World Population Awareness

A century ago, women feared dying in childbirth and yet could do little to control conception. The Comstock laws clamped down on freedom of information by making it a crime to send "obscene" material through the mail, including birth control information and devices. In 1916, Margaret Sanger was arrested for distributing diaphragms. In the 10 days her Brooklyn clinic was open, she fitted 488 women with diaphragms, an indication of women's unmet need to control pregnancy. Legal abortion wasn't even on the agenda.

A Contraceptive's Risks (According to Betsy Hartmann)

We need to combat this misrepresentation by writing LTEs to the New York times.

Dr. Betsy Hartman, director of the population and development program at Hampshire College, wrote the following Letter to the Editor (excerpted) regarding the article Contraceptive Said to Double Risks of H.I.V. (see the link in the headline above).

She said:

"There is a larger context behind the recent finding that the injectable contraceptive Depo-Provera may increase the risk of women and their male partners becoming infected with H.I.V. For over a decade other studies have warned about this connection."

"As a matter of precaution, family planning agencies should have started phasing out injectables, especially in communities at high risk of H.I.V., and encouraged other contraceptive methods. Instead, injectables are vigorously promoted in Africa because they are viewed as a cheap, effective way to reduce population growth."

"Depo-Provera has other serious risks and adverse effects, including loss of bone density in young women, significant weight gain and increased depression. In the United States it is mainly targeted at low-income women and women of color."

~~~ Now, Lets look at a more complete picture:

The most popular contraceptive for women in eastern and southern Africa, a hormone shot given every three months, appears to double the risk the women will become infected with H.I.V., according to a large study published Monday. And when it is used by H.I.V.-positive women, their male partners are twice as likely to become infected than if the women had used no contraception.

The findings potentially present an alarming quandary for women in Africa. Hundreds of thousands of them suffer injuries, bleeding, infections and even death in childbirth from unintended pregnancies. Finding affordable and convenient contraceptives is a pressing goal for international health authorities.

But many countries where pregnancy rates are highest are also ravaged by H.I.V., the virus that causes AIDS. So the evidence suggesting that the injectable contraceptive has biological properties that may make women and men more vulnerable to H.I.V. infection is particularly troubling.

Injectable hormones are very popular. About 12 million women between the ages of 15 and 49 in sub-Saharan Africa, roughly 6 percent of all women in that age group, use them. In the United States, it is 1.2 million, or 3 percent of women using contraception. While the study involved only African women, scientists said biological effects would probably be the same for all women. But they emphasized that concern was greatest in Africa because the risk of H.I.V. transmission from heterosexual sex was so much higher there than elsewhere.

"The best contraception today is injectable hormonal contraception because you don't need a doctor, it's long-lasting, it enables women to control timing and spacing of birth without a lot of fuss and travel," said Isobel Coleman, director of the women and foreign policy program at the Council on Foreign Relations. "If it is now proven that these contraceptions are helping spread the AIDS epidemic, we have a major health crisis on our hands."

Mary Lyn Gaffield, an epidemiologist in the World Health Organization's department of reproductive health and research said "We want to make sure that we warn when there is a real need to warn, but at the same time we don't want to come up with a hasty judgment that would have far-reaching severe consequences for the sexual and reproductive health of women," she said. “This is a very difficult dilemma."

The researchers recorded condom use, essentially excluding the possibility that increased infection occurred because couples using contraceptives were less likely to use condoms.

The researchers also found that oral contraceptives appeared to increase risk of H.I.V. infection and transmission, but the number of pill users in the study was too small to be considered statistically significant, the authors said.

Previous research on the pill has been more mixed than with injectables, which could have a greater impact because they involve a strong dose meant to last for three months.

In another troubling finding, results from the same study, published separately, showed that pregnancy also doubled the risk of women's contracting H.l.V. and of infected women's transmitting it to men. That may partly be due to increased unprotected sex, but could also relate to hormones, researchers said.

But there are no simple solutions, the authors acknowledge. Any warning against such a popular contraceptive method may not only increase complications from pregnancy but increase H.I.V. transmission, too, since pregnancy itself may raise a woman's risk of H.I.V. infection.

First, the researchers and others say, greater emphasis should be placed on condom use along with hormonal methods.

Dr. Ludo Lavreys, an epidemiologist who led one of the first studies to link injectable contraceptives to increased H.I.V. risk, said intrauterine devices, implants and other methods should be explored and expanded. “Before you stop" recommending injectables, he said, “you have to offer them something else."

Long-term Effectiveness of New Family Planning Method Shown in Study

The Standard Days Method® a simple-to-use, fertility-awareness based method of family planning was found in 2002 to be more than 95% effective at avoiding pregnancy. Recently a multi-country study of 1659 women found that this effectiveness continued throughout the second and third years of use. This effectiveness rate is higher than other use-directed methods such as diaphragm or condom

The Standard Days Method identifies the 12-day "fertile window" of a woman's menstrual cycle. These 12 days take into account the life span of the woman's egg (about 24 hours) and the viable life of sperm (about five days) as well as the variation in the actual timing of ovulation from one cycle to the next. It does not involve medications or devices that might affect womens health. It was developed at Georgetown University Medical Center. Women use these methods for health or religious or cultural reasons.

James N. Gribble, Sc.D. of the Population Reference Bureau and senior author of the 2011 paper, says: "Family planning enables women to have the desired number of children and to space and time births. Almost all the 2011 study participants had children, often with at least one child younger than two years old, before they began to use the Standard Days Method," he says. "Yet few of the study participants had unplanned pregnancy over the three-year period of the study due to the method's very high effectiveness."

Women who follow the Standard Days Method often use CycleBeads®, a string of 32 color-coded beads with each bead representing a day of the menstrual cycle, to know on which days pregnancy is likely or unlikely. Beginning with the red bead, which represents the first day of her menstrual period, the woman moves a small rubber ring one bead each day. The brown beads are the days when pregnancy is very unlikely, and the glow-in-the dark white beads (beads 8-19) represent her fertile days.

Funding for the new study was provided by the Institute for Reproductive Health and a grant from the United States Agency for International Development (USAID).

With support from USAID, more than three million women in Asia, Africa, South and Central America have been exposed to the fertility awareness-based family planning methods developed by Georgetown researchers.

U.K.: Contraception: Busting the Myths; We Have More Birth Control Options Than Ever but We've Never Been So Confused

Three out of four women are using some form of contraception when they get pregnant. The Pill has a failure rate of 8% due to incorrect use.

Even though the Pill is widely held to be one of the leading inventions of the 20th century, giving women power over their bodies, birth control in the UK remains hit and miss - with 600 abortions every day and more than 40% of pregnancies unplanned.

A YouGov survey shows that 50% of women spend less than half an hour choosing birth control, with decisions based on half-truths and gossip.

For example, many women believe the Pill is the most effective contraceptive. It has a failure rate of only 0.3% if taken correctly, but one in 12 women forget to take up to four pills every month. Women who work shifts regularly or cross time-zones, such as air stewards for instance, will have problems taking the Pill on time," says the Family Planning Association's information manager, Lynn Hearton.

Another myth is that condoms are useful only to prevent STDs in casual sex, but they are very useful for couples in and out of long-term relationships, says Hearton: "Used properly, they are very effective with no side effects." The failure rate for perfect use is 2%, but can be as much as 15% in typical use in one-night stands. "Anything can go wrong in the heat of the moment," says Hearton. What to do: Practise condom negotiation with the help of the International Planned Parenthood Federation's website: ind.pn/condomnegotiation.

Many think that long-acting reversible contraception (LARCs) is difficult to remove and can cause infertility, but they are, in fact, very effective, easy to remove and do not affect fertility. It is this myth that accounts for the low usage of LARCs, with only 8% of U.K. women using them, including implants, injections, the copper coil (IUD) and hormonal coil (IUS), In Scandinavia and much of Europe has a much higher rate of LARCs usage, because of greater efforts to keep women informed.

Many women do not know that different contraceptive methods can bring major health benefits. Women with heavy periods or endometriosis can benefit from the hormonal coil, which makes periods lighter, shorter or stop. The combined Pill can help alleviate heavy, painful periods as well as alleviate PMS. Acne, hirsutism or polycystic ovary syndrome (PCOS) can be helped with the Combined Pill containing anti-androgenic progestogen. Yasmin is the best product for mild symptoms, while Dianette is suitable for the more severe disorders. There are claims that the contraceptive ring (Nuva ring self-inserted in the vagina monthly), improves blood flow to genital areas, thereby boosting libido. A handful of studies also suggest that contraceptive Pills with lower levels of progestogen boost mood and prevent vaginal dryness.

