Woman; 003; Birth Control

An in-depth exploration of the world of women today with Samantha D. Good evening. Tonight we continue our 10 week exploration of woman as wife a subject is best controlled. And with me is Mrs. Rooth Milla a medical social worker from Planned Parenthood of Buffalo New York. This is Noah would it be safe to assume in your estimation in the recent zero population growth that most couples in the United States use some form or another of birth control. I would say that certainly 50 percent 50 percent or more do. However there would be some who because of religious conviction would prefer not to see. Let's start off by reviewing the presently existing methods of birth control and then we will weigh their relative merits and disadvantages. And then later on in the show we'll discuss what's new what is being tested today for use in the future. So would you review for us what's available today.

Well there is the age old rhythm method which is primarily used by people of the Catholic faith. There is the condom which is the only male contraceptive so far there is the chemical contraceptives creams foams and jellies. There is the diaphragm which is an old reliable method and there is in the last 10 or 12 years the new pill the birth control pill and many new intrauterine device has. How about sterilization and abortion sterilization and both for male and female is a permanent method of birth control considered about 85 percent irreversible now the male operation is called Baz. To me the female new procedure laparoscopy. All right we'll get on to more details about that. And actually I just wanted to bring up abortion as a means of contraception that we won't go into it in any great depth because

later on in the series we'll be having a program dealing with that exclusively. Let's start off with the rhythm method. This is virtually timed abstinence is it not. Right it depends very much on the regularity of a woman's cycle which is difficult to determine. How do you determine this. Well in order to do this effectively you have to keep a temperature reading a daily temperature reading plus a monthly calendar accounting of your beginning of your periods and the end of your menses and after you have collected this material for about a year then a doctor goes over it and helps you decide what seems to be your safe time and what seems to be your fertile time. This is rather lengthy procedure what do you do for birth control in the meantime. That's a good question. Many people during the 12 months they're collecting the data could find themselves with an unplanned or unwanted pregnancy. Thinking I see and there are

many variable factors involved that for instance stress tension and riotous sickness coddle these disrupt the cycle right obvious lation can occur more than once a month and some women lation can also be delayed because of a cold or an emotional upset so that it's exceedingly difficult to determine even one a woman is very regular It's exceedingly difficult to determine when her fertile time is. How would you rate the effectiveness of the resin method. All I could say is that it's probably the least effective of any of the methods I say. The second method you mentioned was the condom. Yes this is about the only method on the market at the moment which puts the entire onus present in preventing conception on the male. Right right. This is the condom or the sheath safety or prophylactic for names for the device that is put to the penis before

intercourse. This is also the only method that prevents the spreading or the acquiring of venereal disease. And in this day one venereal disease is at epidemic proportions in our country. We feel it's terribly important for people to consider this as an effective method of birth control as well as a preventative of venereal disease. This is also the message the U.S. Army advocates isn't it for incidents abroad. What is the likelihood of manufacture's defects occurring in a. Condom and what's done to safeguard the public against this possibility. The manufacture of condoms a supervised by the Pure Food and Drug Administration each condom that is American made is. Tested electronically before it is packaged and the effectiveness rating the failure rating is zero point 1 percent so that it is highly effective if used properly. What is the approximate

cost of the condom. Probably in a drug store around two dollars and fifty cents a dozen three dollars that does nicely and this can be purchased at any drug store without prescription without a doctors present right. This is not the case of course with the diaphragm the diaphragm has to be very expert he fitted does it not by our gynecologist. Often you have been initially fitted with a diaphragm How soon should you go back for a checkup. Well this is just one of the many different sizes of the diaphragm. The doctor has to do an internal examination to measure the size of the uterus and the mouth of the uterus which is the cervix. And once the doctor fits the diaphragm the woman should go back at least once a year for an examination. If she has a weight gain or loss of more than 10 or more pounds either way there is a good chance that the size would

