Saturday, February 18, 2012

Birth Control

Every married couple may not desire to have children. Some might wish to postpone the blessed event to a later time. For example, some couples find the adjustment to married life a difficult enough task without adding newborns into the equation. Others want children, but they prefer to space them out in time.There are several methods available to prevent the conception or birth of a child. Some are useful to the Christian, some are controversial, and some are sinful to use. While contraceptives are widely used and easily available, it does not mean that all methods are acceptable to God. True contraceptives are not sinful. A child does not exist before conception. If the ovum is not fertilized by the sperm, then no human life exists. Abortion kills that which has been conceived. Contraceptives prevent the conception of a life.

Before we progress further into our study, we need to define what is meant by birth control and contraceptives. A contraceptive is any method used to prevent the conception of a child. Contraceptives prevent the male sperm from uniting with the female’s ovum. Birth control is a broader term. It is any method used which prevents the birth of a child. A child might be conceived, but so long as it is not born, then its birth was controlled.

If it is wrong to murder a child after its birth, then it must also be wrong to murder a child before its birth.

For this reason abortion is wrong. It is a form of birth control. It does prevent the birth of a child. However, the killing of the child is a sin, even if the killing takes place before birth because the child is still a living human being.

Plants and animals grow naturally, but not in quantities sufficient to meet man’s needs. Hence, man creates artificial farms, vineyards, and flocks which meet with God’s approval (Genesis 4:2; 9:20; 47:3; Psalm 23; Matthew 13:3-8). The natural mode of transportation for man is walking, but God has approved the use of artificial transportation, such as ships. The use of contraceptives is simply another tool to control the course of nature for man’s needs and enjoyment. There are times when having children would not be wise. For example, when a wife is having health problems, when a couple is older and a pregnancy might risk the woman’s health or carry a high risk of producing a defective child, or when a couple is not financially able to support another child. Sexual intercourse is required in a marriage and avoiding sex simply to avoid having a child is not right.

Like all authorized activities the control of the production of children can be misused. However, because some misuse a right does not imply that a practice is inherently wrong. It is true that man is commanded to be fruitful and multiply, but that doesn’t imply that every couple is to have as many children as is possible. Every child given to a parent, whether planned or unplanned, should be loved and cared for, but nothing says a couple cannot limit the number of children that they will have.

Unfortunately, some so-called contraceptives may not prevent conception. Instead they terminate the life of the conceived child very early in its life. For example, the IUD is a molded piece of plastic that is inserted into the woman’s uterus. As the woman moves, it lightly bounces against the walls of the uterus. It does not cause any harm to the woman, but the mild irritation that it presents prevents a fertilized egg from implanting onto the walls of the uterus. The IUD does not prevent conception, but instead cause the child to be miscarried a few days after it was conceived. In other words, the IUD is a form of early abortion.

To compare the effectiveness of the various methods, a couple having regular sexual intercourse has an 85% chance of conceiving a child in a one year time frame.

Acceptable Forms of Contraception

Some clinics offer women a “morning-after” pill when they had engaged in sex, but do not want to become pregnant. These pills contain strong doses of hormones to force the shedding of the lining of the uterus, even if it is not their normal time of the month to menstruate. Without a lining, a fertilized egg cannot implant and grow. Again, this is not a contraceptive because a child may have been conceived. Instead, it is an abortive. Some “morning-after” pills are actually strong doses of the typical birth control pill that is popular among women. The intention of the birth control pill is to regulate a woman’s hormones so that ova are not released each month. These pills are only about 95% effective in preventing the release of an egg. To increase the pill’s effectiveness in controlling births, a second hormone is typically added to force the shedding of the lining of the uterus each month. Even if an egg is accidently released, the second hormone prevents it from attaching to the lining of the uterus. With the addition of the second hormone, the pill is 98% to 99% effective in preventing births. Not all birth control pills cause abortions, but since the contraceptive-only pills are rarely prescribed, the doctor and pharmacist should be carefully questioned as to how the particular brand of birth control pills they are purchasing actually work.

Condoms: There are two versions available today – one for the male and one for the female.

