Problem: Contraceptives in general, are they good or bad.
Author: Mayur Sarode
Initial prevalence of contraceptives
GOLDIN, C.; KATZ, L. F. (2024) states that the relationship between the diffusion of the birth control pill among young, unmarried college graduate women and changes in their career and marriage decisions. The pill was approved in 1960 but did not become widely available to young, single women until the late 1960s after state law changes reduced the age of majority and extended “mature minor” decisions. The availability of the pill among young, unmarried women lowered the costs of long-duration professional education for women and raised the age at first marriage. The research presents descriptive time series and formal econometric evidence that support the “power of the pill” in influencing women’s career and marriage choices. The research also highlights the limitations of previous surveys in studying contraceptive use among young and unmarried women, emphasizing the need for more comprehensive studies. Overall, the research demonstrates the significant impact of the birth control pill on women’s educational and marital decisions, particularly among college graduate women born around 1950.
Specifically studies the hormonal contraceptives
CHARLTON, B. M. et al (2014) states that This study examines the influence of hormonal contraceptive use and health beliefs on sexual orientation differences in Papanicolaou (Pap) test use among adolescents and young adults . Factors explaining differences in screening include less awareness of cervical cancer risk and negative attitudes and beliefs toward Pap testing. Previous studies have reported that lesbians have a lower risk of acquiring HPV and developing cervical cancer. Physician advice is arguably the most important factor related to Pap test use in all women. However, bisexual people and lesbians said their doctors did not recommend Pap tests. The health belief model (HBM) is a psychological model that aims to explain and predict health-related behaviors. This includes concepts such as susceptibility, severity, benefits, barriers, cues to action, and normative beliefs. The purpose of this study is to provide data on the use of Pap testing in ethnic minority women to inform health care, government, and educational policies.
The popular one
SIEGEL WATKINS, E (2012) states that The most common birth control methods in the United States are sterilization and the pill, followed by condoms. Condoms are commonly used to prevent disease transmission, but they are less effective at preventing pregnancy than hormonal methods. Norplant, a contraceptive implant, fell out of favor and was withdrawn from the market after a decade. Other contraceptive methods such as Depo-Provera, vaginal rings, patches, and implants have lower usage rates. The development and adoption of reversible contraceptive methods such as birth control pills and IUDs in the 1960s promised new innovations in this field.
The good and the bad about contraceptives
ANANAT, E. et al (2012) states that The popularization of oral contraceptives among young, unmarried women has led to a decline in fertility and an increase in the rate of low birth weight babies born in poor households in a short period of time. The use of oral contraceptives results in no significant changes in long-term fertility. However, this increases the proportion of children whose mothers have university degrees and reduces the proportion of children whose mothers are divorced. The short-term effects are due to women being more mobile and not having children early, while the long-term effects are due to delaying childbearing to a later age. There is evidence that the popularity of birth control pills has reduced abortion rates, suggesting that some women have switched from abortion to birth control pills when both options are available. Previous research has been inconclusive about the impact of contraceptive access on young women’s fertility, with some studies showing reduced fertility and others Another showed higher rates of teenage pregnancy.
The direct effects
THIJS, C. et al (1993) states that A meta-analysis of controlled epidemiological study discovered that oral contraception was related with a slightly higher risk of gallbladder disease. The odds ratio for always or never taking oral contraception was 1.36, indicating a dose-response relationship. However, rather than waiting for gallbladder illness to emerge, the authors propose that the safety of novel oral contraceptives be evaluated by evaluating biliary saturation and function. Findings bias is unlikely in studies of oral contraceptives and gallbladder illness since significant disorders such as acute cholecystitis require medical attention. The decreased efficacy found in the extension follow-up trials cannot be attributed to detection bias.
The right way
TRUSSELL, J. et al (1993) states that The article argues that birth control pills should be sold without a prescription because of the high costs associated with prescribing them, including the financial, time, and psychological costs of seeing a doctor, as well as the cost of carrying them. Unintended pregnancy due to limited access to contraceptives. The authors suggest that revised packaging design and patient labeling could enable women to self-screen for contraindications and use oral contraceptives safely and successfully. They propose several alternatives to the current prescription system to make it easier to buy and use contraceptives. The article concludes that neither safety nor effectiveness considerations justify the prescribing of oral contraceptives. They argue that improved package inserts and simplified instructions could improve compliance and that restricting access to contraceptives is paternalistic. They are calling for a national dialogue on the issue.
