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WBA presents birth control today. Freedom and responsibility. This is a series of programs about birth control and how it affects us and our society. Today we focus on one particular method of contraception the IUD. The IUD or intrauterine device is a small flat flexible object between one and two inches in diameter which is placed in the uterus to prevent pregnancy also known as The Loop ring spiral or quail. The device today is made of either plastic or stainless steel and must be placed in the woman by a doctor. If left there the woman is very unlikely to get pregnant. The IUD is gaining widespread acceptance in many parts of the world as an effective and safe method of contraception. However the way it works to prevent pregnancy is still in question. Dr. Lowell Cohen's director of the produce Student Health Center explains some theories of its functioning at an open discussion on the Purdue campus how the IUD works. I think it's controversial. Many people
believe that it really isn't a contraceptive agent that it's an abortive agent that contraception takes place. I'm sorry. Conception takes place in the outer third of the tube and with the entry uterine device conception still takes place. But in 24 to 48 or 72 hours however long it takes as the fertilized egg passes down the tube and into the uterus. If there's a natural uterine device present it will not implant itself into the wall of the uterus but will pass on out the cervix. The theory behind this is there are a couple. One is that there is a foreign agent within the uterus and the uterus contraction and of course with this contraction of the uterus it expels the fertilized A and the other and maybe more plausible would be that when conception takes place the cervix the cervical Canal is a
mediately plug with a mucus plug and this mucus plug stays there until lever begins and as you all know that some of the first symptoms of labor are what we call a buddy show an explosion of the mucus plug with bleeding. This also prevents bacteria from entering in into the uterine body. In other words the child can grow in a sterile median if the entry uterine devices there. The mucus plug does not form. There is no implantation of the fertilized egg and it passes out. This is theory but a lot of people say well ha what work. These are a couple of theories have been expounded. Another theory of the workings of the IUD is that the device stimulates activity of the Flowbee in tubes which in turn accelerates the passage of the egg into the uterine cavity Thus the egg arrives before the end of me or lining is suitably prepared for implantation. The idea of inserting an object in the womb to prevent conception is not new. The
principle has been known for centuries to the peoples of North Africa who placed pebbles in the wombs of their female camels before taking long journeys across the desert. How these pebbles work was never known but it was a foolish man who did not take these precautions with his animals. In the early part of the twentieth century German physicians began to use intrauterine devices for contraceptive purposes. In one thousand twenty eight Graf and Berg devised a metal ring and reported successful results with it in this practice. Unfortunately the use of these rings spread to less qualified and careless practitioners who did not bother to sterilize their instruments during insertion. This led to pelvic infections and being before the days of penicillin and other antibiotics. The infections became dangerous situations as a result the intrauterine method became discredited and was generally abandoned for 30 years. Interest was revived again in one thousand fifty nine when two independent reports were published telling of two types of intrauterine rings that were considered reliable and safe. One was made of
silk worm got and the other made of metal or molded plastic. Since then more modern models have been developed made of stainless steel and memory plastic. This new plastic is a resilient substance that can be stretched out for insertion of the device only to regain its original form once it is placed in the uterine cavity. Studies so far indicate that I made with this plastic tolerate uterine conditions very well and don't need to be removed for cleaning once a year is the older metal rings. The four best known types of plastic I use DS are the Libby's loop the Margolies spiral the burn burnt bow and the safety coil. Let's join Dr. Frank Payton and Dr. William Mansour of the women's clinic in Lafayette as they discuss their experiences with the IUD creator and advice is actually nothing new at all it has a very long history of Hippocrates even described the technique of inserting a small stone into the uterus to prevent pregnancy. We know that the Arabs
even use stones in their camels in order to not get a worrisome animal on a long caravan trip that they may be taking. The Persian medical writers have even a ninth century reported. The thing that is brought it more to the front the vendor was from Japan and Israel reporting very effective method of using the entry device an IUD we feel has advantages over other means of contraception in there following the insertion. There is no special attention is necessary as far as following the patient. There is no general systemic effects or bad side effects. And it's also reversible means of contraception. Most of the IUD that are presently being used in this country are made of polyethylene or other plastic materials. There's
usually a thread attached to the end of the device so that we can check to be sure that it's staying in position and if later on the patient desires a further pregnancy the this thread can be used to remove the device from the uterus. There are several. There are many different designs loops spirals coils bows recently Jack Peyton has been using a steel spring and I've been using a plastic shield. The action or the way that the IUD works say and preventing a pregnancy is truthfully currently unknown. I'm sure that we all feel that it is not causing an early abortion has a lot of folks have thought. Most workers feel that the device stimulates the activity of the fallopian
tubes which in turn accelerates the passage of the egg down into the uterine cavity and thus the egg arrives there before the lining is suitably prepared for implantation. Over the past five years. I would say we probably have but and how you do use it over 500 women and I think probably Dr. Payton has found that we've begun to swing towards the IUD in a lot of a lot of our patients that are seeking advice and birth control. I would like to say something about the time of the month let's say or the technique now of this and show the IUD. There's a great advantage if it's inserted say on the third day of a normal menstrual flow.