The male condom is a thin sleeve that is rolled over the man’s erect penis. Most condoms are made from latex so if either the husband or wife is allergic to latex, a non-latex condom, usually made of polyurethane must be used. Since the husband’s penis must be erect before the condom can be rolled over the penis, foreplay must be started and then briefly interrupt to put on the condom. Care must be used in putting on the condom to ensure that the end of the condom is not tight against the end of the penis. When the husband ejaculates, an area is needed to trap the semen. Otherwise, the end of the condom can swell and pop like a balloon – making the condom useless for preventing conception. Because the condom covers the glans and shaft of the penis, sexual pleasure from intercourse is reduced for the man. If a man is having difficulties delaying ejaculation, this might be a bonus, but many dislike the lacking of feeling that comes with the use of a condom. The condom must be removed shortly after ejaculation because the male penis becomes flaccid, reducing in size, and allowing the possibility of sperm spilling out of the condom and into the vagina.

The female condom is like a loose bag with a rim to keep the condom in place. It is typically made of polyurethane. The bulk of the bag is inserted into the vagina before intercourse takes place. This makes it difficult to use before the wife’s hymen is broken the first time she has sex. However, afterwards, it can be inserted whenever intercourse is planned, so foreplay does not have to be interrupted. Like the male condom, the female condom does decrease sexual pleasure, both for the husband and the wife.

Condoms made in the United States must have a sample failure rate of 7% or less. In other words, up to 7% of the condoms purchased fail. They may fail because of a small hole in the latex or they might tear during usage. There is also the possibility of the male condom being put on incorrectly. Since condoms are rolled on, they can roll back up and slip off. Polyurethane condoms are especially prone to slippage. They are also reported to break more easily than latex condoms. Since putting on a condom requires interrupting foreplay, there is a strong temptation to skip putting it on “just this one time.” In addition, newly married couples are curious as to what sex is like without the condom. More condoms actually fail from the lack of use than from manufacturer defects. Overall, 14% of couples using male condoms end up conceiving a child in one year and 21% of couples using female condoms end up conceiving a child in one year.

Diaphragm: The diaphragm is a soft, molded disk that blocks the end of the vagina so that sperm cannot get by it. Since the shape of each woman’s vagina varies greatly, a gynaecologist must make a mold for the diaphragm to be manufactured. It takes about two weeks to get a diaphragm after seeing the gynaecologist. In addition, to make the mold, the doctor will have to break the woman’s hymen if she has not had sex before. Some women find this preferable to having the pain of the hymen being broken on their wedding night.

Again, advance planning is required to insert the diaphragm before sexual intercourse, even though foreplay is not interrupted. Because it is possible for the diaphragm to slip out of place during intercourse, it is strongly recommended that a spermicide cream is used in addition to the diaphragm. Care must be taken in removing the diaphragm so that semen is not accidently spilled into the vagina. Like the condom, the diaphragm fails more often from the lack of use than from leakage around the edges. Twenty percent of couples using a diaphragm end up conceiving a child in one year.

Diaphragms do wear out, so they must be replaced every two years. In addition, if a woman becomes pregnant, the shape of vagina changes even after pregnancy, so she will need to be fitted with a new diaphragm.

Cervical Cap: The cervical cap is smaller than the diaphragm and is made of thicker material. The cap fits over the cervix and is held in place by suction. Like the diaphragm, it must be made to order by a gynaecologist. New caps need to be ordered each year and after a pregnancy. The cervical cap is not as effective after the birth of a child as it is before a pregnancy. As with the diaphragm, it needs to be used with a spermicide. The cap must be removed after intercourse and care must be taken not to allow semen to slip passed the cap. A woman who has never been pregnant has a 20% chance of conceiving a child in one year. A woman who has had children has a 40% chance of conceiving a child in one year using the cervical cap.

Sponge: This is a small sponge containing spermicide. It is moistened with water and then inserted into the vagina. It provides protection for up to 24 hours. It has been linked with increased yeast infections and toxic shock syndrome so it is not recommended by doctors in the United States. Using the sponge, there is a 20% chance of conceiving a child in one year before the first child is born. After having children, there is 40% chance of conceiving a child in one year.

Spermicides: These are creams, jellies, or foam inserted into the vagina before sexual intercourse. The creams or jellies contain chemicals which kill sperm. Some people are allegoric to the chemicals used. The use of spermicides has been linked to increased urinary tract infections in women. Since spermicides provide no physical barrier, care must be taken to completely cover the cervix. Failure depends on how well it is used. On average, couples using only spermicides have a 26% chance of conceiving a child in one year. However, conception rates can be as high as 50% in one year due to imperfect use of spermicides.

