Birth Control

Birth control is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant. Methods and intentions typically termed birth control may be considered a pivotal ingredient to family planning. Mechanisms which are intended to reduce the likelihood of the fertilization of an ovum by a spermatozoon may more specifically be referred to as contraception. Contraception differs from abortion in that the former prevents fertilization, whereas abortion terminates an already established pregnancy. Methods of birth control which may prevent the implantation of an embryo if fertilization occurs are described (controversially) by either term.

Birth control is a controversial political and ethical issue in many cultures and religions, and although it is generally less controversial than abortion specifically, it is still opposed by many. There are various degrees of opposition, including those who oppose all forms of birth control short of sexual abstinence; those who oppose forms of birth control they deem "unnatural," while allowing natural family planning; and those who support most forms of birth control that prevent fertilization, but oppose any method of birth control which prevents a fertilized embryo from attaching to the uterus and initiating a pregnancy.

Contents
1 History of birth control
2 Birth control methods
2.1 Protection against sexually-transmitted infections 
 
History of birth control
 
A major factor in reducing birth rates in developing countries such as Malaysia is the availability of family planning facilities, like this one in Kuala Trengganu.Probably the oldest methods of contraception (aside from sexual abstinence) are coitus interruptus, barrier methods, and herbal abortifacients.

Coitus interruptus (withdrawal of the penis from the vagina prior to ejaculation) probably predates any other form of birth control. Once the relationship between the emission of semen into the vagina and pregnancy was known or suspected, some men probably managed to think through the haze of passion and withdraw in time. This is not a particularly reliable method of contraception, as few men have the self-control to correctly practice the method at every single act of intercourse.

Folklore has suggested douching immediately following intercourse as a contraceptive method, and while it seems like a sensible idea to try to wash the ejaculate out of the vagina, it does not work due to the nature of the fluids and the structure of the female reproductive tract — if anything, douching spreads semen further towards the uterus. Some slight spermicidal effect may occur if the douche solution is particularly acidic, but overall it is not scientifically observed to be a reliably effective method.

The reason both incomplete withdrawal and douching are not very effective is that the male ejaculate typically consists of approximately 5ml (1 teaspoon) of fluid carrying in excess of 500,000,000 sperm, of which only one is needed to cause reproduction. Thus even a tiny amount of ejaculate can be more than enough. Prior to ejaculation, a man typically releases small amounts of seminal fluid (pre-ejaculate or Cowper's fluid) as a result of becoming sexually aroused, during the erection, and while the penis is being stimulated by the vagina during sexual intercourse. Although the only studies conducted found no viable sperm in pre-ejaculate[1][2], it is theorized that ejaculating two or more times without urinating in between may result in pre-ejaculate containing sufficient numbers of sperm to cause impregnation.

There are historic records of Egyptian women using a pessary (a vaginal suppository) made of various acidic substances (crocodile dung is alleged) and lubricated with honey or oil, which may have been somewhat effective at killing sperm. However, it is important to note that the sperm cell was not discovered until Anton van Leeuwenhoek invented the microscope in the late 17th century, so barrier methods employed prior to that time could not know of the details of conception. Asian women may have used oiled paper as a cervical cap, and Europeans may have used beeswax for this purpose. The condom appeared sometime in the 17th century, initially made of a length of animal intestine. It was not particularly popular, nor as effective as modern latex condoms, but was employed both as a means of contraception and in the hopes of avoiding syphilis, which was greatly feared and devastating prior to the discovery of antibiotic drugs.

Various abortifacients have been used throughout human history, but are not considered by some to be birth control. Some of these were effective, some were not; those that were most effective also had major side effects. One abortifacient reported to have low levels of side effects - silphium - was harvested to extinction around the first century CE[3]. The ingestion of certain poisons by the female can disrupt the reproductive system; women have drunk solutions containing mercury, arsenic, or other toxic substances for this purpose. The Greek gynaecologist Soranus in the 2nd century AD suggested that women drink water that blacksmiths had used to cool metal. The herbs tansy and pennyroyal are well-known in folklore as abortive agents, but these also "work" by poisoning the woman. Levels of the active chemicals in these herbs that will induce a miscarriage are high enough to damage the liver, kidneys, and other organs, making them very dangerous. However, in those times where risk of maternal death from postpartum complications was high, the risks and side effects of toxic medicines may have seemed less onerous. Some herbalists claim that black cohosh tea will also be effective in certain cases as an abortifacient.

There are references in Arabic history to traders inserting a small stone into the uterus of a camel in order to prevent it from conceiving, a concept very similar to the modern IUD, but it seems unlikely that this was used as a contraceptive method for humans since knowledge of the female reproductive tract was very limited until the 20th century, and surgical techniques were poor. The first interuterine devices (which occupied both the vagina and the uterus) for humans were first marketed around 1900. The first modern intrauterine device (contained entirely in the uterus) was described in a German publication in 1909, although the author appears to have never marketed his product[4].

The Rhythm Method (with a rather high method failure rate of 10% per year) was developed in the early 20th century, as researchers discovered that a woman only ovulates once per menstrual cycle. Not until the mid-20th century, when scientists better understood the functioning of the menstrual cycle and the hormones that controlled it, were oral contraceptives and modern methods of fertility awareness (also known as natural family planning) developed.

Birth control methods
 
Three colored condomscelibacy, or sexual abstinence (some may consider these be more properly called alternatives to birth control)
non-vaginal sex, such as
Sex without penetration ("outercourse")
Anal sex or oral sex
Withdrawal, i.e. coitus interruptus
Barrier methods, often combined with spermicides
Condom (male and female)
Diaphragm
Lea's shield
Cervical cap
Contraceptive sponge
Chemical methods
Combined estrogen & progesterone:
Combined oral contraceptive pill ("The Pill")
Contraceptive patch
NuvaRing (vaginally inserted)
Lunelle (monthly injection)
Progesterone used alone:
Progesterone only pill (POP)
Depo Provera (injection every three months)
Implants (such as Norplant or Implanon)
(Most combined pills and POPs may also be taken as high doses as emergency contraception, also known as the morning after pill.)

Intrauterine methods
Intrauterine Device ("IUD") which may also be used for emergency contraception
IntraUterine System ("IUS")
Fertility Awareness Methods aka Natural family planning
Lactational Amenorrhea Method
Abortion methods (not considered by some to be birth control, since pregnancy occurs)
Surgical abortion
Chemical abortion
Herbal abortifacients
Surgical sterilization
Tubal ligation for women
Vasectomy for men

Protection against sexually-transmitted infections
Not all methods of birth control offer protection against sexually-transmitted infections. Abstinence from all forms of sexual behavior will protect against the sexual transmission of these infections. The male latex condom offers some protection against some of these diseases with correct and consistent use, as does the female condom, although the latter is only for vaginal sex.

The remaining methods of birth control do not offer significant protection against the sexual transmission of these diseases.

However, so-called sexually-transmitted infections may also be transmitted non-sexually, and therefore, abstinence from sexual behavior does not guarantee 100% protection against sexually-transmitted infections. For example, HIV may be transmitted through contaminated needles which may be used in tattooing, body piercing, or injections. Health-care workers have acquired HIV through occupational exposure to accidental injuries with needles.