Birth control today; 14; When Birth Control Fails

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 discuss when birth control fails. Almost nine out of 10 American couples use some form of birth control. And yet as many as one fifth of those couples have at least one unwanted child. The national total of unwanted children is more than three quarters of a million each year. Why. Dr. Bernard Nathan's and thinks he has the answer to that question. Dr. Nathan Sen is a gynecologist obstetrician on the staff of two New York hospitals. He's also assistant clinical professor of obstetrics and gynecology at Cornell Medical College. Dr. Nathan doesn't think these unwanted children are the result of birth control failure. He thinks they are the result of patient failure. If you get

very very negative to say then you're with the men and not any other men. Since there are very different methods do we have different rates of effectiveness and failure among 1000 women using the pill for one year. There's only a chance of three of them becoming pregnant. The IUD has a low built in failure rate also only 10 to 50 women out of 1000 in one year will conceive. Failure rates of 12 to 14 percent accompany the diaphragm and condom. And from there the remaining methods are highly unreliable. Withdrawal being 18 percent chemical barriers 20 percent rhythm 24 percent and douches 31

percent. These methods used in combinations can be more effective. Which brings in again the aspect of human strategy. The rate of success depends highly on the motivation of the user to prevent conception. The most effective methods of birth control are those that reduce both the probability of technological failure and human failure. Those methods which require self control or interruption of the sex act would be expected to introduce more human failures no matter how technologically sound the method itself. When these methods are combined with an indifferent attitude toward family planning or a lack of confidence in being able to effectively control pregnancy the human failure becomes even more probable. Use consistently and carefully the condoms should be effective. However the consistency varies with the husband's motivations for planning and his displeasure with the method. Many men complain that it interferes with their pleasure. They feel it may break anyway and it doesn't hurt to take a chance every once in a while. One study in one thousand sixty of low income

urban families found that the main reasons for accidents were in order of frequency of response took a chance. Disliked the method and failure of the method. Leader rainwater shows the social class and religious influence on contraceptive choice. From his in-depth interviews with 409 men and women from two hundred fifty seven different marriages he reports that the majority of lower class Catholics and Protestants alike rely on the condom withdrawal or the do only among upper middle class Protestants are the most reliable feminine techniques the preferred methods among Catholics the rhythm method is the most prevalent method only among the lower middle class. The effectiveness of the birth control methods appears much more related to the attitudes of the users toward them than to the technical efficiency of the method. When husband and wife disagree on either the number of children wanted or in the method of family planning used the efficiency of any method is likely to go down. Confidence in a particular method implies trust in the partner who is responsible for the

precautions as the method becomes less conspicuous. This trust becomes more important and probably reaches its peak with the use of oral contraceptives. Effective family planning appears related to mutual enjoyment of sexual relations. A joint or intermediate or role relationship which implies some sharing of interests and family goals between the spouses and communication between husband and wife. Whether the effectiveness of family planning is a consequence of or a contributing factor to sexual satisfaction is difficult to determine. Certainly anxiety about pregnancy would be expected to reduce the enjoyment of sexual relations especially if this is accompanied by distrust of the partner. Negative feelings toward sex itself reduce the probability of open discussion and cooperation and using effective methods consistently and efficiently. For the woman it reduces her concern in seeking a method which would be acceptable to her husband since she would rather cut down the frequency of contact than make it safe. You have both spouses have a feeling that it is

morally wrong to artificially interfere with the process of conception but also have a desire to limit their family and feel a commitment to each other. They are more likely to seek information which would make the methods open to the more efficient. They are also less likely to resent the restrictions placed on their spontaneous desires or the accident that may result. If however they both feel that there is little one can do it's all fate anyway. Then the willingness to take a chance goes up if husband and wife have different attitudes one thinks it is morally wrong to use artificial methods and the other does not. Or one thinks it's all fate and the other believes in rational control. Efficiency would be expected to go down the frustration of at least one partner would go up and accidents would be more likely to result in blame and resentment. Effective planning no matter what methods used appears to be a consequence of positive sexual attitudes. A mutual regard for each other's feelings and desires. Open communication and an agreement on family planning goals. It probably

heightens the couple's feeling of control over their lives and hence his sexual enjoyment as well as their confidence in each other and increases the probability that the children will be a welcome addition to the family. The situation is somewhat different in the case of the unmarried girl. Why do single girls take their chances with contraceptives. There seem to be several reasons possibly a it can't happen to me feeling a feeling of invulnerability based on misunderstanding of contraceptive effectiveness and usage. Some girls desire self fulfillment and think they can find it in motherhood. Some women desire pregnancy as a form of suicide. They don't like their present lives but haven't the strength to drop out. It may be an unconscious cry for help or attention from parents. Or it may be to manipulate a relationship to get the boy to marry her. No matter what the reason when the woman becomes pregnant something happens she is involved. Her parents or lover or friends are involved and whatever lifestyle she has adopted has been shaken and maybe permanently changed.