change also after a delivery. The first three months after delivery until the uterus resumes its normal size she would probably need a larger size during that period. You know maybe a couple of criticisms leveled both at the condom and the diaphragm. One is that they're not particularly aesthetically pleasing and the other is that they tend to disrupt spontaneity. Do you do you feel these criticisms are justified. Well I think that a little bit of inconvenience might be better than a yearly pregnancy. Absolutely. And when I hear young people using this for an excuse and then are in the office seeking an abortion I feel that perhaps a little bit advance planning and preparation might have prevented a lot of unhappy traumatic experiences. So you take what you lay to rest for me a couple of old wives tales regarding do Xing both do with a diving position and do Xing as a means

of contraception. Well the diaphragm is left in for six to eight hours after intercourse and to be highly effective it should always have a cream. Or a foam and add to it to make it the 97 percent effective rating that it has. When it is left in for six or eight hours expressly so that the spermicidal creen or foam can act to immobilize the sperm cells. Now if there is to be any douche ing it is done after the six or eight hours and the removal of the diaphragm is that I was completely right. Now as far as douche ing alone is a method of birth control the medical profession feels that it is practically useless because conception fertilization takes place so rapidly after intercourse that literally by the time the woman got

out of bed and ready to douche she might have already conceived. I say you mentioned creams jellies and so on. There are many of these on the market and without mentioning any brand names which is the most effective of the foams the jellies the creams and the homes and the aerosol cans the air cell phones are considered the most effective of the chemical contraceptives which come with an applicator and the woman has to. Fill the applicator with the foam and then the applicator is deposited deep inside the vagina and the foam is inserted before intercourse takes place. Let's talk about the IUD which you mentioned the wrong which is on the market which seems to be most popular is the plastic right.

How is this is an improvement over the original stainless steel I used to wear years ago I believe there was a lot of problem with the stainless steel and causing infection. The plastic seems to be a lot less of an irritant and has proved very effective. The one that's probably known throughout the world is Dr. Jack look this is loop which is the double S shaped loop. And this is the insert that the doctor uses to get this into the uterine Candy. Could you explain the principle on which it was. They don't really know for sure exactly how it works but they know that it does. It seems that in some mysterious way. The presence of a foreign object in the uterus somehow interferes either with fertilization or if fertilization did occur it would interfere with the process of

implantation in the uterus. So this is actually a mini abortion which is taking place each month. Well not always or not necessarily because if the theory is correct that it speeds up the travel of the egg through the fallopian tubes so that the egg is moving so rapidly that it cannot be. Impregnated or penetrated by a sperm cell then no fertilization takes place at all. One thing which always makes me curious is what keeps it in position what makes it what prevents it from moving around ever so slightly but enough to set up a friction. Well it it here's to the walls of the lining of the uterus. The reason the lipless loop has been so effective is because they feel that it so closely resembles the outline of the pear shaped uterus that when this goes in place it goes in straight and then it slowly springs back into

shape. And then it is just lying against the walls of the uterus. Now it is true that some uterus is reject this foreign object that muscular contractions start. And there is a small percentage of women who expel them. What is the percentage of women who get pregnant with an open position. We're out of the loop is considered about 97 to 98 percent effective with about a 2 percent failure rate. I say Well with that 2 percent failure rate. Let's suppose Let's hypothesize you did get pregnant. What would be the chances of a say rupturing the placenta damaging the fetus with one of those women. There is no harm to the baby. If a woman becomes pregnant with the u d in place they usually leave it in rather than run the risk of removing it and damaging the

embryo that way. So it stays in place it goes off to one side as the baby starts to grow the embryo grows and develops the uterus expands and the IUD never enters the sack that contains the fetus. And in each case where this is happened we find that the IUD is found in the placenta or the after birth. And what are the chances of hemorrhaging severely. A small percentage of women notice increased bleeding with their men seized in the beginning during the adjustment period. They might also notice that their periods start and stop and come more often than once a month. But a very small percentage I can't give you actual figures but a very small percentage of women actually damage. The thing is that some women if they find the minute the bleeding is heavier than they were

