Birth Control OLD News

Extracts from EEIN 1991-1994. Latest news is at the bottom. Provided by Eubios Ethics Institute , at http://eubios.info/index.html.

The prevented use of RU-486 in the USA, and likely use in the U.K. are commented on in BMJ 302 (1991), 487. A statistical study is presented by J.L. Rogers et al. (1991) "Impact of the Minnesota parental notification law on abortion and birth", Amer.J. Public Health 81: 294-8. It suggests that the rate of young pregnancy decreased with the introduction of this law. A review of A History of Contraception: From Antiquity to the Present Day, by Angus McLaren (Basic Blackwell 1990, pp.275, 25), is in Nature 349 (1991), 661. In points out the widespread use of abortion, especially before animation, in Europe from Greek times. Another review in Nature 350 (1991), 199 is of Generation Pilule , E-E.Baulie (Paris: Editions Odile Jacob 1990, pp.314, FF130). This is an inside historical look by one of the pioneers of the contraceptive pill. Letters regarding the use of the pill are in BMJ 302: 789.
There are ever increasing needs for birth control programs and we should not become complacent with the success so far, because the population is still rapidly increasing. It is estimated that since the 1960's several hundred million births have been prevented by the use of birth control, but there is still urgent need in the developing countries; C.Wahren, "The imperative of population control", OECD Observer (Dec 1990/Jan 1991), 34-7. A summary of the results of 134 surveys in 84 countries of women's wishes and the fertility rates is C.F.Westoff (1990) "Reproductive intentions and fertility rates", International Family Planning Perspectives 3: 84-9.
Another issue is the safety of birth control, and this is discussed in R.Dixon-Mueller (1990) "Abortion policy and women's health in developing countries", International J. Health Sciences 20: 297-314. The high incidence of maternal mortality from unsafe abortions is a consequence of the policies of some governments, and there needs to be change. It is estimated that 100-200,000 women die every year from the effects of clandestine abortions. A more indirect health risk of abortion is the subject of a review by L.I.Remmennick (1990) "Induced abortion as cancer risk factor: a review of epidemiological evidence", J. Epidemiology & Community Health 44: 259-64. The current knowledge points to some cases of increased incidence of breast cancer, but there are conflicting studies, for references see this review.
A paper on the Islamic view of contraception is Z. Sacedina (1990) "Islam, procreation and the law", Internatiuonal Family Planning Perspectives 16: 107-11. It provides some background on the status of sterilisation and abortion in Islamic countries, and the reasons for these policies. A world review on abortion is S.K.Henshaw (1990) "Induced abortion: a world review, 1990", International Family Planning Perspectives 16: 59-65. Another mention of the cultural and religious aspects of family planning is in J. Royal Society of Medicine 84 (1991), 177-8, which discusses a conference.
The rate of general maternal mortality in the UK is falling, but there are still some concerns according to a report from HMSO; BMJ 302 (1991), 743; Lancet 337: 786-7. Letters regarding suicide during and after pregnancy appear in BMJ 302: 591-2.
Research on the process of conception suggests that the egg may send a chemical signal to sperm to encourage the sperm to swim up the fallopian tube; PNAS 88: 2840-4;Science 252: 214; Nature 351: 19-20. The signal is still to be identified. See comment on sperm "warfare" and targetting in Nature 351: 276, 354. Another paper on the fertilisation event is in Science 252: 533-6. A system for the in vitro growth of rabbit embryos is in Biology of Reproduction 44: 1100-7.
The use of Norplant, the implantable contraceptive and its relative safety compared to other contraceptive methods is discussed in FDA Consumer (May 1991), 7-11. It was recently approved for US use, and it is used by half a million women in 17 countries. A general review on the use of contraceptives in Britain is in BMJ 302: 1224-6. The research in male contraception methods is discussed in MJA 154: 230-3. Letters on the use of breast-feeding as a method of contraception are in Lancet 337: 911. The use of "emergency" contraception, within a few days of intercourse, is discussed in BMJ 302: 801, 1272-3. A new weekly contragestive pill containing Centchroman is being sold in India; Science 251: 635. A new report from the US National Research Council is summarised in J.DaVanzo et al., "Health consequences of contraceptive use and reproductive patterns", JAMA 265: 2692-6.
Recently a Kansas state legislator unsuccessfully introduced a bill to give women US$500 to have a contraceptive implant, if they are receiving welfare; Washington Post (8 June 1991), A3. However in many countries money is used to increase the use of contraception; NS (18 May 1991), 15.

