserted. Legislators around the nation propose bills that would offer financial benefits for women on welfare who used Norplant, force women receiving public assistance to use it or lose their benefits, or force those women convicted of child abuse or drug use during pregnancy to have Norplant implanted. These bills are against the fundamental rights given in the constitution to reproductive autonomy, to decide when to conceive a child, and to refuse intrusive medical procedures. Although the incentive programs for welfare recipients were voluntary, they left little choice for women desperate to feed, clothe, and provide shelter for their children. Many of these women would rather give up their constitutional rights than have their families suffer in poverty. For these reasons it is important that our government does not try to regulate the sexual freedom of its citizens (14).

The newest form of birth control to hit the market is Emergency Contraception (EC). In 1997 the FDA approved several types of oral contraceptive to be used as emergency contraception. Emergency contraception is essentially a large dose of birth control pills, and works as such. When taken within 72 hours of unprotected sex, EC thickens the lining of the uterus or disrupts ovulation, thus preventing pregnancy. Studies have shown that EC is very safe with only minor side effects. The most common side effects of EC are nausea, vomiting, and break through bleeding. Recently an EC kit has been developed by the Gynétics company. This kit, Preven, is meant to be prescribed before it is needed. As soon as a woman has unprotected sex, she can use Preven. Have it prescribed before hand eliminates the hassle of an emergency doctors appointment (11).

Emergency contraception has become one of the most controversial methods of birth control on the market. Many people confuse emergency contraception with abortion pills like RU 486. Abortifacients, like RU 486, remove a fertilized egg from the lining of the uterus. When the fertilized egg is removed from the lining a chemical abortion has taken place. Emergency contraception is not a form of chemical abortion. EC is used in the interval between intercourse and implantation. A woman is not considered pregnant until implantation occurs, since EC does not remove an implanted egg, it cannot terminate a pregnancy. In fact, EC works like many other hormonal contraceptives by not allowing the egg to implant in the first place. There are several options out there for women seeking emergency contraception. EC pills can be used within 72 hours of unprotected sex. If the 72 hour deadline is surpassed, the Copper-T IUD works five days after fertilization or ovulation, which ever comes last. Many doctors and health clinicians prescribe emergency contraception to their patients. In Washington state, Seattle pharmacists have been given permission to distribute EC without a prescription. Those who cannot find a physician or pharmacist willing to administer emergency contraception call the EC hot line at 1-888-NOT-2-LATE. EC is a testament to how far contraception has truly come (11).

Skeptics believe that EC will be used as a primary form of contraception. A recent study by the New England Journal of Medicine found this to be false. Women who had an emergency contraception kit, like Preven, in their home were only likely to use it once. They did not abuse the drug and use it as their primary method of birth control. The high cost and unpleasant side effects of EC are several reasons why a woman would only choose to use it as a back up method of contraception.

Where does the future of contraception lie? Many say in the hands or shall I say glands of men. Scientists are currently testing methods of male hormonal contraception. The vessel for this contraception may come in injectable or pill form (12). One thing is for sure, contraception will remain with us as long as sex does. Improvements will be made and the old standbys will be honored as long as they are effective. The struggle for acceptance of contraception is still not over. In 1998, we still fight for methods like EC to gain recognition. On the other hand, birth control has come a long way. It has moved from the tangles of religious and legal prohibition and into the top drawer of the American night stand.

To discover more herbs for health see Natural Health with Medicinal Herbs and Healing Foods  and  Our herb data bases.

Works Cited:

(1). Duke, James A, Handbook of Medicinal Herbs, CRC Press. PP.3-4. 1988.

    (2). Farnsworth, Norman, Problems and prospects of discovering new drugs from higher plants by pharmacological screening, New Natural Produces and Plant Drugs with Pharmacological Biological or Therapeutical Activity, Wagnar, H. and Wolff.P., Eds., Springer-Verlag, N.Y. 1977.

(3). Birth Control. Online. Internet. 20 Oct. 1998. Available http://www.betterhealth.com/healthwise/Chapter16/HW_Chapter16b.html.(4).

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(6). D’Emilio, John and Estelle Freedman. "The Sexualized Society." Intimate Matters: A History of Sexuality in America. New York. Harper & Rowe, 1988: 331-38.

(7). D’Emilio, John and Estelle Freedman. "Sexual Revolutions." Intimate Matters: A History of Sexuality in America. New York. Harper & Rowe, 1988: 307-15.

(8). DepoProvera. Online. Internet. 16 Nov. 1998. Available http://www.epigee.org/guide/barrier.html.

(9). Female Genital Mutilation. Online. Internet. 20 Nov. 1998. Available tolerance.org/fem_cirm.htm.

(10). Heiser, Charles B. Seed to Civilization. San Francisco: W.H. Freeman and Company, 1973: 151.

(11). Ince, Susan. "Pregnancy."Glamour Sept. 1998: 312-334.

(12). Lissner, A. Frontiers in Nonhormonal Male Contraception: A Call for Research. Online. Internet. Available

(13). Meuninck, Jill. Personal Interview. 24 Sept. 1998.

(14). Norplant: A New Contraceptive with Potential For Abuse. Online. Internet. 16 Nov. 1998. Available http://www.choice.org/2.norplant.1.html.

(15). Sanger, Margaret. "Clinics, Courts and Jails." The Birth Control Review. 2.3 Apr.1917: 3-4.

(16). Weeks, Jeffrey. "Sexual Values Revisited." New Sexual Agendas. Lynne Segal, ed., New York. New York University Press, 1997: 77.

(17). "Who’s Getting Sterilized?" Glamour Nov. 1998: 72.

(18). Young, Stephanie. "11 Top Birth Control Blunders..." Glamour Nov. 1998: 60.

(19). Jones, Martin, et. al: The Cambridge Encyclopedia of Human Evolution. Cambridge University Press. Pp.425-426. 1994.