Rhythm method: Since an egg is only released once every 28 days, on average, and sperm survives in a woman’s body for six days, the goal of the various rhythm methods is to restrict sexual intercourse to the times of the month when a woman is least likely to become pregnant. The difficulty is that every woman’s menstrual cycle is not a precise 28 days. Many women’s cycle varies from month to month. It can be as short as 14 days or as long as 36 days. Athletic women and young women occasionally miss a period, which makes determining the next time of ovulation difficult. The greatest disadvantage of the various rhythm methods is refraining from sex for a period of about nine days each month. Even women find this difficult because a woman feels most sexy during the time her egg is released, which is precisely the time the couple is trying to avoid.

The simplest method is the calendar method. It works best if the woman’s blood flow comes at regular intervals. A woman releases an egg 14 days before the start of her next blood flow. If the wife can project when she believes her next period will start, then the couple not desiring children must refrain from intercourse from 20 days before her next period to 11 days before the next period. The extra three days is in case the egg is not released precisely on the projected day. On average, 20% of the couples using this method end up conceiving a child in a year.

A bit fancier is the Sympto-Thermal method. Here the wife takes her temperature each morning before she gets out of bed. She uses a very sensitive thermometer that records temperatures to a fraction of a degree. When her temperature rises a half degree and stays elevated for three days, she has just ovulated. After the three days, the couple can have sexual intercourse for seven days with little chance of conception happening. Of course, this limited time per month for sex is too limited for most couples. Some couples stretch the time to one week before the next projected rise in temperature. It increases the possibility of conceiving a bit, but most find it to be in an acceptable range. The advantage of monitoring the temperature is that it handles variations in the length of the menstrual cycle. On average 17% of the couples using this method conceive a child in one year. If the couple restricts themselves to intercourse only the week after ovulation, only 2% of the couples conceive a child in one year.

Combining a rhythm method with another form of contraceptive is a clever way to have a strong contraceptive approach and still enjoy unrestricted sex one week per month. The couple can still have sexual intercourse during the remainder of the month, they just have to use another contraceptive. It is possible to reach levels equal to or exceeding the use of the birth control pill.

Breast-feeding: Breast-feeding is called the most effective contraceptive method known to man. While a woman is nursing a child, she only has a 6% chance of becoming pregnant within one year. The hormones that stimulate milk production in a woman’s breast also interrupt a woman’s menstrual cycle. As the child begins to eat foods other than his mother’s milk, the odds of becoming pregnant increases.

Withdrawal: This method requires the man to withdraw his penis prior to ejaculating. However, when a man approaches the point of orgasm, it becomes increasingly difficult for a man to withdraw prior to ejaculating. In addition, the interruption of sexual intercourse just before orgasm greatly decreases the pleasures of sex. Since sperm can exist in the fluids from the Cowpar’s glands which drip during sexual arousal, there is still a small chance of pregnancy occurring. On average 19% of the couples using this method conceive a child in one year.

Since the desire for sex all the way to orgasm is strong, it is recommended combining the withdrawal method with the rhythm method. The couple has full, complete sex during the safe week and uses withdrawal through the remaining times of the month.

Sterilization: These methods close of the path of the sperm so they can never reach the egg. Once performed, these methods are considered 99.9% effective in preventing conception.

In a male, sterilization means removing about an inch of the Vas Deferens on each side of the scrotum. The ends of the tubes are tied or burnt shut. The method does not affect the man’s ability to produce semen, nor does it effect his desire for sex. Instead the semen he produces will no longer contain sperm. The sperm produced by the testicles are reabsorbed by the man’s body. Technically, sterilization in a man is reversible, but in practice the success rate is very low. The longer a man remains sterilized, the less likely it is to be reversible. After a vasectomy, a man is not immediately sterile. It takes 15 to 20 ejaculations before the remaining live sperm in the system is flushed out. Since a vasectomy can be done in a doctor’s office using local anesthetics, the cost of a vasectomy is much lower than tubal ligations.

In the female, the tubes leading from the ovaries to the uterus are tied off or pinched close with a rubber band-like device. The procedure is expensive, requiring abdominal surgery in a hospital. Like the man, the procedure is technically reversible, but in practice it is difficult to achieve. Reversal operations are very expensive with no guarantee of success.