Many women feel that, once you've finished your family, sterilization is best,. However, sterilization is rarely reversible. It may make more sense to use a long-acting contraceptive that can be removed.

Women should also know that, as well as the emergency Pill, the copper intrauterine device (IUD) can also be used as emergency contraception as long it is fitted up to five days (120 hours) after unprotected sex.

50% of women make an appointment to see the GP and simply ask for the Pill, usually ending up with the cheapest possible Pill,. Dr Tina Peers, consultant in contraception and sexual health at Surrey PCT said, "Unfortunately, up to 60% of women discontinue the Pill within a year, often because of unwanted symptoms." It is better to spend time getting informed before you see an expert.

FPA has an interactive page on contraception at www.fpa.org.uk/mycontraceptiontool

Female Condoms Slowly Gaining Popularity

The UN Population Fund (UNFPA) reports "For the fourth consecutive year, access to female condoms has increased dramatically, reaching a record number of 50 million... in 2009."

The female condom is a 17cm-long polyurethane sheath with a flexible ring at each end. It provides about the same protection from sexually transmitted infections - including HIV - and unwanted pregnancy as the male condom, but unlike the male condom, can be used with oil- and water-based lubricants without the risk of breakage.

Governments and technical agencies have worked in partnership on the Female Condom Initiative launched in 2005 in 24 countries to ensure that female condom programming was integral to national AIDS policies and reproductive health programs.

The female condom has turned out to be a tool for women's empowerment, enabling women and adolescent girls to take the initiative to protect their own and their partners' health.

In Zimbabwe, billboards, radio spots and TV adverts helped boost female condom distribution by the public sector from about 400,000 in 2005 to more than two million in 2008, while the sales of female condoms went up from 900,000 in 2005 to more than three million in 2008. Hairdressers also helped market the female condom.

"Often the hairdresser will work from a chair in her back yard. Such improvised salons stay open at all hours, so women can have their hair done - and discuss personal matters - in privacy," the authors reported.

This approach was also used successfully in Guyana and Malawi.

Married women in Ethiopia, learned about the female condom at coffee ceremonies, an age-old social custom. Because condoms - perceived to be used by promiscuous people and sex workers - are highly stigmatised in Ethiopian society, programmers highlighted the family planning benefits of the female condom.

In Myanmar, efforts targeted high-risk female sex workers and men who have sex with men.

Male condoms still have a higher popularity rating than the female condom. In Kenya women have shown little interest. Sex workers show a high demand, but overall demand is low due to general unavailability and lack of information.

"Except for female sex workers and highly empowered women, most other women do not have the capacity to demand safe sex... the majority of women depend on their sexual partners to protect them."

U.S.: IUDs, Implants Advocated for Birth Control

The American College of Obstetricians and Gynecologists (ACOG) reports that IUDs (intrauterine devices) and contraceptive skin implants are the most effective type of reversible contraceptive, and should be offered as options to most women seeking birth control.

IUDs, or intrauterine devices, are inserted into the uterus, where they release small amounts of either copper or the hormone progestin to prevent pregnancy. The contraceptive skin implant, about the size of a matchstick, is inserted under the skin of the arm, where it releases controlled amounts of progestin.

In the U.S., birth control pills and condoms are more popular than IUDs and implants, with IUDs used by only 5.5% of women using contraceptives - up from 1.3% in 2002 -, and implants, approved in 2006, not yet being tracked.

Year's Supply of Birth Control: Limits on Birth Control Pills May Be Costly

A study found that only 1% of lower-income California women who got a year's supply of the Pill had unplanned pregnancies compared to 3% of those women who got only enough packages for one or three months at a time.

Currently private and public health insurance plans in the U.S. generally limit how many months' worth of birth control pills can be prescribed at once.

Morning-After Pill May Be OK for Non-Emergency Use

A new report published in Obstetrics and Gynecology say the morning-after pill may be safe and effective as a regular birth control method, comparing favorably with condoms and spermicides in terms of reported rates of unwanted pregnancies. However, it is only approved as an emergency backup after unprotected sex, and the government discourages using it as regular contraception.

Women who have sex infrequently, or for some other reason, may not want to use a regular birth control method and would prefer to use the morning-after pill just before or after the infrequent sex.

The morning-after pill is not as effective as methods women use on a longer basis, such as patches or regular birth control pills, but women using pill around the time they had sex have an estimated 5% chance of getting pregnant over one year, compared to 16% of women whose partner used a condom.

In the U.S., the morning-after pill costs between $10 and $70 and is available over the counter for people over 17. Most morning-after pills (brands include Plan B One-Step and Next Choice) are made of levonorgestrel, a synthetic hormone.

A Guide to Contraception

Study: Home-Administered Misoprostol Safe Abortion Option for Women Up to 63 Days Pregnant

Swedish researchers conclude that taking misoprostol at home as part of a medical abortion regimen is a safe option for women who are 50 to 63 days pregnant. In the U.S., women have been permitted to take physician- prescribed misoprostol at home since 2000.

Mifepristone -- the first drug in the medical abortion regimen, which is taken three to four days prior to misoprostol -- is administered at a clinic, physician's office or hospital. Most European countries require that women take both drugs in a clinic, doctor's office or hospital.

Among women who were fewer than 50 days pregnant, 199 experienced complete abortions, while 186 of the women who were between 50 and 63 days pregnant experienced complete abortions. Ten women required surgery. About six in 10 women needed extra pain medication. rw

U.S.: HHS Moves to Define Contraception as Abortion

The Department of Health and Human Services released a proposal that allows any federal grant recipient to obstruct a woman's access to contraception. It is attempting to redefine the birth control, which 40% of Americans use, as abortion. This would protect extremists. The proposed laws prohibit federal grant recipients from requiring employees to help provide or refer for abortion services.

Abortion is the termination of a pregnancy and there are two views on when a pregnancy begins. Some consider it begins at the fertilization of the egg by the sperm, while others consider it to begin when the embryo implants in the lining of the uterus. About 49% of Americans believe that human life begins at conception and think that any action that destroys human life after conception is abortion. Those who believe pregnancy begins at implantation believe abortion only includes the destruction of a human being after it has implanted.

Some medical authorities have defined the term "established pregnancy" as occurring after implantation. Others present different definitions. For example, pregnancy is "the state of a female after conception and until the termination of the gestation." or "the condition of having a developing embryo or fetus in the body, after union of an oocyte and spermatozoon".

Up until now, the federal government followed the definition of pregnancy as: pregnancy begins at implantation. It now claims that pregnancy begins at some biologically unknowable moment and there would be no way for a woman to prove she's not pregnant. Thus, any woman could be denied contraception.

There is no scientific evidence that hormonal methods of birth control can prevent a fertilized egg from implanting in the womb. This argument is the basis upon which the religious right hopes to include the 40% of the birth control methods Americans use, under "abortion." In 1999, the physicians released an open letter stating: "Some special interest groups have claimed that some methods of contraception may have an abortifacient effect. It is speculation, and if a family, decides to use this modality, we are confident that they are not using an abortifacient."

The absence of evidence does not slow anti-abortion attempts to classify hormonal contraception as abortion. Because the statutes seek, in part, to protect the conscience of the individual or institution within the bounds of reason. Both definitions of pregnancy are reasonable. The Department proposes to allow individuals and institutions to adhere to their own views. So HHS proposes that anyone can enforce his or her own definition of abortion "within the bounds of reason." This new rule establishes a legal precedent that may be used as a basis for banning the most popular forms of birth control with abortion. rw

Scientists Will Gather to Discuss Safety of Abortion Pill

Worried about a bacterial infection that led to the deaths of at least five women who took the abortion pill RU-486, scientists from the FDA, the Centers for Disease Control and Prevention, and the National Institutes of Health will consider whether the means of administering abortion drugs make pregnant women more susceptible to the bacterium Clostridium sordellii and whether the deaths signal the emergence of a more virulent strain of the bacterium. The five deaths were from infection by Clostridium sordellii, which can induce toxic shock. The cause of a sixth death has not been announced. Clostridium sordellii infections are rare, but pregnancy appears to increase the risks. Abortion experts have been at a loss to explain why four of the deaths occurred in California. Tests had found no evidence of contamination of the pills .