And I really mean a normal flow not a abnormal or a pill flow or anything else by one of our own normal clothes. One is then showed that. Not starting as I say on an early pregnancy and it is easier to assert at that time any believing that may occur from the instrumentation of this is masked by the menstrual flow. And lastly that the lining the endometrial lining of the uterus is ready to really grow old for the next two or three weeks and adapting itself to the presence of the device. Medically we also should trash the technique such as a very careful public examination of the patient and after the upper vagina has been planned the cervix or mouth of the womb is grasped with what we call attacking them in order to help straighten the uterus out and then the cervix is dilated a bit and then lodges the canal and at the same time we know exactly in
what direction to put the egg. And of course it comes in a little crazy sterilized packet and all ready to go from there and makes it much easier after we put this in. We have something to say to the patient and. It might be interesting. What do you tell us. We feel it follow up care is important I'm mentioned earlier that there is no special attention that's needed but we do feel that this lady should be seen following her first period after the insertion of the IUD to make certain that it's staying in position to her and any other problems. And then we also advise that she have a checkup once a year or to report any abnormal bleeding or any any problems. The patient can actually check the IUD to be sure it's staying in position and we advised particularly the first month
I would say that it's an position that they check this weekly or possibly each time prior to intercourse to make certain that the device is in position after the after the initial month and her first check up following the IUD. I think that it's advisable for him to check it once after the period is is over and perhaps once at the mid-cycle just to make certain that it's in position. This is fairly easily done the lady simply feels in the vagina and feels the thread is on the end of the IUD to make certain that it hasn't slipped out. Some women feel they are a little uncomfortable doing this and it is not really essential that it be done but I feel it's advisable that maybe Dr. Payne feels differently about this. No I think that it's very wise to accept that some women aren't acquainted with them shall share and they don't find that it's as simple as theirs
are some of them may feel rather repugnant about self-examination and show why they. They can forget it as far as I'm concerned. Wonder speaking of going to CERN it's rather interesting that most people are afraid they're going to drop out or they're going to expel it. It has been a bit of a problem that a say since it was first used and this is really some of the important. Factors of the new designs and the new types of AI DS to decrease this expulsion rate which is probably in the neighborhood of 10 percent generally speaking our rate here is certainly much lower than that and I would say it's considered of little significance. Now the reason for this is that the cervix the mouth the womb of course should be healthy first that any chronic infection or deep scar you know or weakness of the
cervix. The same could be said if there is an ill fitting or a poorly designed IUD. All of those things would increase the possibility of expulsion. How long do you tell him to wear the IUD. I tell him they can wear it as long as they don't want to get pregnant. Do you think that patient who or a woman who is wearing the IUD has a normal natural flow. I always tell a patient that the first one or two periods are going to be heavier and lasts longer than their normal periods and that they may have some spotting in between these periods after after these initial two periods. They should return pretty much to their normal menstrual flow. Although occasionally we have a way you would notice a slight increase in
flow. Occasionally this is an indication for removing the IUD Again this doesn't happen very often but we have seen patients that have had flow to the menstrual flow to the extent that we've had to remove the IUD. Again this I think all over the country of most people's experience this is been around 5 percent I think this is the average figure so expulsion and bleeding are our side effects. Kasian they happen but not real common. But I think that the patients should be told at the first two periods maybe heavier and last a little longer. I think that I agree with this. I would like to related an interesting thing that is always coming up and that they seem to accept this reading just like their side effects from any method as long as this little jobby is in position and doing its job. I recall one woman that bled enough to require a
transfusion and they are willing to take and go quite awhile before they're ready to have this removed. Some people worry about the infection that may enter as mentioned before if the cervix is cleaned to begin with the chances are very slight. I have seen but one woman that got into severe a type of pelvic infection from it. The report of having more than a discharge or look are rare with the use of the UTI is very rare and if so it is probably due to preexisting trouble that she would have had anyhow. There have been reports that the IUD causes tubal pregnancy as far as total numbers of tubal pregnancies are. These are not increased with IUD. It will prevent you to Ryan as well as extra uterine or or tubal pregnancies and it seems to be more effective in
preventing the uterine pregnancies therefore there if a pregnancy does occur there's a slightly greater chance it'll be in the tube. This is again a rare thing but I believe we've only seen one such case out of five hundred women that have had the IUD. Where is this something we have to keep in mind I don't think it's any it's any problem the perforation of the uterus is also then reported but as far as I know that this is never happened to a gynecologist if the technique of insertion is that here too. And pelvic exam is done prior to the insertion and this probably should never occur. There have been some questions about patience fertility maybe after wearing the IUD and then having it removed will she still be able to get pregnant.