The UK Licensing Authority has approved the use of RU-486, 'Mifegyne', until 9 weeks of pregnancy; Lancet 338: 111; NS (13 July 1991), 19; Nature 352: 99. It will be prescribed in accordance with the abortion law. Recently, the drug RU-486 has become more available for research in the USA; Nature 352: 6.
A new contraceptive pill, Centchroman, that has been developed in India is being promoted there; NS (3 Aug 1991), 6. The efficacy of post-coital contraception is questioned by a study; L. Silvestre et al., "Postcoital contraception: myth or reality?", Lancet 338: 39-41. On the safety of medroxyprogesterone see BMJ 303: 13-6.
A report on the approval and use of Norplant in the USA is in JAMA 265: 3139-41. Environmentalists in the USA are finally beginning to speak out about contraception and birth control, and the population explosion; Science 252: 1247. There may also be more presidential support for population planning, including backing UN measures. However, as discussed in the following section, a recent US Supreme Court decision is affecting birth control measures in developing countries in a negative way (in terms of effectiveness); SA (Aug 1991), 8-9. On birth control, and health in general, in Kenya see Lancet 338: 239-40.
On the use of sterilisation as a voluntary form of birth control, and what factors make people choice this method, see M. De Wit & F. Rajulton, "Voluntary sterilisation among Canadian women", J. Biosocial Science 23: 263-73; and B. Thompson et al., "Some factors in the choice of male or female sterilisation in Aberdeen", J. Biosocial Science 23: 359-63. The practice of contraception among Hindus and Catholics in Goa, India is reported in J. Biosocial Science 23: 353-8. Reports on the dangerous use of misoprostol as an abortifacient in Brazil are in Lancet 337: 1534-5; 338: 247. A comment on women's reproductive health is BMJ 303: 75.

The Columbian constitution has been revised to give the right of family planning to individual couples, which is a opposite trend to some other South American Catholic countries; Lancet 338: 876. A critic of a recent UNFPA report on world population is in Nature 353: 596. On the higher frequency of ectopic pregnancies for users of intrauterine contraception (e.g. IUDs) see Obstetrics & Gynecology 78: 291-2.
On sex education in the U.K., and reducing the number of unplanned pregnancies see Lancet 338: 626; BMJ 303: 579, 598, 604. Calls for the approval of RU-486, to allow more early abortions, have been answered by the approval of RU-486 in the U.K.; Science 253: 264. On contraceptive uses, rather than abortive uses, of RU-486, see Lancet 338: 942-3.
A WHO study on the use of repeated small doses of RU-486 (mifepristone) for abortions is in Fertility & Sterility 56: 32-41. Lower doses than 600mg may be used if at early stages of pregnancy. On the use of RU-486 in the USA, or the lack of availability, see a book review in JAMA 266: 1141. In Japan, there has been opposition to the idea of using RU-486 by some doctors. The reasons include the less than 100% success rate (what does!), and that it must be used with prostaglandin, and that it requires a multiple visit to a physician. The issue of the morality of it may not be so important, rather it should be remembered that the medical profession has prevented the general use of the contraceptive pill for many years based on "safety" concerns; though there is some recent talk of approval of a generally available contraceptive pill. On the safety of oral contraceptives; Obstetrics & Gynecology 78: 161-8.

The relationship between population control and sustainibility is discussed in BMJ 303: 1194-7.
At long last, Japan has agreed to provide access to the contraceptive pill (EEIN 1: 77), providing there is no back down early in 1992; BMJ 303: 1157. There was a backdown by the Ministry of health and Welfare in 1965, so it is about time they reconsidered it! There are at least 400,000 abortions a year, usually because of failed contraception, but the real number is unknown.
In the UK, as in many other countries, there is a problem of unplanned pregnancies, and sex education; BMJ 303: 992, 1355; Nursing Times 87 (16 Oct 1991), 16-7, (6 Nov 1991), 52-3.