Another theory concerned the role a dry climate might play. Some experts believe that pregnant women who take RU-486 with another drug, misoprostol, are more vulnerable to infection. The pill causes uterine contractions that expel the dead fetus.

The F.D.A. in 2000 approved a protocol that requires women to take misoprostol orally. But abortion providers have instructed women to insert misoprostol vaginally and some scientists say the vaginal insertion may introduce bacteria.

In 2004, the F.D.A. put strong warnings regarding the risks of infection on RU-486 labels but is not considering further restrictions.

The National Abortion Federation's insurer insisted that its clinics use the F.D.A. protocol when providing abortion drugs. In the US some abortion doctors have decided against using RU-486 altogether.

Until March, Planned Parenthood, continued to instruct its doctors to give misoprostol vaginally, but with the sixth death, the organization now uses an oral protocol. The risk of death with pill-based abortions now appears to be about 10 times that of surgical abortions.

RU-486 might make women more susceptible to Clostridium sordellii because the drug may inhibit mechanisms that moderate immunity.

The oral administration of misoprostol is more common in Europe, but vaginal use has been growing.

The British Pregnancy Advisory Service, which provides 25% of all abortions in Britain, said her agency relied on vaginal drug insertion.

Clinics in Sweden and Hong Kong do the same, and vaginal use is growing in France. rw

U.S.: After 2 More Deaths, Planned Parenthood Alters Method for Abortion Pill

Planned Parenthood announced that it would change the way it gives RU-486, or Mifeprex. The F.D.A. has received reports that six women in the US died after taking the pills, and a seventh died in Canada. The previous four resulted from infections with Clostridium sordellii. One of the two recent deaths occurred within days of the victim's undergoing a pill-based abortion, while the other woman died within five weeks. Mifeprex has been used in more than 560,000 medical abortions in the US and more than 1.5 million in Europe. The risks of death after using the pill are similar to the risks after surgical abortions or childbirth. When Mifeprex was approved in 2000, the standard regimen was to give the drug in a doctor's office followed two days later by an oral dose of a different drug, misoprostol, also in a doctor's office. Women expelled the fetus over the following days or weeks in a process that mimicked a miscarriage. The procedure must begin within 49 days of conception. Soon after Mifeprex's approval, most doctors instructed women to insert misoprostol vaginally at home two to three days after taking Mifeprex. But this regimen was not approved by the drug agency. As reports of deaths trickled into the F.D.A., officials issued warnings that doctors should stick to the approved regimen but until Friday, Planned Parenthood had rejected those warnings. Patients would still be asked to take the second drug orally at home. The drug agency said it was "investigating all the circumstances associated with these cases." The agency repeated that women who undergo pill-based abortions should be vigilant for signs of nausea, vomiting or diarrhea and weakness with or without abdominal pain and they should be given antibiotics. Doctors may not associate a death with a pill-based abortion, especially if the death occurs weeks later. The risk of infections could be eliminated if abortion patients were given antibiotics as a preventative. But officials say that the risk of infection from Clostridium sordellii is so slight that it does not merit such a precaution. rw

Australia: Evidence Shows RU486 May Be Safer Than Surgical Abortion

The Royal Australian College of Obstetricians and Gynaecologists is backing an effective ban on the pill RU486 to be lifted. The drug should be made available to Australian women. The evidence suggests it may be safer than surgical termination of pregnancy. John Howard signalled he would offer Liberal MPs a conscience vote on the issue. In Australia, women wanting to use RU486 have to apply through their doctor for government approval. The Australian Democrats plan to move an amendment which would remove Mr Abbott's powers to grant approval for the drug's use. Mr Abbott has cited health department advice which warned it could be dangerous for women in rural and remote areas because its use requires medical supervision and access to emergency care. But that advice has been discredited by experts. The first decision a woman makes is whether or not she wishes to have a termination of pregnancy and why she would prefer a surgical or a medical termination. Practitioners would have good evidence so they could discuss that with the woman so she can make an informed decision. rw

U.S.: More Health Professionals Balk at Giving Birth Control

The overwhelming number of Americans support birth control and use it. However, A small percentage of physicians, nurses and pharmacists have steered clear of supplying contraceptives because of religious convictions. A pharmacist in Cincinnati refuses to fill birth-control prescriptions because she considers abortion a sin and a termination of human life. Some doctors contend that millions of American women are wrongly prescribed birth-control drugs when alternatives such as natural family planning are cheaper and carry fewer health risks. More than 400 health care providers attended the American Academy of Fertility Care Professionals conference, triple the number the previous year. Organizers say the increase is fueled by religious doctrines and advances in drug-free contraception and fertility practices. The issue centers on when human life begins and for many this is when a sperm penetrates an egg, for others once the fertilized egg is implanted in the woman's uterus. Others believe it is when a baby draws its first breath. With such wide-ranging interpretations, the forms of contraception can present difficult moral choices for health care practitioners and some experts wrestle over whether measures of contraception are ethical. The Catholic Church and other religious institutions have long preached against most forms of birth control beyond abstinence or the rhythm method. Twelve million women rely on hormonal contraceptives, which require a prescription, to keep from getting pregnant, but the number of physicians and medical professionals who believe that using birth control and morning-after pills is abortion appears to be increasing. The war on choice is not just about abortion anymore, it's about the right to birth control. In rural communities, patients may have to drive miles to obtain or fill a prescription. Wal-Mart, dispenses birth-control pills but refuses to sell emergency contraception. The San Diego office of Planned Parenthood allows patients to sign up over the Internet for the morning-after pill, which has to be taken within hours of intercourse to be fully effective. Trying to force your beliefs on others is not only arrogant, it breaks the American covenant, which is tolerance of other people's beliefs. Most of the regulatory boards allow health care professionals to opt out of treatments for moral reasons as long as they arrange alternatives for their patients. At least 20 states have bills pending that would recognize the rights of physicians and pharmacists to deny prescribing birth control, but such legislation has only become law South Dakota. Some companies allow workers to refuse service to customers, and others do not. rw

Finally, a Pill for Men 'with No Side-effects' Which Could Be on the Shelves in a Few Years

Scientists have developed a drug which temporarily stops sperm production without causing any side effects or long-term harm to male fertility. It will be a male version of the contraceptive Pill.

Until now there has been limited success comimg up with a male Pill, although attempts have been made for many years. Most of the drugs recently developed involve an injection, and many contain steroids which have damaging side-effects including heart disease and impotence.

It has only been tested on mice, long-term studies on humans will be done within a few years.

The pill impairs the male body's ability to use vitamin A, which is vital for the production of sperm. The drug's developers say it will not affect sight. They also claim a man would start producing sperm again almost as soon as he stopped taking the pill.

The pill probably would be taken once a day, but scientists are working on a version that would only need to be taken once a week.

This pill does not affect levels of the sex hormone testosterone, which was a problem with earlier male contraception, especially since altering testosterone levels has been linked to changes in cholesterol levels, which can raise the risk of heart attacks and strokes. It can also affect a man's sex drive and lead to weight gain.

Experts believe that a male version of the Pill would give couples more choice and place more responsibility on the man rather than the woman.

Radical New Birth Control for Men 100% Effective

Men have had only two options when it comes to birth control, condoms or vasectomy, compared to women's many choices: pills, shots, patches, lubes, and tying their tubes.

However, now scientists in India have developed an injection for men called RISUG, or "reversible inhibition of sperm under guidance" that has so far proven to be 100% effective. It lasts 10 years and can be reversed with another injection with no side effects.

Having their partner assume the responsibility for birth control will help some women who suffer side effects of birth control: weight gain and loss, hormone imbalances, and frail bones, and others who have low fertility levels to start with, which is emotionally and physiologically draining if combined with a contraceptive that also lowers fertility.

Getting the injection is the difficult part, involving two needle sticks into the scrotum, the procedure taking about 15 minutes or so. A non toxic, positively charged polymer is injected into the tube that the sperm pass through on their way from the testicles. The polymer shocks (kills) the sperm, which have a negative charge.

Because the injection last 10 years, drug companies won't be making money from RISUG.

India is about to go into Stage III trials with RISUG, practically the last step before it can be used by anyone in India. Thanks to Bill Gates and a 100k donation from the Gates Foundation, we might get RISUG approved here in the US. The company in charge of trying to bring it here is Parsemus, and they are trying to see if RISUG can work on women, too. vp

The author suggests giving RISUG to adolescents: there would be less abortions, and less accidental pregnancies.

