Birth Control and Abortions

Anna Mayer

Birth Control and Abortions

            Each country has different laws and regulations regarding birth control and abortions.  There are various factors that contribute to the availability of birth control and abortions in different countries.  This paper analyzes oral contraceptives, the most famous abortion Supreme Court Case in United States history along with comparing birth control regulations in Egypt, France and the United States.

One of the most well-known types of birth control is the oral contraceptive.  Oral contraceptives were invented in the United States back in 1950 and they were first sold in the 1960’s (Rengel, 2000, p. 162).  They are pills that provided a highly effective way to prevent pregnancy that did not require any attention immediately before, during, or after sexual intercourse (Rengel, 2000, p. 162).  In the 50 plus years since both their discovery and marketing, oral contraceptives have evolved and been changed to make them more safe and effective (Rengel, 2000, p. 162).  Currently, over 70 million women around the world rely on oral contraceptives to avoid unwanted pregnancies (Rengel, 2000, p. 162).  There are now over 50 different brands of oral contraceptives that have been approved for use in the United States and they come in two main forms: combined oral contraceptives (COCs) and progestin-only pills (Rengel, 2000, p. 162).  The more common combined oral contraceptive is also known as “the pill” and it contains doses of both progesterone and estrogen (Rengel, 2000, p. 162).  Progestin-only pills are also known as “mini pills” and contain a dose of progestin (Rengel, 2000, p. 162).  Levels of these two hormones prevent ovulation by preventing the pituitary gland from secreting the hormones FSH and LH which are needed to start ovulation (Rengel, 2000, p. 162).  The synthetic versions of the hormones estrogen and progestin found in oral contraceptives act to mimic the function of natural hormones that occur in the woman’s bloodstream which are similar to what is found naturally within the second half of the menstrual cycle (Rengel, 2000, p. 162).

Oral contraceptives are some of the most highly effective products that are currently on the market for preventing unwanted pregnancies (Rengel, 2000, p. 162).  All of these oral contraceptives have to be taken daily to maintain postovulatory levels of FSH and LH (Rengel, 2000, p. 162).  When women follow the package directions precisely including following instructions as to what to do if you forget to take a pill, that is said to be perfect use (Rengel, 2000, p. 162).  Perfect use of COCs are 99.9% effective and progestin-only pills are 99.5% effective with perfect use within the first year of usage (Rengel, 2000, p. 162).  Oral contraceptives are becoming more and more common in developing countries but their effectiveness is hindered by the lack of education of women in how to take them and what they need to do if they miss a dose (Rengel, 2000, p. 163).  When women do not follow the package directions, that is said to be imperfect use and the effective rate is 95% during the first year of usage (Rengel, 2000, p. 163). 

Roe v. Wade is the most famous reproductive rights court case in history.  When unmarried carnival worker, Norma McCorvey, was pregnant with her third childen, she attempted to get an abortion and was denied (Rengel, 2000, p. 199).  She then found a lawyer that agreed to sue Texas because they denied her the abortion that she had wanted (Rengel, 2000, p. 199).  On January 22^nd, 1973, the United States Supreme Court ruling in the case of Roe v. Wade, declared it unconstitutional by a vote of seven to two in state laws that had denied women the right to have abortions (Rengel, 2000, p. 199).  The decision in this court case made abortion legal throughout the United States and it affirmed a woman’s right to privacy when choosing to end a pregnancy (Rengel, 2000, p. 199).  The right to privacy was deemed broad enough to include a woman’s decision to terminate a pregnancy without any interference from the government (Rengel, 2000, p. 199).  In the Roe v. Wade trial, the Court had placed two limits upon the right to privacy which included: recognizing a state’s responsibility to determine who was qualified to perform the abortions and how abortions would be preformed to ensure the health and life of the woman and that at 24 to 28 weeks from the woman’s last menstrual period, the fertilized egg becomes “a viable human being that the state has an interest in defending” (Rengel, 2000, p. 199).  After the 24 to 28 week mark, the state could only prohibit abortions that were unnecessary to protect the woman’s health (Rengel, 2000, p. 199).

By 1999, family planning clinics had spread across the United States and their citizens had easily accessible information on birth control and family planning (Rengel, 2000, p. 233).  In the United States, clinics such as Planned Parenthood offer two types of abortion: in-clinic and a two-step pill process; both of which cost over $300 (Abortion, 2012).  The United States is a wealthy, developed nation that has contributed billions of dollars to other countries and organizations around the world to help support reproductive health, family planning and attempts to decrease the population yet they faced subtle social problems that continue to challenge access to contraction, reproductive health care and abortion (Rengel, 2000, p. 233).  In the United States, there are conflicting opinions on how people should be educated about both reproduction and pregnancy prevention.  Some schools have completely banned sex education, some schools teach abstinent only classes and others offer comprehensive sex education.  The variation of access to sex education is concerning to health care professionals who are worried that teen pregnancy rates will increase (Rengel, 2000, p. 235). 