Unwed Mothers are faced with several undesirable and perhaps tragic choices. They need help in making future decisions. The increasing rate of illegitimacy in the United States has led to the formation of a National Council on Hilla GMAC in New York Ruth Friedman director of NCI and Mrs Henry Steger chairman of NCIS advisory board. Talk of the purpose of the organization the National Council on the legitimacy was established some six years ago as a new national agency and is co-sponsored by the Child Welfare League of America and the Family Service Association of America. The two largest standing setting agencies in the field of Family and Child Welfare NCI is the only agency in the United States and Canada with an exclusive and an all inclusive concern for the problem of intimacy. Basically our function is threefold to reduce the incidence of illegitimacy. To help the community understand the complicated issues involved in the problem of illegitimacy and to provide and inspire resources to combat the causes and to ameliorate the

consequences of illegitimacy. We have found that no community in the United States has an adequate program for preventing illegitimacy or for serving the needs of unmarried parents and their children. The majority of unmarried mothers receive no help from community agencies. Usually there is either no services available to the unwed mother at this critical point in her life and the life of her child or IT services do exist. The girl who becomes pregnant does not know about them since available services are often restricted and are too little known. The unwed the unwed mother frequently an adolescent with no resources is left to carry her burden alone. The community generally often has little in the way of social services before delivery. When a child is born the community fails again to a sister. If she is faced with the incredibly difficult task of rearing a child without a father the destructive effects of illegitimacy on the lives of both mother and child are severe greater attention to their needs and more services to meet those needs and more understanding of the factors leading to illegitimacy

are a national responsibility and the NCI has as noted undertaken to fulfill this responsibility to the best of our ability and in accordance with our resources. We are concerned with the social climate in the community and we work to reduce unhealthy social conditions which foster a illegitimacy and final pain is that we work to increase community acceptance of the unmarried mother and her child. We foster comprehensive study of the type of pattern and services needed to help prevent illegitimacy and to provide guidelines for assistance to unmarried parents and their children. We foster research and demonstration to advance professional and technical knowledge. We serve as a clearinghouse of information on all aspects of the problem. We develop position statements on issues affecting the field of illegitimacy which are used as guidelines for action and the development of services in the field of social welfare such as on the importance of continued schooling for pregnant girls and young mothers on medical care from minors. An inclusion of illegitimacy item on birth certificates and the use of short

birth registration form a card in respect to race on family life education and last but not least on family planning and birth control. The basic reason contributing to social agencies becoming sufficiently concerned a few years ago to establish a national agency in this area NCI was the statistics had more and more been showing that out of wedlock births had become a social problem of major dimension in the United States whereas in 1938 three point six percent of all live births were out of wedlock births by nineteen sixty five point two percent were out of wedlock by 1965 7.7 percent. And since 1965 there has been a continued steady rise. Compare these figures for the last few years. Nine hundred sixty nine thousand nine hundred sixty one thousand nine hundred sixty six. Three hundred two thousand four hundred children were born to unmarried parents in

1967. Three hundred nineteen thousand in one thousand sixty eight over three hundred thirty nine thousand. It is projected that by 1980 the number of illegitimate births will be four hundred and three thousand per year. It is true that the rate which is the number of illegitimate births per thousand unmarried women of childbearing age has leveled off in the last two years to about twenty four. But even if this rate should remain constant since the population is on the increase and simultaneously the number of women of childbearing age is also growing. We have every reason to expect that the number of out of wedlock children would climb steadily and dramatically upward. And if you add to the figures about the out of wedlock birth the number of other persons adversely affected by and involved in the problem over and beyond the child itself the figures can be quite astronomical. There is the child its mother its father.