India: RISUG - the Revolutionary New Birth Control Method for Men

A new contraceptive procedure for men, known as RISUG (for reversible inhibition of sperm under guidance) is undergoing clinical trials. The new method does not have some of the drawbacks associated with a regular vasectomy. First, sperm would still be able to escape the body normally, which means there will not be the pressure and granulomas that sometimes accompany a vasectomy. More important, it could be reversed easily, with a simple follow-up injection.

In a vasectomy a white tube called the vas deferens, which sperm travel through from the testes to the penis, would be severed, cauterized and tied up the ends, and tucked it all back inside. With RISUG a nontoxic polymer is injected into the vas that forms a coating on the inside of the vas. As sperm flow past, they are chemically incapacitated, rendering them unable to fertilize an egg.

Ronald Weiss,a leading Canadian vasectomy surgeon and a member of a World Health Organization team that visited India to look into RISUG said "If we can prove that RISUG is safe and effective and reversible, there is no reason why anybody would have a vasectomy."

RISUG is not the product of some global pharmaceutical company or state-of-the-art government-funded research lab. It was developed by an Indian scientist named Sujoy Guha spent over 30 years refining RISUG while battling bureaucrats in his own country and skeptics worldwide. In study after study, RISUG has been proven to work 100% of the time. The procedure is now in late Phase III clinical trials in India, which means approval in that country could come in as little as two years.

RISUG is not available to Western men, although there is much interest. Thanks to a novel collaboration between Guha and a San Francisco reproductive health activist, RISUG could soon be on the road to FDA approval in the US.

India will soon surpass China as the world's most populous nation; in the poorest Indian state, women bear an average of nearly four children. Cheap to produce and relatively easy to administer, RISUG could help poor couples limit their families-increasing their chances of escaping poverty. In the developed countries, it would help relieve women of the risks of long-term birth-control-pill use and give men a more reliable, less annoying option than condoms. About half of all pregnancies in the US are unplanned.

The article goes on to describe Guha who turns out to be very interesting, and to describe more about the development of RISUG. You can read it by clicking on the link in the headline.

Contraceptive Jab for Men 'is Just as Effective as Pill'

A male contraceptive injection, which temporarily halts sperm production, has proved to be as good as the Pill in preventing pregnancies.

In the latest study of more than 1,000 men in China, about 1% conceived a child, similar figures to the 1 or 2% of women who become pregnant while taking oral contraception.

However, one stumbling block will be whether women would sufficiently trust men to make reliable use of hormonal contraception. Almost one third of the men enrolled in the trial did not complete it and no reason was proposed.

Until, male options have been limited to vasectomy, condom and withdrawal.

A side effect is the lowering of natural testosterone output. To counteract this a small amount of testosterone is given regularly.

The men's fertility returned to normal in all but two participants after the treatment was stopped. Sperm counts return to normal four to six months after the injections are halted.

Hassle-Free Pill for Men Gets Nearer

A male pill to prevent pregnancy without affecting sex drive is being developed. Taken every day, the hormone-free contraceptive would have no long-term effect on a man's fertility.

The drug would not protect against sexually-transmitted infections and was most likely to appeal to those in a committed relationship.

Most women are trusting of their partners when they are in a stable relationship. Some women will be reluctant to trust their partners to take their tablets regularly. The development of a male pill would be really useful for a lot of relationships.

The drug, known as CDB-4022, has been tested only on animals. Research, funded by the U.S. government, showed that the drug quickly blocks sperm production. Inside three weeks test animals were considered infertile.

Sperm levels quickly returned to normal after the drug was stopped. Hormone levels, and libido, were not affected and the monkeys did not suffer any visible side-effects.

It didn't have any effects on hormones such as testosterone. Plans are to carry out longer term studies, in which the animals will be mated with females to confirm the drug actually prevents pregnancy. The pill is one of several male contraceptives being developed by companies eager to claim a share of the 21 billion spent each year around the world on the female pill.

Many of the drugs being developed, however, are based on hormones and carry the risk of unwanted side-effects.

It is thought the drug blocks a crucial stage in sperm development. The testing needed to ensure the drug is safe and effective means it is several years from the market. rw

India;: Let Men Do Their Bit

For 30 years, vasectomy has been taboo, and the burden of family planning has been on women. But modern vasectomy techniques are a success in the West. India needs to try them.

India's most populous State, Uttar Pradesh, will account for 22% of India's population by 2026. Fertility rates here destined to take decades to reach replacement levels. Andhra Pradesh, Karnataka, Kerala and Tamil Nadu are forecast to jointly account for only 13% of the population increase during the same period.

Currently, 42% of India's population produces three or more children. Of 188 million couples requiring contraceptive coverage, only 53% cent are using contraceptives. The percentage of women having more than three children is 57% in Uttar Pradesh, 54% in Bihar and 49% in Madhya Pradesh. Almost half the girls there are under 18 at marriage.

There is urgent need to push up the age of marriage, delay the birth of the first child and widen the scope for spacing and limiting families. Vasectomy is a feasible way.

Unfortunately, any efforts to limit population are attacked by critics as an invasion of "human rights". Given the culture of the northern States, such goals are dumped as "unacceptable" and "impossible" and invariably shunned by many politicians.

The Millennium Development Goals do not envision family planning as the route to improving maternal and child health. This acts as a deterrent to organisations getting involved overtly.

Concentration on maternal and child health services has excluded men. Counselling on vasectomy is just not their business. In India, men have ceased to be the object of family planning ever since eight million male sterilisations were conducted coercively and haphazardly during the draconian Emergency period.

Even now horror stories of three decades gone by give shudders to politicians, especially in the Hindi belt. With no other terminal option available, millions of women have perforce to undergo tubal ligations having already borne the brunt of unwanted pregnancies and induced abortions.

The recent resurrection of the vasectomy programme comes as a welcome surprise. Madhya Pradesh has doubled vasectomies in the span of just one year from 7,000 to over 15,000. Haryana has shown higher and higher performance each passing year. Punjab has quadrupled the number of vasectomies in a matter of one year. Rajasthan has upped the vasectomy performance from just 1,700 during 2003-04 by almost five-times.

On October 6, in Vadodara, nearly 900 vasectomies were performed and hundreds of men had come willingly for this outpatient procedure.

At every health facility, ANMs and village women togged up in their best attire escorted the "acceptors" for vasectomy. Surgeries progressed speedily and while the patients waiting their turn, paranthas, enthusiastic counselling and a bag full of condoms were kept in readiness to complete the day's work.

Whether the carrot was the Rs 200 motivation money or the Rs 1,000 compensation for acceptors, an enormous response was evident. But India's annual vasectomy total remains less than a 10th of the pre-Emergency levels, despite hundreds of surgeons having acquired the Chinese non-scalpel skill.

In India, vasectomies are treated as the poor man's option. In some Latin American countries vasectomy has been presented as an alternative to female sterilisation. What is needed is for decision-makers to stop worrying about resurrecting the ghost of 1975 and understand that our population growth is having a detrimental effect on maternal and infant mortality. rw

United States: Breakthrough in Male Birth Control Remains Elusive

Men have basically two choices of birth control: condom or vasectomy. Many researchers say men should have more options and a shared responsibility.

Dr Bremner and Dr. John Amory, conduct clinical trials testing whether hormone injections or creams adequately reduce sperm enough to prevent pregnancies. One study showed a 98% success rate in couples using a hormone male contraceptive. Side effects include weight gain and acne. One option being developed is a set of tiny implants that block the flow of sperm.

It is more difficult to turn off sperm production than egg production. Women produce one egg per month, men produce 1,000 sperm. And male contraception is a difficult sell to pharmaceutical companies.

Men aren't the ones at risk of getting pregnant, which carries its own hazards. The litigious nature against those in reproductive health and religious opposition are hurdles as well.

Thirty percent of contraception is male-driven, half condom, half vasectomy, and up to 80% of men claimed they would use a new male contraceptive. About 98% of women in monogamous relationships said they would trust their partners.