I've been more than pleased with the subsequent fertility of these patients I've even wondered if probably didn't increase their fertility because most of them we've had 25 or more that have I think within the first two or three months after having their IUD removed they were back for a subsequent pregnancy. I would like to think that that was the only reason that I polled and I was for a subsequent pregnancy. I had a patient who wears one in this way. It is a very very happy person because there really is what I call family planning. What about contraindication do you have a kind of a patient that comes in and ash for an IUD and you turn around and say no you don't qualify. There are some definite counter indications that everybody should be aware of that's using you that's putting in the IUD is in these pelvic infection. Certainly this would be a contraindication to the insertion
of Dr. Paine's already talked about service situs or any irritation of the cervix they should be cleared up prior to the insertion. If the lady already is having menstrual problems heavy prolonged bleeding or in her menstrual bleeding this should be investigated prior to the use of the IUD. If there are some abnormalities of the uterus itself which distort the camogie of the uterus these days where you would know it when doing the pelvic exam and this would also be a kind of indication. And of course you wouldn't want to put this in in an early pregnancy this is the reason we prefer to put it in during the menstrual flow so that we would not be disturbing in her early undetected by the patient pregnancy. There's been some talk about the use of this IUD and women that have never had a baby because the cavity of the uterus is
small and I my own feeling up until very recently was that this probably was a relative contraindications other words I would try to discourage girls that never had a pregnancy from using the IUD but now they've developed some new unis that are smaller and according to reports from Johns Hopkins and other parts of the country they've had very good results with the use of this in girls that have never had a baby so I mean rare and they have teeny weeny for teenagers It happens all right. What about compact cash and do you consider that important before putting an IUD and well like I consider this very very important as part of the pelvic exam and if the PAP smear isn't normal then I don't think that I think that this ought to be investigated prior to putting in the IUD. Oh and as far as an IUD causing any abnormalities in the
cervix or any of your abnormalities in the past where I don't think this is ever been shown I don't think this is a problem and I would like to say overall that where there was shy of her mentioning this some of the complications to show for it but we have to be honest in this but they are show rare that the overall usefulness of this device is wonderful. Do you agree that it probably 98 percent effective. I think that's pretty close. And if a pregnancy did occur and that 2 percent it'll go ahead and proceed normally most often it will That's right. As far as the pregnancies about 2 or 3 percent that get pregnant with it in place. Say there are three girls in a hundred. This one of them the IUD would have slipped out of position and this is something that we as we mentioned earlier that you can teach the patient to check this to be sure that it hasn't slipped out of position. The other two that get pregnant will
get well or get pregnant with the IUD in position in most of these will go ahead with a normal pregnancy. But as compared with other means of birth control this is comparable to the pill. In fact there is a recent report out of Johns happenings where they felt that the use of this shield that I've been working on is is better than the sequential time pill which is about 98 99 percent. When you think that the chief virtue of the DV though is after all it does not require continuous motivation on the part of the patient. And when you are shochet that if it's sitting there minding its own business it's not affecting then the rest of the body whether it's the weight of the saggy or whatnot. And in the long run that say that the drawbacks are very very few and that a
bit of scale and it shouldn't. Can be acquired. Future. I think that every obstetrician gynecologist is prescribing contraceptives and measures to be familiar with the use of the IUD. I think it is proving to be a very viable means of birth control. The cost of an IUD varies. The device itself is about $5 for 20 to $25 a clinic in the Lafayette area provides the device the insertion a checkup a month later and removal once the device is inserted and working properly there is little or no cost involved. The medical committee of Planned Parenthood world population states that among clinic patients in the United States continuation rates have been much higher for the IUD than for traditional contraceptive methods. About 80 percent of women will continue to use Ru DS for the first year after insertion. 70 percent for the second year and from
limited data available about 50 percent of women are still using the IUD at the end of the 50 year they state that the incidence of involuntary expulsion varies widely among different types of IUD. The great majority of expulsions occurs in the first year of use about one half of the total within four months after insertion. More devices seem to be expelled with the menstrual flow than at any other time. Expulsion rates for all types of RU DS tend to decline steeply with increasing age of the woman and with increasing time after childbirth for all you D's voluntary removal at each of the doctors or the wearer's initiative is the most important cause of discontinuation the most common reasons for removal. Other than planned pregnancies are bleeding and pelvic pain and account for about 60 percent of all removals. Some 6 to 8 million Ru Ds are now in use. About 1 million in the US. Dr Seelig new guard practicing obstetrician and gynecologist and author of a recent book called