The parents of the unmarried parents had to repeat over three hundred thirty nine thousand illegitimate live births were reported for nine hundred sixty eight. That makes over three hundred thirty nine thousand unmarried mothers the same other number of fathers two sets of grandparents conservatively speaking. That adds up to approximately two and one third million individuals implicated with illegitimacy and quite quite intimately in a single year. From the vantage point of a national agency concerned with the social problem of illegitimacy What would you say is the relationship between the availability of sex counselling and endless information about contraceptive methods and the incidence of out of wedlock births. If there is a relationship to tell I would say that there are signs of a definite tie in between the dispensing of contraceptive information and counseling and the prevention of out of wedlock births. And yet strange as it may seem in this day and

age although we tend to accept that the availability of information about contraceptives is widespread when we track down the real facts of the situation we find the one thing that sounded meaningful counseling and sex education are not as readily available to the young people who need them as we would like to believe. To quote an article that appeared in a July 1970 issue of Look magazine the most surprising revelation is the amount of sheer sexual ignorance that still exists in this supposedly swinging aware generation. A recent survey for example showed up at more than one half of the 40 percent of a coed at Oberlin College who would have sexual intercourse use no birth control method at all and that the others generally generally relied on techniques which have very high failure rates. I remember the article I remember also that at the Oberlin coeds were by and large students from middle and upper middle class homes among the low income members of the younger generation.

The look article pointed out ignorance of contraception is abysmal and powerful emotional factors prevent many youngsters from using whatever theoretical knowledge about sex they may possess. I'm out of fear. Others because they feel it is unromantic to use contraceptive devices. Still others do not want to admit to themselves that they are prepared in advance to have intercourse and some have religious scruples. Some girls it goes without saying know about birth control methods but don't use them because they have an emotional need to become pregnant others in their impetuosity failed to look ahead to the kind of consequences of it of course. But the main reason it seems to me that birth control fails with women of childbearing age who produce are out of wedlock children. Is that still despite the strides of birth control and family planning of made in the last decade. Try becoming a household word and strange though it may seem it still is not

sufficiently readily available and sufficiently widespread along with sex counseling and family life education including sex education to unmarried young people. A number of studies have taken place and projects have been carried out in recent years which have demonstrated fairly firmly that sound sex counseling and sex education when combined with readily available contraceptive information and help do indeed result in cutting into the rate and the incidence of illegitimacy. More than anything else that we need right now to make a real and lasting dent in the problem is more and still more and better and more widespread programs and a far more profound education of the public especially of the susceptible public that have been put in operation today on the local level Lafayette has a family services agency supported by United Front Colleen Gary talked with Mrs. Mary Ellen casework supervisor about the agency's services.

What services does the family service agency provide for the community. The Family Service Agency is primarily a professional counseling service and we offer counseling to any individual in Tippecanoe County around problems encountered in family adjustment or individuals who are having some difficulty with life's problems and experiencing the phone s that they want from their relationships. Do you counsel unwed mothers. Yes we do. Just this year in February we began a pilot project because of our awareness of the need in the community. We have been hearing increasing really alarming numbers of illegitimate births nationally we know that there are approximately 300000 illegitimate births per year. The statistics we have for our typical new county have been on the increase in nine hundred

sixty eight. There were 95 illegitimate births recorded and in the first nine months of 1969 there were 113 illegitimate births recorded. From this we felt that. There should be something geared specifically to the local girl so that she might have a core of services to look at the overall problem. We began in February and a counseling program group therapy for the pregnant unmarried teenage girl. In these weekly sessions we tried to deal with the many aspects facing the girl not only the decision making aspect but also an experience in sharing feelings learning about family attitudes bringing in the aspect of prevention. Wanted pregnancies. Trying to develop successful relationships.

And the need for future planning which includes education care of the child etc.. So we do have this specific program in conjunction with our counseling program. The YWCA provides also on a weekly basis activities for the girls both social and recreational skills as well as educational services such as tour through the hospital exercises or preparation for delivery. So we feel that the 14 girls who have participated in this program to date have gained something and we are hoping that the community will continue to make referrals to this program. What about counseling married couples with an unwanted pregnancy. Again I refer to a statistic that in Indiana. One out of every six brides is pregnant. We think this probably has

increased some. Of course the numbers of couples who come to an agency such as Family Service the fact that they were pregnant at the time of the marriage is a larger percentage. We think probably in excess of 50 percent of marriages start with a pregnancy. I might say that this is not usually the thing that brings a couple to family service for counseling. It is not that the pregnancy provides the crisis but it comes later in the marriage when the unstable relationship existing in the marriage presents itself where is it Ted and the couple then seeks help. I think then that we might say that the child is not the cause but rather an effect. In secure unstable relationships.