On population control see letters in BMJ 303 (1991), 1547. A paper on the effectiveness of breast feeding as a contraceptive is in Lancet 339: 227-30. It was found to have a similar level of efficacy to most modern contraceptives. A review on the topic of the safety of contraceptives is K.F. McGonigle & G.R. Huggins, "Oral contraceptives and breast disease", Fertility & Sterility 56: 799-819.

The annual UN Population Fund report has predicted that until the year 2000, the world population will increase by 97 million a year. They presented three scenarios for world population by the year 2150; 1) 28 billion, if current fertility rates continue, with some countries having high fertility rates; 11.6 billion if the fertility rate falls to where couples replace themselves only; and 8.5 billion if low fertility rates become worldwide. The UN Conference on the Environment and Development dropped the population issue, under pressure from groups such as the Vatican, Argentina and the Phillipines, but there are still calls for its inclusion as there should be.
The results of opinion surveys (from 1982) conducted in Sri Lanka on the factors involved in women desiring contraception is W.I. de Silva, "Relationships of desire for no more children and socioeconomic and demographic factors in Sri Lankan women", J. Biosocial Science 24: 185-99. Some of the factors involved were education and religion. Other studies on contraceptive use are H.H. Akhter & S. Ahmed, "Determinants of contraceptive continuation in rural Bangladesh", J. Biosocial Science 24: 261-8; O. Fakeye, "Reproductive characteristics and contraceptive method choices of Nigerian women requesting terminal fertility control", Int. J. Fertility 37: 19-23; T.M.M. Farley et al., "Intrauterine devices and pelvic inflammatory disease: an international perspective", Lancet 339: 785-8. European politicians have formulated a European Agenda for Action on World Population; Lancet 339: 605-6, and the US National Academy of Sciences and the UK Royal Society have also joined forces to call for management of the world population; Nature 355: 759.
The latest excuse for a ban on the use of the contraceptive pill in Japan is that it could enhance the spread of HIV; BMJ 304: 863. Earlier this year the Ministry of Health and Welfare had announced that the pill would be introduced, after continual rejection. It is ironic, that until very recently HIV has been poorly discussed in Japan, not being seen as a threat. At least we can expect more discussion of HIV and prevention measures which is welcome. It is also not surprising that they reversed their decision following government concern about a falling birth rate among Japanese (the government recently introduced guidelines for paid postnatal leave for either woman or man for up to a year from their work, though some companies already have three year periods, and the amount of money varies). Of course, these are not valid reasons for preventing people use of the contraceptive pill, and the Japan Family Planning Association will continue to attempt to introduce oral contraceptives to Japan. Some background on Japanese public opinion is in Studies in Family Planning 22 (1991), 378-83. In contrast to this approach, an AMA approach to encourage birth control is "Requirements or incentives by government for the use of long-acting contraceptives", JAMA 267: 1818-21. A new service in Nagoya, Japan, is a postal pregnancy service where urine test strips are sent out to requesters via post. In the first three months of this year they had requests from women from 14 years, with about 10% being women in their 50's.
On the use and lack of maternity services in developing countries see Lancet 339: 487. There are still concerns in Britain over the maternal death rate; Lancet 339: 546-7; BMJ 304: 657, but it is improving. A UK report on maternity services has been released; Lancet 339: 478-80, 812. The results of a survey of sexual behaviour among US young adults is discussed in JAMA 267: 628, and the situation in England is discussed in J. Public Health Medicine 14: 17-25. Overall in Britain, women appear to be leaving it later to have children; BMJ 304: 796-7. The number of missing women in different Asian and African countries (presumably because of abortion or infanticide or neglect) is discussed in BMJ 304: 587-8. See also NEJM 326: 898. In Rumania the abortion rate is now about three times the birth rate, due to economic conditions (about 1 in 6 women of child-bearing age had an abortion last year).
RU-486 use is being debated in Germany, and Hoechst wants to market it there; NS (28 March 1991), 18. There was meant to be a single abortion law in Germany from the start of this year, but there are still differences and debate. The use of RU-486 and medical issues of its use for abortions in Britain are discussed in BMJ 304: 914. The debate in Australia is discussed in Search 23 (Jan/Feb 1992), 10-11.