contraception says that at the present time the IUD is the most exciting new development in contraception. It is safe effective requires little patient cooperation and very little medical attention. Dr. new barke believes the coil is well suited to the woman who wants an effective contraceptive and for one reason or another cannot take the pill. He always recommends the pill first because it is the most effective and also tends to promote light regular periods. The coil is slightly less effective may produce heavier than normal periods and does nothing to correct menstrual irregularity. How effective the IUD is in preventing pregnancy varies from one point five to three pregnancies per 100 women during the first year of use. These rates tend to decline during the successive years. The size of the device and the age of the patient also influence the rate of effectiveness. As mentioned before one of the most important aspects of intrauterine contraception is the fact that it requires only the decision to have the device inserted rather than sustained
motivation of both partners. Some nations that have a serious population problem and a large number of poorly educated women are starting to rely on intrauterine devices besides the pill for just this reason. By the end of 969 Taiwan had about 600000 IUD insertions Korea 1 million and India 3 million although not the only effective method available for birth control the IUD seems to have a bright future for helping to curb the population explosion. The information center on population problems gave us this report on how India with the help of the Peace Corps is teaching her people about the IUD and other birth control methods. There are some signs of hope. India has increased its food production sharply since 1967. The roots of self-help are taking hold. The roots of new strains of rice and wheat are digging deep. Fed by new sources of water new gifts of fertilizer. There is a bit more food
each year but there are also millions more to feed each year in the critically equation of hunger. Population growth must be slowed down to let food production catch up here too. There is a sign of hope. The sign of the Red Triangle the red triangle is India's symbol of available birth control. It stands before every clinic and hospital in the land where the three quarters of all Indians who cannot read the red triangle stands for condoms and foams for Enter uterine loops and for birth control pills and all over the country on bridges and road signs and billboards and flashed on the screen in movie houses is the slogan. Two children are enough I am sure says the president of Planned Parenthood world population Alan Guttmacher that people dream and waken think two children are enough. Whether this is going to get across or not I cannot tell you.
One small but important help in getting the message of birth control across as provided by the American Peace Corps volunteers in India Dr Richard Sherman is a Peace Corps physician. He is Regional Medical Officer for Asia part of his work in India is directing Peace Corps volunteers who help the Indian state governments advise the people about family planning. Dr. Germ describes the work and training of the Peace Corps volunteer and his efforts to advise the people of the various methods of birth control available at the sign of the Red Triangle. He is being trained to understand the use of all of these various methods. What we do is we then follow up the guidelines of the state and what their preferences are and if they are pushing foam and if theyre pushing the pill. And this is what the volunteer will be doing together with that. Dr. Berman speaks with enthusiasm of the work of a Peace Corps physician. He feels that this work is as rewarding for Americans as it is for their foreign hosts. I think that the unique part of being a Peace Corps physician is that either directly or
indirectly he can become involved with some of the aims of the host government. I was able to do very similar work and assisting in the in Syria. And helping out in family planning clinics birth control can't solve all the problems of developing nations like India but it does zeroes in on one very important factor in those problems. Perhaps the most important factor of all the population fact or. This has been birth control today. Freedom and responsibility. The next programme will cover the medical aspects of the pill. Special guests today were Dr. Frank Payton and Dr. William Ensor of the woman's clinic in Lafayette Indiana. The series was written and produced by Colleen Gary and narrated by David Brody recording engineers Morris Moggridge. Your announcer Roger priest. The series is presented through the instructional radio division of WBA at Purdue University West
Lafayette Indiana. This is the national educational radio network.
Series
Birth control today
Episode Number
3
Episode
The I.U.D.
Contributing Organization
University of Maryland (College Park, Maryland)
AAPB ID
cpb-aacip/500-00003n6w
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Description
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No description available
Date
1971-00-00
Topics
Social Issues
Media type
Sound
Duration
00:30:16
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University of Maryland
Identifier: 71-16-3 (National Association of Educational Broadcasters)
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Duration: 00:30:00?
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Citations
Chicago: “Birth control today; 3; The I.U.D.,” 1971-00-00, University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC, accessed March 28, 2024, http://americanarchive.org/catalog/cpb-aacip-500-00003n6w.
MLA: “Birth control today; 3; The I.U.D..” 1971-00-00. University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Web. March 28, 2024. <http://americanarchive.org/catalog/cpb-aacip-500-00003n6w>.
APA: Birth control today; 3; The I.U.D.. Boston, MA: University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from http://americanarchive.org/catalog/cpb-aacip-500-00003n6w