What happens to individuals and families when birth control fails. I. Wonder if we can really say when birth control pills are if we're not dealing with a broader question and that is what happens when birth control is not even considered or planned for. Traditionally speaking of birth control or most methods of birth control have been placed in the responsibility of the woman. Yet there is not a single birth control method that a woman can take responsibility for. That does not have to be planned for in advance with the young couples in particular those who are not yet married. I think they are reluctant to say I am planning to have intercourse outside of marriage. Therefore the aspect of planning in advance they do not do this. I think there is also the feeling that it would take away from

some of the romance to plan for this in advance. As far as the married couple is concerned I think we have perhaps put tremendous emphasis on using childbirth and using sexuality to build up the feminine and masculine role is to assure status in our society as a happy family. The success of a marriage is determined by how well you provide for your children and how you care for them which seems to indicate we must have children. So I think that we must say it is perhaps more a human failure rather than a mechanical failure when we're dealing with the issue of birth control. And you attribute this to misinformation. I think much of it is misinformation I think much of it is society's values that we have placed on the family and the function of the family or the

function of marriage. With much emphasis being placed on reproduction do you. High school courses or sex education programs would help this. Yes I do not think sex education in terms of basic biology and physiology is so much needed. It is needed but I think we need to add something to that and that is the matter that birth control or making a decision to bring a child into the world should involve considering the emotional needs of this child considering the responsibility of developing relationships. And if we are placing the primary emphasis on the physical aspects. Can I care for this child with food clothing shelter medical care. I think then we are overlooking one of the most responsible parts of family planning. How. Could you possibly take a few

case studies that you worked with and tell us what kinds of adjustments couples or single people have made. Yes I would like to consider the unmarried pregnant girl. I have been very pleasantly surprised that there is the concern about the need for education. The girls seem to feel that their education is not just something for themselves but something to prepare themselves for meeting the needs of a child. I think this is one thing that is a big adjustment. The idea I am to assume this kind of responsibility. I think another thing that comes through. Is making the tremendous shift from a teenage girl being a dependent person in her family's home to becoming the independent person who must then let a

newborn child be dependent on her in adolescence. The dependency independency struggle is difficult enough and it's tremendously emphasized for the unmarried pregnant girl. The undesired child that is born in a marriage. I think this does not necessarily create an immediate crisis. And rarely do we see this as a presenting problem at Family Service. However later after the child is born and then the couple is willing to face what is the real problem and that is the crisis in their relationship then they may come for counseling. So I would say that the young these are child born or conceived in a marriage is not usually considered as the cause of a problem but rather the effect of a problem that is the

unstable. Relationship within the marriage. When a child is conceived of an extramarital affair I think the same thing would be would hold true. That is that if the child is not necessarily the cause of the problem but rather the effect. Generally speaking this can be pretty well hidden by the woman in the marriage. And I think it would only be at the problem at the point that her guilt or fear of being found out might make her withdraw from the marital relationship in some cold or an affectionate manner that it would then come to us and perhaps the backlog of feelings as well as the history up a poor relationship in the marriage as well as the extramarital affair might be revealed. And this then brings me back to the point I was

making earlier that the emphasis on contraceptive methods for birth control has in my opinion been overemphasized. I am certainly in favor of informing the general public of the mechanical abuses and they do have a very definite venue but I think the emphasis must also include the human aspect. The awareness of having to make a responsible decision to provide not just physical care for a new live being but also to meet the emotional needs to realize that this child will make demands and must have a relationship that is giving that is caring that provides the security for him. I think just the use of contraceptives in our emphasis on

this is not going to solve the population problem. This has been birth control today. Freedom and responsibility. Graham and the series will cover population control and social stability. Guests today were Dr. Barnard going to college just an professor at Cornell Medical College and director of the National Council on New York chairman of the advisory board and Mrs. King casework supervisor of family service agency in Lafayette. Thanks for the use of material from the book Marriage Family and values by Dr Catherine Johnson and Dr. Christiansen to be published in Spring 1970. The series was written and produced by Colleen Gary and narrated by David Boddie Recording Engineer as Morris announcer Roger priest. The series is presented through the instructional radio division of WB University West Lafayette Indiana.

This is the national educational radio network.