used to. Sometimes panic and feel that this is hemorrhaging but it usually is not. We feel that if a woman is bleeding so heavily that she has to change her pad every hour that would be considering hemorrhaging and she needs to see the doctor or a hospital immediately. What is the approximate cost. Well in a private gynecologist office the price could vary from 25 to 50 to $100 for an insert. At a government clinic it might be free of charge at a Planned Parenthood Sandor it would be based on a sliding scale income patients ability to pay. According to her in a room before the show you were telling me about a later development in the IUD field that was called the dotcoms shield right. That is one that is also used. And it looks like this. It is plastic also. And

this one is able to be used in a woman who has not ever carried a baby. We call that the no lip for us woman. Where as the lupus loop. Seems to have been too painful to insert before a full term pregnancy and too difficult to retain because the uterus expels it the darkened Shield has been quite successful in being inserted into the woman who has never had a baby. How does it compare from a cost point of view. I would say similar similar. And. Then. Next message you mentioned I think was the pill. Now the pill has been on the market you were telling me since 1960 and is used by approximately 8 million women in the United States. Is this then the most popular method of birth control right now. Right now I would say it probably is and as far as effectiveness rating it is still considered closest to 100 percent of every method.

But I should say here that we're still looking for the perfect contraceptive and by perfect it would mean one that agrees with everybody has little or no side effects is inexpensive enough to be accessible to every woman who would want it and would also be. Easy to tolerate and 100 percent effective and we haven't gotten there yet. What does this pill contain and how does it work. The pill was the first method. If it interrupts one of nature's normal processes it prevents violation by introducing into the body to synthetic hormones estrogen and progesterone which closely resemble the hormones that a woman's body gives off. Once she does become pregnant the hormones that are given off after pregnancy prevent

her from letting during the nine months of her pregnancy. Now by introducing to synthetic hormones by use of the pill. The doctors often say you are tricking your body or fooling your body into believing you're pregnant so that you're simulating a pregnancy. And in this way you are preventing the monthly egg from coming out of the ovary and traveling through the fallopian tubes. And if it doesn't come out and it isn't in the tubes then fertilization cannot take place. There are many different pills on the market are there not. How would you know which is the correct pill who you. Well there are probably 15 to 20 different brands a lot of drug companies making a lot of money on the pill. When a woman goes to her doctor he usually has one that he prefers. But of clor so close medical supervision is necessary

and a doctor does a medical history. And if there is any contra indication if the woman has had any blood circulation problems and a history of cancer in her own body or any indication diabetes any indication that the pill wouldn't agree with her. The doctor would so advise her. One has read and I'm sure everybody has read about the dangerous complications which are a possible side effect and I was just wondering if you had any statistics which show just what percentage of pill users are afflicted by these dangerous side effects. I don't have statistics I know that a few years ago we had that scare when the British report came out on the pill and as a result the Congress of the United States had hearings on it many people panicked and went off the pill. There was a. Increase in pregnancies over the next nine months to a year. But it was declared to be perfectly safe

under close medical supervision. The thing that has been definitely established is that there is a relationship between the possibility of thrombosis embolism or a blood clotting. With taking an estrogen progesterone combination How would you recognize in the initial stages the symptoms of blood clotting. Well some of the early signs of trouble in general might be chest pains or leg pains or cramps and numbness in fingers or toes and a severe headaches that are really blinding headaches pounding in the temples. And he should be reported to the doctor immediately as for runners of a problem. What is the reliability factor with the pill what happens if you miss a day for instance. Well the pillows normally are started on the fifth day of a woman's menstrual

period. If she forgets one she should take it as soon as she remembers it and hope and pray that it wasn't too late. If she misses more than one pill in any one month then it is suggested and recommended highly that she continue taking the pill but that she use an additional method of birth control for the remainder of that month such as the foam or condoms until the package is completed and the next period has begun. This is a double precaution about the missing pill. What are your chances of being able to conceive right off to come off the pill. There has been a lot of controversy in two schools of thought about that. I don't think they've resolved it yet. There was one research team that felt that after your body has been used to taking pills for say a couple years and then you wish to conceive when you stop the pill that it might take