Although not related to birth control, the performance of female circumcision in Europe by Africans is reported in BMJ 304: 1134.
The use of compulsory contraception in court cases is debated in Lancet 339: 1104-1105, we need to protect people's reproductive rights, and also ensure that people are free to use contraceptives and receive cost coverage.
In the last issue the Japanese reversal of their decision to remove restrictions on the contraceptive pill was reported (EEIN 2: 36). A report on this is in Lancet 339: 865. A paper arguing for international rights to use contraception is E. Diczfalusy, "Contraceptive prevalence, reproductive health, and international morality", Amer. J. Obs & Gyn 166: 1037-43. A commentary on the limits to human population growth and life, and ways to use epidemiology to predict health effects of carcinogens is in Nature 357: 185-6.

The better access to contraceptives in Hungary has been said to have halved the annual total of abortions performed in the 20 years up to 1990, from 200,000 to 90,000 abortions performed; Conscience XIII, 37-8. After two years of financial pressure which stopped condom import, the number of abortions in Russia is increasing (from 4 million a year, compared to 2 million live births); NS (1 Aug 1992), 10. The number of sterilisations in eastern Germany is increasing; BMJ 305: 75. Fertility rates in the developing world are dropping, but woman still have on average 3.9 children. Still the WHO says that 300 million people in the world who want to use contraceptives have no access to family planning services; BMJ 305: 10. Comment on the Rio conference and birth control is in BMJ 304: 1525.
A review on the history of oral contraceptives, for 3,000 years is J.M. Riddle & J.W. Estes, "Oral contraceptives in ancient and medieval times", Amer. Scientist 80: 226-33. A book review is in NS (27 June 1992), 44. The results of a Schering Health Care company public survey in August 1990 found that only 10% of all women in the UK knew that post-coital contraception could be taken up to 3 days after unprotected intercourse. Several reviews on the use of oral contraceptives are in International J. Fertility 37, Supplement 1.
The July 1992 issue of J. Biosocial Science 24(3), is the proceedings of the Workshop on Methodology and Protocol of Human Fertility Studies under Field Conditions, and includes 10 papers of general interest. A letter on natural family planning is in Lancet 340: 309. In the US, the FDA committee has voted to approve Depro-Provera, a long-acting injectable contraceptive; Science 256: 1754. It was actually recommended to be approved in the mid-1970's, but doubts over safety led to this long delay.

Papers on contraceptive use in Bangladesh and Ghana are in J. Biosocial Science 24: 427-32, 463-76. A review on the difficulties of population control following the Rio conference is in SA (Sept 1992), 16-7. Oral contraceptive marketing in Nigeria using high prices is reported and criticised in SSM 35: 903-6. The success of population control in half of Asia , including Japan, China, Thailand, Korea (N&S) has already reached the level of replacement only; Lancet 340: 603. However, population control in India and Bangladesh are not yet having such an impact. The need for behaviour change for family planning is discussed in SSM 35: 1065-76. The WHO maternal mortality figures suggest there are 500,000 maternal deaths each year; World Health Forum 13: 271. In Africa the figure may have increased from 150,000 to 169,000 a year (women dying in pregnancy or childbirth).
A review of J.M. Riddle, Contraception from Ancient World to Renaissance (Harvard University Press, 245pp., 32) is in NS (29 Aug 1992), 46-7. A review of P. Harrison , The Third Revolution (I.B. Taurnis, 359pp., 17) is in NS (15 Aug 1992), 38, which is about population growth. A book review of an autobiography of the inventor of the pill, Carl Djerassi, is in JAMA 268: 1033. A review of data showing the protective advantage of taking oral contraception against ovarian cancer is S.E. Hankinson et al., "A quantitative assessment of oral contraceptive use and risk of ovarian cancer", Obs & Gyn 80: 708-14. A barrier contraceptive for women to protect them against virus transmission is being tried in Switzerland; World Health Forum 13: 266.
Research on developing contraceptives is discused in JAMA 268: 1248. A patent for the use of contraceptive vaccines based on antibodies to trophoblasts (early embryo cells) is discussed in NS (17 Oct 1992), 20. About 90% of US women of reproductive age use contraception at some time. The injectable contraceptive, De Provera, has finally been approved by the FDA for use and sale in the USA. In the UK it was approved 8 years ago, but it is still used by only 1% of the women who use contraceptives (compared to 5% who use the IUD, and most who use the pill). To use this contraceptive, an injection is required every 12 weeks. It is basically a progesterone (the male hormone) mimic. The needs of women and various alternatives for contraception are considered in A.P. Hardon, "The needs of women versus the interests of family planning personnel, policy-makers and researchers: conflicting views on safety and acceptability of contraceptives", SSM 35: 753-66.