Contraceptives and the bones
KIRTZ-SILVERSTEIN, D. et al (1993) states that The long-term effects of prior oral contraceptive usage on bone mineral density were investigated in 139 postmenopausal women, 35.1% of whom reported previous oral contraceptive use. Women who used oral contraception for six years or more had considerably greater bone densities in the lumbar spine and femoral neck than those who did not use oral contraception. Estrogens in oral contraceptives boost calcium absorption, reduce calcium loss, and have a direct influence on bone resorption, potentially improving bone mineralization. The notion that oral contraceptives might reduce the incidence of postmenopausal bone loss needs additional exploration. The long-term impact of contemporary lower-dose oral contraceptives on bone mineral density is uncertain.
Contraceptive and postpartum
LABBOK, M. et al (1985) states that About 20% of lactating women are sexually active and do not use contraception between 2 and 6 months postpartum. Among those using contraceptives, the highest rate of contraceptive choice was 14% who used birth control pills early in the postpartum period. From 1973 to 1976, the proportion of women using contraception while breastfeeding increased and the proportion using oral contraceptives decreased. From 1973 to 1976, 14% of contraceptive users started using birth control pills within the first month after giving birth, a higher rate among lactating black women (48%) than among black women who were breastfeeding. White women (11%). Four to six months after giving birth, nearly 20% of breastfeeding women may be unprotected against the risk of pregnancy. There are racial disparities in contraceptive use, with black women using pills more and contraceptives less.
The easiest way
MOREAU, C. et al (2009) states that A French national cohort study examined the impact of access to emergency contraceptive pills (EC pills) on women’s use of highly effective contraceptive methods. Recent national studies in France and the UK show no decline in the use of highly effective contraceptives following the removal of the requirement to prescribe contraceptive pills. Six months after using EC birth control pills, women were more likely to use effective contraception and less likely to use condoms than when they were using EC birth control pills. The proportion of women not using contraception 6 months after using topical contraceptives was similar to that at the time of pill use. EC pills are primarily used to compensate for inconsistent use or errors in contraception, with birth control pills and condoms being the most commonly used methods before using the pill EC. Only in a small proportion of reported cases of oral contraceptive use were women not using any contraceptive method.
Trends and Dynamics in Contraceptive Use
FORREST, J. D. (1985) states that Contraceptive use patterns remain unstable, and new information and lower drug dosages and changes in perceptions may influence contraceptive choice. New contraceptive methods being tested and developed may also affect the ranking of methods in terms of risks, benefits, and effectiveness. The wide variation in contraceptive use over the past decade shows how unstable and unpredictable trends can be. Public dissatisfaction with current contraceptive methods is driving the development of new contraceptives. There is some evidence that the use of oral contraceptives may be increasing, which is positive given the health risks and benefits, potential reduction in unwanted pregnancies, and increased more time to consider sterilization. There are concerns about the dose levels to which some women are exposed and the need for research into the risks and benefits of lower dose medications. Approval of oral contraceptive use among women 18 to 44 years of age increased steadily from 1977-78 to 1982. The proportion of people using oral contraceptives remained stable from 1979 to 1982, while the number of prescriptions dispensed increased 36% from 1979 to 1983. A report on patients at a family planning clinic in California shows increasing choice of birth control pills among poor women . Increased awareness among health professionals and women of the health risks and benefits of oral contraceptives could lead to more widespread use of oral contraceptives. Stock analysts predict increases in drug sales and profits.
Conclusion
In the mid-20th century, the introduction and widespread availability of the birth control pill revolutionized women’s reproductive autonomy and societal dynamics. Initially approved in 1960, it wasn’t until the late 1960s, following legislative changes, that young, unmarried women gained access to the pill. This accessibility reshaped the landscape for women, particularly college graduates born around 1950. With lowered barriers to education and delayed marriage, women found themselves able to pursue long-duration professional education, altering their career trajectories and marital decisions significantly. The impact of the pill extended beyond individual choices. It sparked discussions on healthcare policies and highlighted disparities in access and recommendation, as seen in studies examining the influence of hormonal contraceptive use on Pap test utilization among different demographic groups. Meanwhile, the evolution of contraceptive methods, from sterilization to implants, rings, and patches, promised innovation and increased options for women. As the pill gained popularity among young, unmarried women, it contributed to declines in fertility rates and abortion rates, reshaping family structures and educational outcomes. However, concerns about its potential health risks, such as a slightly higher risk of gallbladder disease, led to calls for thorough evaluations and policy discussions regarding its prescription requirements. In response to challenges in contraceptive access and compliance, there were growing calls for over-the-counter availability of birth control pills to reduce barriers and empower women in managing their reproductive health. Studies also explored the long-term effects of oral contraceptives on bone density, revealing potential benefits that warranted further investigation. The story of contraceptive use reflects an ongoing dialogue between healthcare providers, policymakers, and women themselves. It underscores the need for comprehensive studies, equitable access, and informed decision-making to ensure the health and autonomy of women across diverse backgrounds and circumstances. As contraceptive technologies evolve and societal attitudes shift, the narrative continues, driven by a quest for safer, more effective, and accessible reproductive options.