your body a good six months to a year to begin normal lation again. And then there was another research team that felt immediately after discontinuing the pills a woman might be highly fertile because her. Ovaries might start releasing more than one egg a month which would make her more susceptible. This pill is not to be in any way confused with the high fertility pill that is causing multiple births and we get lots of questions about that. Am I going to have twins or triplets or quadruplets later. This is a different dosage completely. I would like to say here that when pills first came out in 1960 they were 10 milligrams per pill a very high dosage of the two hormones. And we were seeing a lot more serious side effects at that point. But in the last 11 years the pill has really been reduced to 10

to five to two and a half and now one milligram. And with the lower dosage pill there are many less complaints and what's the approximate cost of a month's supply. Well again in a drug store probably 250 or 275 a package. At or. Federal clinic. They might be free at a hospital or a Planned Parenthood clinic. They might be based on income. Let's talk relatively briefly about sterilization and the new tubal ligation which is now being offered. That is the laparoscopic side. Originally it was a serious operation with a very large incision. The new technique is been so popular lately that the phone doesn't stop ringing about it. There is a very expensive instrument called the lacquer scope that is inserted into the navel of the woman at the end of this last scope. There is a light and a magnifying lens

which enables the physician to locate the two points in the fallopian tubes that he would like to cauterize electrically and then the incision is so small that only a bandaid is needed to cover the opening. That's how he gets his nickname the Band-Aid operation right. Right. What is the degree of reversibility. At the moment I believe it's considered irreversible or at least 85 percent versus the bull they're hoping to make it reversible. That's one of the aims for the future right. And the doctors would like a woman and her husband to be very certain that they've had a number of children they wish to have before they make this decision because it may be permanent. Right. Let's get on to the future propositions what is being tested now for use in the future. Oh there are lots of exciting things on the drawing board under study right now is the copper key

which I have here a plastic. Into uterine device. Which has a copper mesh wound around the stem. The addition of this non toxic metal. It is supposed to be and added preventative against pregnancy. It still is under study under research has not been approved by the Drug Administration. If it proves to be effective as effective as they hope it will it will rate. 99 percent like the pill but we don't have enough facts and figures in yet to know for sure what else is on the drawing board. The other things a new intra uterine device that is in the shape of the T but instead of the stem having copper It contains a milk like substance called progesterone which we have in our pills and this will be very

slow. Daily release minute amount of progesterone so that this will be combining the intrauterine devices effect along with. The hormonal effect like the pill. And that is for the future. How about the male pill. The male pillow is still under a great deal of question. There is a subcutaneous capsule that they're talking about. That would be inserted surgically perhaps in the pit and this would give minute amounts of testosterone a male hormone. But this has to be very carefully evaluated because so far they have found that while it might interfere with male fertility it will have some other side effects on the body that may not be wanted. Right. So that's basically it for the future is it. And then

there are some oral steroids which have reached the most advanced point drugs that are being studied that when taken will actually alter the entry meet and Romy Trium the lining of the uterus that might prevent implantation. I have one question that I mean to ask you earlier on the necessity for birth control during the menopause is very important. This is a time in life where no woman wishes to become pregnant and could find herself pregnant if she doesn't use her birth control method for 12 consecutive months after missing a period she could become pregnant. And how about the breastfeeding mother. ROSS Right after having given birth right there are a lot of mistaken bits of information about that a woman is immediately fertile after pregnancy and delivery immediately fertile after an aborted procedure needs to use a contraceptive device. And this is

also true that the nursing mother is fertile right and would need a method. This is thank you so much this has been extremely informative and I'm sure will help to allay much of that 28 day anxiety syndrome. Good night. You're.