A male contraceptive will be available in five to seven years, it's going to happen. It's just a matter of time. rw

Quinicrine for Sterilization

India: Drug Firms Push Unapproved Fertility Drugs

Lax drug regulations in India allow companies to push unapproved drugs and contraceptives that pose risks to women's health. They are distributed through private practitioners and quacks and nothing is being done to prevent it. The government agreed to investigate the use of anti –cancer Letrozole as a pro-fertility drug. SUN Pharmaceuticals and Dabur (India) Ltd have been warned from promoting Letrozole pending its approval as a fertility drug. It has been approved in India for breast cancer but doctors have used it to improve fertility in women. Several doctors acknowledged that they were encouraged to test the drugs on infertile women by representatives from the pharmaceutical companies. 400 women are believed to have used the drug on a trial basis. It is said to be toxic to embryo and foetus, by the original discoverer, and drug regulators, including the US (USFDA), the British (BMHRA) and Australian (TGA). The anti malarial drug Quinacrine banned for use as a contraceptive has been widely distributed and used on women who are not informed of its effects. 32 women who where sterilised with Quincarine were unaware it had been banned and had serious health hazards. Practitioners who break the ban are immune from prosecution. rw

Birth Control: Yesterday, Today and Tomorrow

On the heels of the Institute of Medicine (IOM) recommendation that birth control be covered by all insurance plans, and without co-payment, the author reviewed Janet Farrell Brodie's fascinating Contraception and Abortion in Nineteenth-Century America.

In antebellum America,there were tracts like Charles Knowlton's "Fruits of Philosophy or the Private Companion of Young Married People" (contained a summary of what was then known about the physiology of conception, listed a number of methods to treat infertility and impotence, and explained a method of birth control: to wash out the vagina after intercourse with certain chemical solutions); newspapers carried ads for medications; and douches and 'womb veils,' early forms of the diaphragm, which some women wore for years at a time.

In most states abortion before 'quickening' was legal until after the Civil War and widely practiced; abortifacient drugs were easy to find under brand names like The Samaritan's Gift for Females.

Nineteenth-century methods included withdrawal (not for everyone), reusable condoms, and douching with cold water and baking soda after intercourse. Some so-called experts got the rhythm method exactly backward. With these methods backed up by abortion, the average native-born American woman had only four in 1900 compared to eight in 1800, despite the clampdown on birth control and information by the Comstock laws of the 1870s.

Contraception is not some newfangled fad foisted by the cultural elite on decent God-fearing folk. Americans have striven to separate sex from reproduction for more than two centuries. Today 99%of women have used birth control at some point. It is lifesaving and health-preserving medicine. And yet the myth that birth control is 'controversial' persists.

How many women does it take to equal one bishop?

Burning Bras? It's the Pill That Gave Women Freedom

The availability of birth control pills and liberal abortion laws have had the greatest impact by far on women's lives in recent years. A new study by researchers at the London School of Economics, which collected data from 45,000 women in Britain and 11 other European countries, indicates that the birth control pill, which became available to married women in 1961, has enabled women to stay in school longer, get better paying jobs and derive better satisfaction from life.

The study found that other items on the feminist agenda, such as parity in divorce laws and better maternity leave policies, had minimal, or in the case of divorce, a negative impact on women's lives. But the benefits of birth control and legal abortions for women have been on a par with substantial pay rises.

Anti-abortion advocates have maintained that while these benefits have indeed accrued to women, their extension to teenagers and younger women have resulted in loose morals and lower birth rates, without the same economic advantage that is deemed vital for the woman who has entered the workforce.

U.S.: AMA: Doctors Should Be Able to Sell Drugs

The American Medical Association wants physicians to be able to dispense medications if a pharmacist claims a conscientious objection and balks at filling the prescription. Faced with reports pharmacists are citing conscientious objections to filling prescriptions for contraceptives and other drugs, the AMA called for state laws that would allow physicians to dispense medications when no nearby pharmacist is willing to do so. The policy would affect rural areas where no pharmacist can be found within a 30-mile radius. The new policy is an attempt to overcome a trend by pharmacists who say they cannot dispense the emergency contraception pill, birth control pills; drugs used to treat psychiatric illnesses; and, often, pain medications. Not only are the patients not getting prescriptions filled, but pharmacists are refusing to return the prescriptions and lecturing the patients about the drugs. The Pharmacists Association recognizes an individual pharmacist's right to exercise conscientious refusal and supports systems to ensure patient access to legally prescribed therapy. Physicians say that means pharmacists must refer patients to other pharmacists who are willing to fill the prescriptions. The Pharmacists Association said it has not received any complaints about pharmacists refusing to refer patients or refusing to return prescriptions. The pharmacist organization has no mechanism to censure pharmacists who refuse to refer patients or refuse to return prescriptions. rw

U.S. Government Says Study on Birth Control Pill's Benefits was Flawed

A study concluding that birth control pills slightly lowered the risk of heart disease has been called flawed by federal officials who say it wasn't properly reviewed. The National Heart, Lung and Blood Institute said these analyses hadn't been properly reviewed, and a new analysis determined that the heart findings were flawed and they could not find a relationship. The breast cancer findings also are suspect now, she said. The research is best known for its finding that taking hormones after menopause raised the risk of certain cancers and heart problems. It relies on women's memories of drugs they used in previous years rather than actual records. Previous studies that were scientifically sound have found that pill-users have a small increased risk of blood clots, heart attacks and stroke. Pill users reported a 8% less risk of cardiovascular disease and 7% less risk of cancer. But those findings were not verified with medical records. Scientists want to look at the data. rw

U.S. Clears Bristol-Myers Chewable Contraceptive

U.S. regulators approved the first chewable oral contraceptive for women, a spearmint-flavored tablet called Ovcon 35. Bristol-Myers will manufacture the product, and Warner Chilcott, will market it, the Food and Drug Administration said. It contains progestin and estrogen and may be swallowed whole or chewed and swallowed. Women who chew the tablet should drink an 8-ounce glass of liquid afterwards so the full dose reaches the stomach. The drug's possible side effects are similar to those of other birth control pills. rw

South Africa: Can a Faster Condom Help Prevent HIV? Unwrap This Timesaver Before You Get Busy

Pronto is a condom that claims to go from package to shaft within three seconds. The inventor of South African Willem van Renburg, who sought to develop a barrier method that didn't "kill the mood" with all that awkward fumbling. South Africa has the world's highest population of HIV-positive people.

Men refusing to wear condoms is a major factor in the global spread of HIV. Traditional rubbers present problems of smell, fit, feel, the length of time and difficulty in putting them on. Reducing that process to a second could go a long way in convincing some couples to stay safe.

Pronto's packaging doubles as an applicator. Users just need to crack the package in half, slip it on, and discard the applicator in one quick motion.

U.S.: Female Condoms Are Gaining Ground

The female condom has been redesigned, and seems to be making a comeback in the U.S.

Free FC2s - second-generation female condom - were handed out on Valentine's Day by San Francisco's health department, and Walgreens stocked them in about 10% of its 7,600 stores.

The number of FC2s distributed in the USA tripled in the past year., says the founder of the Female Health Co., which makes the condoms. It's the only female condom on the U.S. market, but it's sold in more than 100 other countries.

The first female condom in was approved 1993, but it was hard to find in stores other than Walgreens and it cost more than male condoms.

FC1 was made of polyurethane while FC2 is made of easier-to-work-with synthetic latex and has no seams, so it's more comfortable to wear.

Rwanda;: Culture Hindering Use of Female Condoms

Culture is one of the major hindrances to the use of female condoms. Sometimes women don't know how they introduce female condoms to their spouses. It is difficult in African societies for women to propose the use of condom to their husbands.

In some cases, women complained that they are not user-friendly and that they make a lot of noise during sexual intercourse. A female condom lines the vagina and prevents pregnancy and sexually transmitted infections.

Anti-AIDS campaigners expressed their concern about the unpopularity of female condom.

One reason why female condoms were not popular is because of lack of women empowerment. Some condoms have been rejected because of their bad smell. rw

India;: Condom as a Safe Tool for Sex

In India the condom is seen as a family planning device but among married couples it is still to be projected as one that can be used to guard against HIV/AIDS.

There are no efforts to collect information on reproductive tract infections (RTIs) women may be suffering from. In Andhra Pradesh and Tamil Nadu, where HIV and AIDS cases are high, their spread among the population, especially largely monogamous women, is likely to increase because once a woman is sterilised she cannot negotiate with her partner about the use of a condom.

Promotion of dual methods of contraception, along with appropriate counselling, has no place in the family planning programme. Media should be used to spread awareness among couples. Four South Indian states Andhra Pradesh, Karnataka, Kerala and Tamil Nadu where 22% of India's total population of 1.02 billion live, have completed their fertility transition. According to a recent survey, fertility rate ranged between 1.8 and 2.1 in these states.

In the wake of sterilisation for promoting family planning, the consequences are dire. The success of southern states in population stabilisation will be helpful in framing similar strategies for rest of the country.