A report on the international situation for family planning by the Population Crisis Committee, World Access to Birth Control, is available for US$5 from the Population Crisis Committee, 1120 19th Street NW, Suite 550, Washington D.C. 20036, USA. A paper predicting contraceptive use from 1990-2010 is in AJOG 167: 1160-4. A book review of a book on Marie Stoppes is in Nature 360: 381. US use of surgical sterilisation, the most common method of birth control used by women over 30 years, is reported in JAMA 268: 1833-4. However, use of sterilisation reduces condom use, increasing chance of transmission of viruses such as HIV. In the UK a legal suit is underway following a failed vasectomy; BMJ 305: 912.
The effects of oral contraceptives on health are discussed in papers in AJOG 167: 1165-70, 1171-6, 1777-84; JAMA 268: 1900-2. The use of RU 486 as an emergency postcoital contraceptive is reported in NEJM 327: 1041-4, 1088-9; BMJ 305: 927-31. The acceptance of Depo-Provera in the USA (EEIN 2: 77), may still be contested by some groups fearing adverse health effects; Science 258: 1086. A birth control program including very young students or those with mild mental retardation is discussed in Mental Retardation 30: 195-203. A review of medical barriers to contraception and family planning is in Lancet 3540: 1334-5. The use of the IUD is discussed in Fertility & Sterility 58: 670-3.
A short viewpoint stressing the need for humans to add responsibility to their idea of rights to reproduce is in Lancet 340: 1083. A WHO report on the future of South East Asia is reviewed in Lancet 340: 946-7. The lack of family planning in some Amazonian Indians is discussed in Natural History (Dec 1992), 31-6. A paper looking at the effect of a legacy of a former slave society of St. Vincent's in the Caribbean on the acceptance of family planning is in SSM 35: 1273-82. The subject of West Indian gender relations is also discussed in SSM 35: 1245-57, 1259-71. Family planning in Albania and the Philippines is discussed in Lancet 340: 964; and the effect on the environment in Guatemala see Ambio 21: 460-4. The increased use of oral contraceptives in Finland is said to have led to decreased abortion and birth rates in a study in BMJ 305: 1053-7. Strict penalties for failure to use family planning methods are reportedly being enforced in Tibet by the Chinese government; BMJ 305: 911.

The lack of international government action on population control is criticised in Nature 362: 379; NS (3 April 1993), 4. The population is expected to reach 8 billion by the year 2025. Modern contraceptives have decreased family size in average however, NS (13 March 1992), 7.
Population birth interval data from the Indian states of Uttar Pradesh and Kerala show strong correlation between socio-economic factors and child-spacing; J. Biosocial Science 25: 143-53. A constitutional amendment in India plans to ban politicians who have more than two children from parliaments, of the country or states, and impose tax penalties on people who have more than two children; Lancet 341: 426-7. The child-spacing of Canadian women indicates that those with higher education are having children later in life, with closer time intervals; J. Biosocial Science 25: 155-67. In Zambia, women with more education are found to result in greater male awareness of family planning, in married couples; J. Biosocial Science 25: 17-23. A report on contraception and abortion in Romania is in Lancet 341: 875-8.
A survey of the knowledge of UK patients requesting abortions has found a lack of awareness of emergency contraception methods; BMJ 306: 556-7, 931. The effectiveness of the female condom, Femidom, in preventing HIV transmission and pregnancy is questioned in Lancet 341: 696. Even if barrier methods are available many couples do not use them, Lancet 341: 887. Letters on the use of RU-486 as a contraceptive are in NEJM 328: 354-5. Some RU-486 has been imported into the USA from China, in efforts to pressure the French company to market its product there, or else face the cheaper Chinese product. Reasons for the lack of contraceptive research are discussed in SA (April 1993), 8-10.