References
ANANAT, E. O.; HUNGERMAN, D. M. The Power of the Pill for the Next Generation: Oral Contraception’s Effects on Fertility, Abortion, and Maternal and Child Characteristics. Review of Economics & Statistics, [s. l.], v. 94, n. 1, p. 37–51, 2012. DOI 10.1162/REST_a_00230. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=989d56fa-a7da-3e99-b7a1-7399f4d8f2ab. Acesso em: 23 fev. 2024.
CHARLTON, B. M. et al. Influence of Hormonal Contraceptive Use and Health Beliefs on Sexual Orientation Disparities in Papanicolaou Test Use. American Journal of Public Health, [s. l.], v. 104, n. 2, p. 319–325, 2014. DOI 10.2105/AJPH.2012.301114. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=ff5b78ac-2bf0-388d-a9e4-9b73f2b78664. Acesso em: 23 fev. 2024.
FORREST, J. D. The Public and the Pill: Is the Pill Making a Comeback? American Journal of Public Health, [s. l.], v. 75, n. 10, p. 1131–1132, 1985. DOI 10.2105/AJPH.75.10.1131. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=4cd03b20-388e-3ca2-a2fe-911e81ec7da3. Acesso em: 24 fev. 2024.
GOLDIN, C.; KATZ, L. F. The Power of the Pill: Oral Contraceptives and Women’s Career and Marriage Decisions. Journal of Political Economy, [s. l.], v. 110, n. 4, p. 730–770, 2002. DOI 10.1086/340778. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=2d9d865b-4764-34c9-8828-565d675a63c4. Acesso em: 18 fev. 2024.
KIRTZ-SILVERSTEIN, D.; BARRETT-CONNOR, E. Bone Mineral Density in Postmenopausal Women as Determined by Prior Oral Contraceptive Use. American Journal of Public Health, [s. l.], v. 83, n. 1, p. 100–102, 1993. DOI 10.2105/AJPH.83.1.100. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=cbec4b9e-fe6c-32eb-b326-040bd745f1bc. Acesso em: 24 fev. 2024.
LABBOK, M.; FORD, K.; GRAY, R. H. Contraceptive Usage during Lactation: Analysis of 1973 and 1976 National Survey of Family Growth: I. Age and Race. American Journal of Public Health, [s. l.], v. 75, n. 1, p. 75–77, 1985. DOI 10.2105/AJPH.75.1.75. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=b326d300-3b43-3e61-9de5-4f0e8ac77f00. Acesso em: 24 fev. 2024.
MOREAU, C. et al. The Effect of Access to Emergency Contraceptive Pills on Women’s Use of Highly Effective Contraceptives: Results From a French National Cohort Study. American Journal of Public Health, [s. l.], v. 99, n. 3, p. 441–442, 2009. DOI 10.2105/AJPH.2007.118935. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=74ebe811-29bc-343f-90c4-47a654c6a54d. Acesso em: 24 fev. 2024.
SIEGEL WATKINS, E. How the PILL Became a LIFESTYLE DRUG: The Pharmaceutical Industry and Birth Control in the United States Since 1960. American Journal of Public Health, [s. l.], v. 102, n. 8, p. 1462–1472, 2012. DOI 10.2105/AJPH.2012.300706. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=f3741857-5ad6-30dd-b4d4-db5fd2efae95. Acesso em: 23 fev. 2024.
THIJS, C.; KNIPSCHILD, P. Oral Contraceptives and the Risk of Gallbladder Disease: A Meta-Analysis. American Journal of Public Health, [s. l.], v. 83, n. 8, p. 1113, 1993. DOI 10.2105/AJPH.83.8.1113. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=2793f759-9fb4-3341-8fa1-6bef0466c397. Acesso em: 23 fev. 2024.
TRUSSELL, J. et al. Should Oral Contraceptives be Available Without Prescription? American Journal of Public Health, [s. l.], v. 83, n. 8, p. 1094, 1993. DOI 10.2105/AJPH.83.8.1094. Disponível em: https://research.ebsco.com/linkprocessor/plink?id=b7cfb7e9-37ac-3361-9e25-097c9cd82e33. Acesso em: 24 fev. 2024.
Name/Author: Mayur Sarode
Roll no: 108
Institution: Kohinoor Business School MMS 1st year batch/division: B