But HIV continues to be a cause of concern in the South, along with anaemia and malnutrition among children. Sex selection and pre-birth elimination of females is rampant. The government will raise public spending on health from 0.9 of GDP to 2% to 3%. rw

Kenyan Catholics Support Condoms More Than Other Faith Groups

In this East African country where 1/3 of the population is reportedly Catholic, and 1/5 of citizens are suffering from HIV/AIDS, more than three quarters of Kenyans support condom use for family planning and prevention against sexually transmitted diseases, a report that comes as a shock to Kenya's Catholic hierarchy.

One third of the adult population feels that religion's role has not changed, but another third believe its influence over morality is waning. A majority of Kenyans support the Church's role in politics and believe that the Church should be more involved.

The new Catholic Archbishop of Kenya's coastal city of Mombassa is advocating the use of condoms among HIV-positive married couples; a contradiction to Catholic teaching which prohibits condoms, saying infected couples were a unique situation. With some counseling, and this is something we don't tell everyone, you can ask couples to use condoms.

Catholics form the majority of the 800,000 Kenyans infected with HIV, and obliquely some accused the Church for the rise of infections.

Polling results indicate that if infections are rising among Catholics, the result may be the consequences of ignoring the Church's teaching on chastity and fidelity in favor of condoms, which have been proven to be far less than 100% effective at stopping diseases.

Kenya's bishops, under the leadership of Kenya's Primate have advocated chastity and fidelity that has worked in Uganda to cut the rate of AIDS/HIV in contrast to their neighbors whose infection rates increase despite millions of dollars spent on sex education and condoms. rw

Condoms Stay Faithful When Prevention is the Goal

Most people have more than one sexual partner. Hence, we have an epidemic of sexually transmitted diseases, and the most disastrous is AIDS.

The value of condoms goes beyond disease prevention. Their consistent and correct use provides excellent protection against unwanted pregnancy. Condoms are 98% effective in preventing pregnancy if used from start to finish every time you have sex. Condoms, again if used properly and consistently, greatly reduce the risk of acquiring most sexually transmitted diseases.

The newest study shows that condoms can prevent infection by human papillomaviruses that cause cervical cancer. Condoms can be used effectively at any age with no risk of harmful side effects.

A study of 243 sexually active women reported common impediments to the consistent use of condoms. The women were provided with free condoms and detailed information, but nearly 44% reported inconsistent condom use, with the least consistent use among those who were most sexually active. Thinking they were not at risk of pregnancy was the most common reason.

The highest risk of unprotected sex occurs among adolescent women. The most common reason is fear of losing the boyfriend.

In a study of 1,843 men and women followed for 18 months, women had nearly twice the risk for getting a herpes infection as heterosexual men. Forty percent of the participants reported condom use zero to 25% of the time, and 2% reported using them more than 75% of the time. Those with the highest level of condom use had the lowest rates of herpes infections.

There is recourse for people exposed to HIV It involves a six-week regimen of antivirals.

Condoms sometimes, though rarely, break. They include instructions, but few people read them. rw

Condoms - Only Safe Sex Option - Ignored, Workers Say

Condoms aren't being used enough or promoted and this is hampering efforts to control the spread of HIV, said speakers at a conference on methods of prevention such as protective gels and vaccines.

The conference is right to focus attention on prevention but the things being talked about don't even exist. What we have today are condoms.

Increases in funding helped increase the number of HIV patients receiving treatment in low- and middle-income countries by about 450,000 a year between 2003 and 2005. Over the same period, the number of people who became infected averaged 4.6 million a year. Countries which have condom distribution programs have seen a decline in new infections.

The UN estimates that only 8 billion to 10 billion condoms are being used every year. This represents only half of the total need. People aren't using condoms enough and those that are, aren't always using them correctly. The Thai efforts, which centered on a policy of 100% condom use in all commercial sex encounters, has kept the country's epidemic in check. Consistent condom use results in a 90% reduction in the risk of HIV.

The problem is finding the funds to buy them.

The cost of supplying a man with condoms would be between $5 and $10 a year. It costs at least $300 a year to treat someone infected with HIV.

Condoms should be subsidized where people find it difficult to afford them and given free to the most vulnerable populations.

The UN estimates that $630 million a year by 2015 is needed to meet demand. Treating everyone infected with HIV would cost about $13 billion every year.

Condom distribution has been hampered by the reluctance of some governments to sponsor condom-distribution plans. That means fewer people have safe sex and more people die.

Social issues and embarrassment about the condoms are also a barrier to more widespread use. rw

Fertileview

FertileView is the most advanced fertility management program on the market today. FertileView is a simple tool that allows you to chart your fertility signs and interprets your information based on your fertility goal of either achieving or avoiding pregnancy. This comprehensive software program is designed to teach you about your own personal fertility.

Philippines Shifts Campaign to Natural Family Planning

The Population Commission (Popcom) has shifted to natural family planning after the US stopped the supply of contraceptives. Popcom supported by several NGO's had campaigned for scientific approaches to family planning. These contraceptives were given to us by USAID, but now purchased by the users, unless the Government will shoulder the cost. The regional office of the Commission on Population now gives emphasis on the Natural Family Planning (NFP) methods and organizing Responsible Parenting Movement (RPM) up to the barangay level.

With the shift of the campaign to natural family planning, it does not follow that they will also abandon the scientific method.

The shift was due to the fact that most of those who are adopting the family planning and reproductive health approach were coming from the poorest sectors and, with the pull out of the USAID, could not afford to buy one.

Popcom's emphasis on natural family planning methods will have the Roman Catholic Church as an ally. rw

Modified Rhythm Method Shown to Be as Effective as the Pill� But Who Has That Kind of Self-control?

A new German study has found that, when practiced correctly, a method of periodic abstinence known as the sympto-thermal method (STM) leads to an unintended pregnancy rate of only 0.6% annually, comparable with women who use birth control pills.

For SMT to work, women must keep track of their core body temperature, the fertile days as measured by a calendar, and their cervical secretions. Using this information, women are able to abstain from sex during their fertile period. STM is more effective than the other abstinence methods because it uses more than one type of information to predict a woman's fertile period.

The method is free and appeals to women who want a natural birth control method, but requires a commitment on the part of both partners.

"But the researchers went back and took data from an ongoing study from the past 20 years. They chose the users who were the best for this method.

Periodic abstinence has been jokingly referred to as "Vatican roulette,"

Some often stop using periodic abstinence methods after only a few months because it's difficult to abstain from sex for two out of four weeks. STM requires only 7-10 days of abstinence, but related methods practiced in the U.S. do require up to two weeks of abstinence every month.

Studies of periodic abstinence are often motivated in part by religious beliefs. Some 74% of the women who participated in a study, listed their religion as Roman Catholic, a faith for which this is the only church sanctioned method of family planning.

But a Canadian volunteer organization devoted to teaching couples how to practice the method, says that although religion was the early impetus, couples who practice STM are now seeking "natural" birth control.

But another insists it is misleading. STM is very unpopular, hard to use, and has a poor success rate in average couples. A U.S. study in 1980 had a 90% dropout rate after less than two years.

Less than 1% of women who use birth control in the U.S. use STM as it can only work for couples who stick to the plan 100%.

All contraceptive methods have their drawbacks, including the potential of passing along transmitted diseases best prevented by condoms. Ultimately, the best method for a couple to use is whatever they want. rw

Pioneer of 'Billings Method' of Contraception Dies

John Billings, founder of the natural contraceptive system known as the Billings Method, has died in Australia aged 89. The doctor and his wife Evelyn began work on their natural family planning system in 1953, and spent the next five decades perfecting the method which bears their name. It allows a woman to determine her ovulation cycle, and therefore avoid sex when she is most fertile, by monitoring cervical mucus.

The Billings Method has assisted couples to achieve pregnancy through enhanced understanding of the woman's ovulation cycle.

The Billings Ovulation Method has been introduced into China, where it is the only government-approved method of natural family planning.

Billings is survived by his wife and eight of their nine children. rw

Natural Contraception 'Effective'

The symptothermal method (STM) assesses fertility levels by measuring body temperature, and observing cervical secretions.

A study found using STM correctly led to a rate of 0.4 pregnancies per 100 women per year.

Natural family planning is effective - provided it is taught and carried out correctly.

The lowest pregnancy rate was among women who abstained from sex during their most fertile period.