On overpopulation and overconsumption see BMJ 306: 1185-6. A mathematical model of the predicted life history of the human race is in Nature 363: 315-9. They predict a history of 0.2 - 8 million years, and that we won't populate the galaxy. However, such calculations may depend more on politics than on scientific potential! The birth rate in Japan now averages 1.% births per woman per life, similar to Germany (Italy is lower with 1.3 children per woman). Papers from China suggest that in the 1960's about 40 million people died of starvation, which may explain why they continue the one child per family policy.
In India some intrauterine contraceptive devices ( IUCDs ) have been said to be defective, Lancet 341: 1403. India faces a huge population , becoming the world's highest total, and the government has decided to try to make its new birth control program more people orientated; BMJ 306: 1290-1. India is still researching the use of Norplant ; Lancet 341: 1016.
A review of hormonal contraception is in NEJM 328: 1543-9. Hormonal contraception is the most popular form in Western countries. A paper looking at what hormones are safest in terms of thromboembolic attacks is in BMJ 306: 956-63. Emergency contraception use in the UK is reported in Lancet 341: 952-3.
No link between vasectomy and cancer were found by a NIH panel review; JAMA 269: 2620. Reproductive freedom for refugees (in a general sense) is debated in Lancet 341: 929-30. Family contraceptive counseling in Uzbekistan is in Lancet 341: 1466-7.

A review of contraception and factors affecting its use is Studies in Family Planning 24: 87-99. On the health risks of vasectomy; JAMA 270: 705-8; Bulletin of WHO 71: 413-9; and on health and hysterectomy, NEJM 329: 275-8; JRSM 86: 432-4; Lancet 342: 361. A paper from Vietnam reporting on 31781 cases of quinacrine induced female sterilisation claims it may have saved 242 maternal deaths; Lancet 342: 213-7, 188-9. A supplement of AJOG (June 1993) 168: 1979-2015 is on contraception for women with medical problems.
China has prohibited the manufacture of a steel ring IUD in favour of the modern copper ring IUD, which is 6 times less likely to fail; NS (17 July 1993), 11. This may reduce the approx. 3 million abortions performed annually on women who use the steel IUD. Data from surveys of sexual activity and contraception in 7 African countries reveals very different situations regarding practice, Int. Family Planning Perspectives 19: 10-18; and data on sterilisation in 26 countries is in pp. 4-13. Family planning in Sudan is in SSM 37: 685-9. The OECD still has a low level of support for family planning aids, Lancet 341: 1655.
The female guppy fish reduces family size in overcrowded aquariums, NS (14 Aug 1993), 15. A review of ecological limits to population is in PNAS 90: 6895-9.
A review is R.J. Cook, "International human rights and women's reproductive health", Studies in Family Planning 24: 73-86; see also pp. 18-30; AJOG 168: 1649-54, 2042-8, 169: 128-33; JAMA 270: 234-6. Historical book reviews on contraception are in NEJM 329: 143-5.
A new journal on these issues is Reproductive Health Matters, first published in May 1993. The editorial office is 1 London Bridge Street, London SE1 9SG, U.K. The first issue focuses on population and family planning policies: women-centred perspectives, and includes a number of relevant papers on birth control and abortion topics.

A joint statement by science academies in many countries about the need for population control has been made in October; Nature 365: 382. It is addressed particularly to the 1994 United Nations Conference on Population and Development. See a book review of V.D. Abernethy, The Choices that Shape Our Future, in Lancet 342: 482.
Two religious views (Catholic and Islam) of family planning are criticised in Lancet 342: 447-8, 473-5, 808-9. An alternative view is, R.E. Ryder ""Natural family planning": effective birth control supported by the Catholic Church", BMJ 307: 723-6. A review of contraceptive development in Latin America is F&S 60: 227-30.
The availability of oral contraceptives is discussed in Lancet 342: 565-6. In India they are over-the-counter medicines, and in South Africa also, but still a prescription is needed in the UK and the USA. Also on the safety of the pill, and health benefits in reducing ovarian and endometrial cancer risks, Contraception 47: 427-44; Nature 365: News & Views . A call for deregulating emergency contraception is made in BMJ 307: 695-6.
A survey of family planning use in the Sudan found that it had not been ever used by 87% of pregnant women, SSM 37: 685-9. Programs to reduce the risk of maternal mortality in Africa are discussed in SSM 37: 745-52; World Health (May/June 1993), 26-7. On female circumcision see Harvard Law Review 106: 1944-61; BMJ 307: 460-1. A series of papers on contraception and family planning in Africa and Asia are in J. BioSocial Science 25: 303-10, 319-32, 425-44, 445-64.

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