Contraception: Freedom from Fear

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"The pill" is a miraculous tablet that contains as little as one thirty-thousandth of an ounce of chemical. It costs 11¢ to manufacture; a month's supply now sells for $2.00 retail. It is little more trouble to take on schedule than a daily vitamin. Yet in a mere six years it has changed and liberated the sex and family life of a large and still growing segment of the U.S. population: eventually, it promises to do the same for much of the world.

"The pill," as oral contraceptives are now universally known, may well have as great an impact on the health of billions of people yet unborn as did the work of Pasteur in revealing the mechanism of infections, or of Lister in preventing them. For if the pill can defuse the population explosion, it will go far toward eliminating hunger, want and ignorance. So far, it has reached only a tiny fraction of the world's 700 million women of childbearing age, but its potential is clear from U.S. experience. Of the 39 million American women capable of motherhood, 7,000,000 have already taken the pills; some 5,700,000 are on them now.

Until this year, it appeared that because of their cost and the need to take them on a rigorous schedule, the pills were only for the few in advanced countries with high literacy and living standards. For those in the slums and back-lands of such nations as Brazil and Malaysia, hope seemed to lie with a much cheaper and simpler mechanical contraceptive, the intrauterine device, or IUD. Once inserted by a doctor, an IUD can be left in place and forgotten. But latest reports show that illiterate women who can't count can still take their pills on schedule. In Pakistan, Denver's Dr. John C. Cobb got dozens of them to do it, simply by starting them on the night of the new moon. In semiliterate Taiwan, where lUDs have won wide acceptance, more and more women are switching to the pills. The number of users outside the U.S. is about 5,000,000, and the figure is rising.

Hormonal Messenger. The pills were first approved for prescription use in the U.S. in June 1960. Now there are twelve varieties, divided into two main classes, but all have two principal effects. First, they regularize a woman's monthly cycle so that she has her "period" every 26 to 28 days, as nature presumably intended. To this extent, the pills are biologically normalizing. Their second major effect is to do something that nature neither intended nor foresaw, and that is to prevent the release of a fertilizable egg from the woman's ovaries during the cycle in which the pills are taken, and thus make it impossible for her to conceive.

Females of many animal species are fertile for only a short time at comparatively long intervals. The female human animal is an outstanding exception, with a fertile period of three to six days out of every 28. The cycle begins with the start of menstrual bleeding. For the first four or five days, her uterus sloughs off part of its lining (endometrium). This accomplished, her complex hormonal system sends a messenger chemical to her ovaries, telling them to ripen one of the 50,000 or more potential egg cells with which she was born. Usually, only one ovary responds, and on Day 10 or soon after, a fully formed ovum is released into the Fallopian tube. The ovum takes three or four days to work its way down

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