Among those who used a condom, the pregnancy rate rose to 0.6 pregnancies per 100.

Among women who had unprotected sex during the fertile period, the pregnancy rate was only 7.5 pregnancies per 100 women per year. This was because women probably only had unprotected sex around the boundaries of their most fertile period.

For a contraceptive to be rated as highly effective it should lead to less than one pregnancy per 100 women per year.

The effectiveness of STM is comparable to modern contraceptive methods, and is an acceptable method of family planning, but STM is governed by rules, which take some time to learn.

Studies suggest that a woman's libido is higher during her fertile period, and this could be one of the reasons why natural family planning methods have had a reputation for being less effective but women also identify other parts of their cycle with increased sexual desire. rw

Natural Family Planning Offered

Researchers at Georgetown University's Institute for Reproductive Health say natural methods have been under-represented among the family-planning options because they require lengthy instruction and are difficult for many women to learn. But offering these methods fits well with the philosophy of nurse-midwives. The goal in developing natural methods is to meet the needs of the women who want to manage their own fertility without without hormones or devices and the burden of daily monitoring and charting required by older natural methods. These new methods are effective as well as easy to teach, learn and use. The findings are published in the Journal of Midwifery & Women's Health. rw

Ugandan First Lady Launches Family Planning Device

Uganda launched a new family planning device called Moon Beads to help women control their pregnancies.

The string of 32 colored beads can help women know when they can get pregnant, through counting the beads.

The first lady called on local health service providers to ensure that such vital services could also reach the people in the countryside.

The device requires an individual to move a ring around different beads with different colors everyday starting from the red bead.

Once the ring touches the white beads, it means it is not safe for unprotected sex. When it moves to the brown beads it would be safe.

Family planning is one of Uganda's key policies, and focuses on saving women and children's lives, and involving men in responsible decision making.

The device is to be distributed throughout Uganda in a five year project funded by the US. rw

Mule's Earwax Just Part of New Case Collection; History of Contraception Has More Than 650 Items

The History of Contraception Museum, at Case Western Reserve University presents the only collection of its kind in the world, representing the practices and products to prevent unwanted pregnancies. Exhibits go back to ancient Egypt where crocodile dung was employed as a suppository prior to intercourse, and the first-ever prescriptions for a contraceptive device (a medicated tampon). Folklore preventatives include beaver-testicle tea, weasel testicles tied to a woman's thigh, and elephant dung. There are displays of intrauterine devices and cervical caps. Condoms stretch from artistic to desperate (candy bar wrappers), not far from the corked, tubed and rubber-balled douches. The items were largely donated by medical professionals and family-planning services, or are re-creations of devices such as the amulet of mule's earwax. The Museum embodies social history, ethical issues, medical concerns and women's issues. People have been trying to devise ways to prevent conception for more than 2,000 years and transcends religions and cultures. rw

Canada: Museum Puts Contraception on Display

The History of Contraception Museum is the latest addition to the Dittrick Medical History Center at Case Western Reserve University. In ancient Egypt, crocodile dung was employed as a suppository before intercourse. Beaver-testicle tea was brewed by Canadian women. The collection includes some 350 intrauterine devices. The items were largely donated by medical professionals and family planning services. Dittrick is a museum and library dedicated to medical history. James Edmonson, Dittrick's chief curator, said the History of Contraception Museum "embodies social history, ethical issues, medical concerns and womens' issues. The collection also has 150 reference books. The collection shows that people have been imagining means of conception for more than 2,000 years. rw

India: Birth Control Goes Herbal

Indian scientists are developing the first effective and safe herbal contraceptive pill from a 2,500-year-old medical text. The ingredients are false pepper (embelia ribes) and long pepper (piper longum) mixed with borax. It is to undergo trials on humans, and could be on the market in two to three years. In the ancient world, Europeans used herbal contraceptives. One, a plant, silphium, was over-harvested and became extinct. In its modern form, the herbal contraceptive (pippalyadi yoga) would be taken as a daily pill for three weeks each month to inhibit ovulation. Dozens of plants are mentioned in India's ancient medical texts as preventing pregnancy, including Chinese hibiscus (hibiscus rosa sinensis), a small tree native to southern India. Developing an effective and safe herbal female contraceptive would be a coup for India. With a population in excess of one billion, only 2% of females use the modern contraceptive pill. No natural birth-control products have met the standards in clinical trials and herbal products can also have harmful side-effects. Chinese scientists developed a male contraceptive pill based on the seed of the cotton plant, trials showed it lowered men's sperm but also diminished libido. rw

Delay 'Sexual Debut' - Study: Teen Abstinence; 'Did Not Reduce Plans to Use Condoms'

Abstinence-only programs can reduce sexual activity among teens and delay their "sexual debut." A study of 662 African-American Grade 6 and 7 students from found that those taught abstinence-only were less likely to have had sexual intercourse 24 months later. Abstinence programs delay sexual debut and make teens more likely to use condoms when they do start having sex. It did not reduce intentions to use condoms, reduce beliefs about the efficacy of condoms, or decrease consistent condom use. The youngsters in the study ranged from 10 to 15; half were girls; 23% said they had sexual intercourse at least once before the study began.

The study compared abstinence-only with those put through a "safer sex" intervention that emphasized frequent condom use but makes no mention of abstinence.

Planned Parenthood has called the approach a challenge to the nation's sexual health. The Bush administration has promoted abstinence as prevention, a policy critics say ends up discouraging condom use.

But there is no logical reason that an abstinence intervention cannot be effective.

The abstinence intervention in this study promoted abstinence from vaginal, anal and oral sex until a youth would be able to handle the consequences of a sexual relationship. rw

India: Achieving Family Planning Goals with 'Cycle Beads'

What the 'nasbandi' of the 70's and the family planning drives could not achieve, doctors are trying to accomplish through a simple colour-coded set of beads. Called the Standard Days Method (SDM), it uses colour beads to identify fertile and non-fertile days and plan spacing between pregnancies. The method has been developed by American researchers and is being used in nearly 25 countries. In a country like India, where 78% of pregnancies are unplanned and nearly 25% unwanted, it can serve as an inexpensive, and 95% per cent effective method of preventing pregnancy. The Indian government has included it in the Reproductive Child Health programme for expanding contraceptive choices and this simple, method should be made widely accessible. rw

U.S.: How Green Are the ‘Childless by Choice’?

Follow the headline link for an interview with author of the book "Two Is Enough", Laura S. Scott, who has surveyed and interviewed more than 170 people for her Childless by Choice Project. "I'm keenly interested in the process of decision-making," she says. "How do we get from assuming parenthood for ourselves to the point where we're saying, ‘No kids, thank you!'?"

9 Silly Things People Say When They Hear You Don't Want Kids (and Ways to Counter Them)

This is a cute article which is best to read the whole thing. Follow the link in the headline if interested.

Meet the Women Who Won't Have Babies - Because They're Not Eco Friendly

When Toni terminated her pregnancy, she did so in the firm belief she was helping to save the planet.

At 27 this young woman was sterilised to "protect the planet".

Her boyfriend (now husband) presented her with a congratulations card.

Toni says "Having children is selfish. It's all about maintaining your genetic line at the expense of the planet. Every person uses more food, more water, more land, more fossil fuels, more trees and produces more rubbish, more pollution, more greenhouse gases, and adds to the problem of over-population."

Nothing in Toni's upbringing gave any clues as to the views which would shape her adult life. "No sooner had we finished our wedding cake than all our relatives started to ask when they could expect a new addition to the family.

"When I was a child, I developed a passion for the environment - I became a vegetarian when I was 15. The only person who understood how I felt was my first husband, who didn't want children either. We both wanted to save the planet - not add to the problem."

"I'd been on the Pill for five years and didn't want to take hormone-based contraception indefinitely.

"My GP said I was far too young to be sterilised, and that I was bound to change my mind one day.

"We decided my husband would have a vasectomy instead. He was 25, but the GP allowed him to go ahead.

"I found it insulting that she thought that, just because I was a woman, I'd reach a point where an urge to breed would overcome all rational thought."

"Through my job I made many friends who, like me, were more interested in trying to change society and save the planet rather than having families of our own.

"We used to say that if ever we did want children, we'd adopt, as there are so many children in need of a loving family.

But when she was 25, she discovered that despite taking the Pill, she had fallen pregnant by her boyfriend.

"I went to my doctor about having a termination, and asked if I could be sterilised at the same time.

