This article is the third in a series on Birth Control, compiled and presented with the aid of the Women’s News Co-op.

Because of the media’s big push for the “pill” over the last few years, little information has been readily available on other birth control methods. There are, in fact, many of us who are not even aware of the number of different medically approved methods which are both safe and inexpensive. There is presently no one method of birth control that is perfect for everyone. Since this choice must be made on an individual basis, correct and current information is necessary to aid in that decision.

Intrauterine Devices (IUDs)

IUDs are small plastic or stainless steel devices in a variety of shapes and sizes which, when placed inside the womb (uterus), can serve as an effective method of birth control.

The devices themselves are not expensive and do not have to be frequently renewed since they are left in place once inserted. The cost to the patient will vary according to the charge by the doctor for the examination, insertion and check-up visits. Since there are no jellies or pills involved, there are no further expenses.

How do they work? Their actual mode of action has not yet been determined, but scientists believe that the presence of the device in the womb may so speed the time taken by the egg to pass from the ovary into the womb that pregnancy cannot occur. Once the device has been placed inside the womb, it is left there and provides protection against unwanted pregnancy without requiring any further action by the man or woman.

When the IUD is inserted by a doctor the discomfort is no greater than the moderate cramping frequently associated with a menstrual period.

The device is effective as soon as it has been properly inserted by a doctor. There is no need to use any other method of birth control. If there is spotting or cramping, your doctor may suggest waiting a few days before having sex relations.

Studies have shown that the device may be safely left in place indefinitely without removal. It is essential, however, that you visit your doctor each year for a thorough examination.

IUDs have been receiving extensive clinical testing in the US and other countries over the past six years. More than 17,000 women have been using them in carefully supervised studies. The results indicate the safety of this method of birth control.

Continuing scientific studies have shown absolutely no connection between the development of cancer and the presence of an IUD. Any new medical development requires considerable time before it is accepted by all doctors. As time passes and further experience and scientific evaluations of this method are reported, more and more doctors are prescribing IUDs for their own patients.

The Food and Drug Administration is kept informed of the progress of scientific tests with these devices. The FDA retains control of labeling and branding by the manufacturers of these and other devices, but so far has no authority regarding their clinical use. Therefore, they have neither approved nor disapproved of their use.

While not 100% effective, IUDs are among the most effective means of birth control available. Some women have cramping for a short time following insertion. This is usually mild and does not last long. The womb occasionally pushes out the device. If this happens, call your doctor at once.

Menstrual regularity is not affected. Following insertion the first few periods may be heavier or a little bleeding between periods may occur. This usually does not last long. Tampons may be used.

When pregnancy is desired, the device is simply removed by your doctor. The use of the IUD in no way affects future children or your ability to have them.

Vaginal Foams, Creams and Jellies

Special contraceptive creams, jellies and vaginal foams can be bought without a doctor’s prescription at drugstores. They are simple to use and no doctor’s examination is needed. Special applicators which measure the right amount come in the box when you buy them. To be effective these must be used each and every time before sex relations. Next to the condom, the contraceptive foams, creams and jellies are the most effective birth control methods you can buy without a doctor’s prescription. Because the foam is less noticeable, many women prefer it to jellies and creams.

Chemicals in these foams, creams and jellies quickly kill the sperm. The jelly or cream is squeezed out of the tube into the special applicator. In the case of the vaginal foam, the bottle is first shaken well, then the applicator is placed over the valve at the top of the bottle and filled with the foam. Not more than one hour before sex relations, the applicator should be placed gently but deeply into the birth canal. Pressing the plunger sends the foam where it provides protection. Each time sex relations are repeated, another applicator-full must be used. Douching is not recommended. If douching is desired, a six hour wait after the last sex act is a must.

Vaginal foaming tablets and suppositories have not proven reliable enough to be generally recommended.

Products such as vaginal douches or other aids for “feminine hygiene” (sprays, etc.) do not prevent pregnancy and are not to be relied upon as birth control devices. Advertising which alludes to the birth control powers of such products is false and misleading.

The Condom

The condom (or rubber) is made to be placed over the penis just before sex relations. It keeps the semen with its sperm from getting into the birth canal. Condoms are safe, reliable and can be bought without a doctor’s prescription at any drugstore. Condoms are highly effective and widely used.

There is a slight possibility that the condom may break during use, or slip off after the man releases his semen. As a result, the man’s fluid may spill into the birth canal. Slipping off can be avoided if the man holds onto the condom as it is taken out of the birth canal. Breakage usually occurs because the condom is dry, and can be avoided by using vaseline or any kind of cream.

The government Food and Drug Administration checks on condoms and destroys those found defective or inferior in quality. That is why most condoms are of high quality and breakage is rare. For greater protection, the woman may use a contraceptive jelly, cream or foam at the same time the man uses a condom.

The Rhythm Method

It is advisable to consult a doctor familiar with the difficulties of this method if rhythm must be used. This method is based on the fact that a woman can become pregnant only during that part of her menstrual cycle when the egg is released from the ovary—around ovulation time. It is hard and time-consuming to determine the ovulation time each month for a particular woman. Only a very few women are regular every month. A menstrual record must be kept for from 8 to 12 months. An exact record of her body temperature, taken each morning before rising, is also usually needed. A series of these carefully kept monthly charts shows a slight rise in temperature after ovulation and helps forecast when a woman will release an egg (ovulate). Also, because the time of ovulation is hard to learn in the menstrual cycle, several days must be added before and after and counted as part ‘of the unsafe period when you cannot be sure you can have sex relations without becoming pregnant. The fertile or unsafe period may last from 7 to 21 days. If a woman’s period is irregular, her safe and unsafe days will also be irregular.

For many women, the rhythm method may not be reliable, because they have trouble calculating the time of ovulation. A doctor can help you calculate your safe and unsafe period more effectively. Some women combine the safe period with other family planning methods. They use contraceptives only during their fertile days.

Withdrawal (Coitus Interruptus)

Coitus interruptus refers to the withdrawal of the penis before the man reaches orgasm so that sperm are not deposited in or near the birth canal. No drug or chemical is needed for withdrawal. This method is not completely reliable. Failures may occur because of poor control, carelessness, or because sperm are sometimes released before the man’s climax. Also, worry that withdrawal will not take place in time may lessen the enjoyment of sex relations.

Sterilization

Sterilization involves an operation on either the man or woman. Once done, it makes the man or woman unable to have children. Sterilization of the man (vasectomy) is relatively simple and may be done in minutes in the doctor’s office. Complete recovery from the operation takes only a few days and the man experiences no change in his virility, his sex desire or in his sexual performance. Sterilization of the man involves tying off the tubes thru which the sperm travels.

Sterilization for the woman involves an operation in a hospital. It is often performed just after childbirth. For this reason, if the operation is to take place, it should be planned several months before the baby is born. Sterilization does not involve the removal of any sex gland and it does not change the woman’s sexual desire or femininity in any way. Sterilization of the woman involves tying off the tubes thru which the egg travels.

To be effective, all birth control methods must be used regularly and according to directions. Because they remove the fear of unwanted pregnancy, modern birth control methods should not interfere with sexual enjoyment, but should serve instead to make the relationship a happier one.

The responsibility for child-rearing has historically been placed upon women. In this period when women are seriously questioning their lack of control over the roles they have been forced to play in society, it is important that we understand and accept the responsibility for birth control. The ability to prevent unwanted pregnancy gives women the power to decide for themselves when and if they wish to take on a role as mother.

Remember, it takes two people to make a baby, but only one informed, decisive person to prevent it.