The number of sexually active teens in the United States fell below 50% in the 1990s and teens were waiting until later in life to engage in their first act of sexual intercourse with many waiting until they were older than 19 (Rengel, 2000, p. 233).  By 1999, over 90% of sexually active women who did not want a baby were using modern contraceptives (Rengel, 2000, p. 233).  In the United States, both women and families have relatively easy access to both medical services that provide reproductive health care along with a wide variety of companies that produce condoms, birth control pills and spermicides which leaves men and women with easy access to many forms of birth control (Rengel, 2000, p. 233).  Gynecologists have increasing access to better barrier methods which includes intrauterine devices and long-term hormonal contraceptives (Rengel, 2000, p. 233).  Over time, the number of abortions being performed in the United States has increased, yet the percentage of pregnancies ending in abortions has decreased (Costa, 1996, p. 134).

Since the mid 1950’s, the government along with the people of Egypt have struggled to slow down its rapidly growing population (Rengel, 2000, p. 70).  Back in 1980, the average Egyptian woman gave birth to 5.5 children and since then, the Egyptian government has been working to encourage families to only have two or three children (Rengel, 2000, p. 70).  Their growth has been leveling off which suggests that people have taken their advice (Rengel, 2000, p.70).  Egypt would require a 2.0 fertility rate to ensure stabilization of growth of the population (Rengel, 2000, p. 70). 

Egypt’s official and social policies support greater education for women and with greater education, women are finding more options in their lives other than marrying and having children (Rengel, 2000, p. 70).  Educating of women is seen by the world as important in helping to lower a nation’s overall fertility rate of population growth (Rengel, 2000, p. 70).  By educating teenagers and encouraging people to have fewer children, both governmental and nongovernmental organizations expect to curb the growth and increasing the use of modern contraceptives is hoped to be a useful tool in achieving this goal (Rengel, 2000, p. 70).  Due to the fact that abortions are not legal for everyone, the illegally performed ones are not likely to be as safe.  It seems as though this country deems education on safe sex and other options for women to be more important than openly providing birth control and abortions to whomever may need them.  About 46% of women of reproductive age in Egypt use modern contraceptives such as intrauterine devices and oral contraceptives (Rengel, 2000, p. 70).  Intrauterine devices are T-shaped devices that are put in the uterus by a doctor or health care provider (FDA, 2011, p. 17).  Egypt laws allow for abortions to be performed only to protect the health of the mother and about 25/1000 women age 15-44 undergo abortions each year and many of them are performed illegally (Rengel, 2000, p. 70).

French couples that cohabitate seem to view contraception as a joint effort and they work together to obtain and use contraceptives which is not necessarily a trend that is seen in many other countries (Rengel, 2000, p. 95).  Single women and men in France rely heavily on oral contraceptives to avoid unplanned pregnancy and women are far more likely to undergo sterilization than men are (Rengel, 2000, p. 95).  Younger people in France are turning to condoms more often though usage is still less than 10% (Rengel, 2000, p. 95).  Health care providers expect condom usage to increase as the risk of STDs and AIDS in particular increases (Rengel, 2000, p. 95). 

Teens have easy access to contraceptives in France and their teen pregnancy rate is very low (Rengel, 2000, p. 95).  Since contraceptives are easily available in pharmacies and condoms are available throughout the country, teens and adults can both easily avoid unwanted pregnancies (Rengel, 2000, p. 95).  Teen girls in France do not need permission from their parents to receive contraceptives but they do need parental consent to have abortions performed (Walter, 2003, p. 213).  Abortions became legal in France back in 1975.  Abortions are free up until 10 weeks, but second-trimester abortions are only allowed if having a baby will threaten the mom’s life (Walter, 2003, p. 213).  It comes as no surprise that France is not very strict in regard to access to abortions and birth control due to the fact that many French people have wine with most meals and give off an appearance of a country that follows the motto: “Eat, drink and be merry!”  Some of their laws are considerably less strict than other countries.  France has the 6^th highest rate of abortions in the world, with 17 being performed per 1,000 women age 15 to 44 (Seager, 2009, p. 38).

Overall, birth control regulations in the United States, Egypt and France all vary.  The United States is the only one of the three countries mentioned that has organized sex education of any type taught at school.  It has been shown that every country’s government has their own approach to regulating birth control and abortions.

Bibliography

Abortion. (2012). Retrieved from http://www.plannedparenthood.org/health-topics/abortion-        4260.asp

Costa, M. (1996). Abortion: a reference handbook. 2nd ed. Santa Barbara, Calif.: ABC-CLIO.     Available from

http://www.netlibrary.com.ezproxy.mnsu.edu/urlapi.asp?action=summary&v=1&bookid=1282

FDA Office of Women's Health. (2011). Birth control guide

Rengel, M. (2000). Encyclopedia of birth control. Phoenix, Ariz.: Oryx Press.

Seager, J., Seager, J., Lewis, I. (2009). The Penguin atlas of women in the world. 4th ed., completely rev. and updated. New York: Penguin Books.