"This time it was a male doctor. He said: 'You may not want a child, but one day you may meet a man who does'. He refused to consider it.

"After my abortion, I was more determined than ever to pursue sterilisation. I had my mother's support - she realised I wasn't going to grow out of my beliefs.

At 27, Toni moved to Brighton, where her dream of medical intervention was realised.

As Toni awaited the surgery which would destroy her fertility, she met her future husband, Ed, 38. "I liked him immediately, and I told him what I was doing because if he wanted children then he needed to know I wasn't the woman for him."

"But Ed didn't want children for the same reasons."

Ed and I married in September 2002, and have a much nicer lifestyle as a result of not having children.

"My only frustration is that other people are unable to accept my decision.

"What I consider mad are those women who ferry their children short distances in gas-guzzling cars." rw

Infertility in Europe May Double

Infertility could double in Europe over the next decade, with obesity and sex infections adding to the problem. One in seven couples has trouble conceiving, but this could rise to one in three. Women should be offered career breaks so they could have children younger, when they are more fertile and the rise in obesity is contributing to infertility. The rise in sexually transmitted infections was likely to mean more teenage girls would suffer from blocked fallopian tubes and when these young women want to become mothers, they find they can't conceive. Both the quality and quantity of sperm appeared to be in decline. The sustainability of the population of Europe is at risk because there are too few children being born. rw

U.S.: The Only Child Stigma is Fading; More Families Are Opting to Have Just One

For generations, only children and their parents have gotten a bad rap. But research suggests only children tend to be higher achievers, they get along with their peers, they aren't spoiled or lonely or aloof. From 2003, about 20% of U.S. children under 18 had no siblings at home. The country's birth rate has been deflating since 1960. A greater proportion of women have their first children at later ages. With couples delaying marriage and childbirth and mothers remaining in the workforce, single-child families are becoming more common. rw

Germany: Childless Couple Told to Try Sex

A German couple went to a fertility clinic after 8 years of marriage and found they are childless because they weren't having sex. Doctors found they were both fertile, and should have had no trouble conceiving. When asked how often they had had sex, they said: 'What do you mean?'" They were brought up in a religious environment and were unaware of the physical requirements necessary to procreate. rw

The Childless Revolution

From the NPR show with Dick Gordon (audio stream broadcast): Imagine restaurants with no crying children, adult-only neighborhoods, a museum with no kids. These are some of the ideas that a new group is advocating. They call themselves THINKERS - T-H-I-N-K-E-R - Two Healthy Incomes No Kids Early Retirement. They're tired of being discriminated against, and inconvenienced by a society obsessed with children. They're fed up with parking spaces reserved for pregnant moms, time off work for parents, and unequal expectations at the office. With baby boomers nearing retirement, and fewer households having kids, this movement is rephrasing old questions about a woman and a man's right to choose. rw

Costs and Net Health Effects of Contraceptive Methods

The net impact of contraception on women's health has not been reported previously. An analysis compared 13 methods of contraception to nonuse of contraception with respect to healthcare costs and quality-adjusted life years (QALYs). The analysis applies to women of average health and fertility, from 15 to 50 years old, sexually active in a monogamous relationship. Compared with no contraception, contraceptive methods of all types result in cost savings over 2 years, ranging from US$5907 for tubal sterilization to US$9936 for vasectomy and health gains ranging from 0.088 QALYs for diaphragm to 0.147 QALYs for depot medroxyprogesterone acetate. Even in 1 year, any method other than sterilization results in financial savings and health gains. Every method of contraception dominates non use. Increasing the use of more effective methods will improve health and reduce costs. Methods that require action by the user less frequently than daily are both less costly and more effective than methods requiring action on a daily basis. rw

U.S. Health Advisers Recommend Against Setting Failure Limits on Birth Control Pills

Lower-dose pills are less effective at preventing pregnancy, but offer health benefits or fewer side effects. That has split FDA on the need to define a pregnancy or failure rate that would be too high for next-generation pills. The earliest birth control pills to win approval failed just once per 100 woman-years. Newer pills contain less estrogen and progestin and reduce the risk of blood clots, stroke and other side effects. But failure rates have climbed.

The FDA has approved pills with failure rates that exceed two pregnancies per 100 woman-years. But allowing the less pills on the market can increase the options for women and their doctors.

Most women take the pill to prevent pregnancy, others rely on them to regulate their monthly periods.

The FDA scheduled meetings to gather advice on guidelines that drug makers could follow in seeking approval for new hormonal contraceptives.

The FDA is looking at how well studies done prior to approval of new birth control pills reflected their "real-world" use. The women in clinical trials are younger, skinnier and healthier than are U.S. women on average. The more clinical trials mimic real-world use, the more confident women will be that the pills both work and are safe.

The exclusion of smokers, obese and older women from clinical trials underscores the need for follow-up studies. Nearly 12 million U.S. women were on the pill as of 2002. rw

Hormonal Contraception Use Does Not Increase Women's Risk of HIV Infection

The use of hormonal contraception does not increase women's risk of HIV infection. A study followed about 6,000 women ages 18 to 35 in Thailand, Uganda and Zimbabwe. The women were offered birth control pills, depot-medroxyprogesterone acetate injections and condoms, and were tested for HIV four to five times a year for 15 to 24 months.

None were HIV positive when the trial began. Two-hundred-and-thirteen participants in Africa and four participants in Thailand at the end of the study were HIV positive. No evidence was found that linked use of hormonal contraceptives to an increased risk of infection.

The study could not exclude an increase in risk for HIV infection among women already at higher risk, such as sex workers. rw

U.S.: The War on Contraception

The president of the American Life League, Judie Brown, said that when a baby is conceived accidentally, a couple using contraception have this negative attitude toward the child and therefore seek an abortion. The league opposes all forms of contraception.

Americans United for Life, see contraception and abortion as part of a mind-set that's worrisome in terms of respecting life and has to include how we think and act with regard to sexuality and contraception.

Many Christians who are active in the anti-birth-control arena state that they want to change the way Americans have sex.

Focus on the Family posts on its Web site: "Contraception, encourages sexual promiscuity, sexual deviance (like homosexuality) and a preoccupation with sex that is unhealthful even within marriage".

For those who work in the public health field, and respect long-standing public health principles it's extremely disheartening to think they may be set back decades.

There are 6.4 million pregnancies a year in the U.S., 3.1 million are unintended and 1.3 million end in abortion. If women had quick, easy access to a backup contraceptive, those rates would drop.

At a White House press briefing Scott McClellan would not say whether Bush supported contraception. rw

India: Sangrur Locals Allege Forced Sterilisation

Hundreds of people from Punjab's Sangrur district have complained that they were forcibly sterilised and claim they went to hospital for treatment, and were operated upon without their knowledge. But the administration denies any knowledge of it. Sukhdev Singh was diagnosed with tuberculosis and referred to the civil hospital in Sangrur. But instead for getting treatment for TB, Sukhdev said he had a vasectomy without his knowledge. The government had organised a family planning camp in Sangrur recently, where the sterilisation procedures were carried out on 511 men and 300 women. But no one can be sure whether these were voluntary. The administration insists it knows nothing about forced sterilisations. Said Hassan Lal, DC, Sangrur. "If somebody comes with the complaint, I will take action. Certainly this will hamper the family welfare programme." Unscrupulous officials have been known to force these operations on unsuspecting villagers to fill the quota demanded by the government. rw

Birth Control Pill Study Flawed

Federal officials said that a new analysis shows no evidence that oral contraceptives cut the risk of heart disease. A new analysis determined that the heart findings were flawed and the breast cancer findings are suspect. Once age and other factors were considered, they could not find a relationship between pill use and heart disease. Previous studies that were scientifically sound found that pill-users have a small increased risk of blood clots, heart attacks and stroke but also had 8% less risk of cardiovascular disease and 7% less risk of developing cancer. But the findings were based on information women gave and were not verified with medical records. rw

China: Shanghai Installs Smart Condom Machines

New machines use smart cards, which are distributed to residents and entertainment workers free. It is still a pilot program that will be promoted if it works successfully. Local people will have convenient access to condoms. The commission has distributed 10,000 such cards to entertainment venues and residential areas. Employees check and restock the machines on a regular basis. There is also a phone number printed on the machines for contraceptive knowledge and AIDS consultation. The commission has established 16,000 free condom distributing spots in the city. There are 1,185 centers providing 24-hour service, located in residential areas, wet markets and office buildings. 19.5% of locals use condoms, up from 9.11% in 1995. rw