Historia de la anticoncepción y planificación familiar: una revisión narrativa / História da contracepção e do planeamento familiar: revisão narrativa / History of contraception and family planning: a narrative review

Introduction: Contraception has played a central role in much of human history. Since the separation of reproduction from sexuality, in addition to preventing sexually transmitted diseases, contraceptive methods have been used as a tool for birth control, varying in their presentation throughout history, influenced by socio-economic and cultural processes. Method: A narrative review was conducted in the biomedical databases: Scielo, Pubmed, Dialnet, CUIDEN and Google Scholar. The literature search was conducted between August and December 2021. Results: Initial search strategies identified a total of 48247 articles. Once exclusion criteria were applied, 19 journal articles (6 in Scielo, 3 in Pubmed, 2 in Dialnet, 2 in CUIDEN, and 6 in Google Scholar) and 2 books were selected. Conclusions: The resources and culture of society have conditioned sexuality and reproduction in each historical moment. In the 20th century, the struggle for women's rights and freedom over birth control began, thus implementing family planning, which has since provided information about contraceptive methods and facilitated free and confidential access to them.(AU)

Introducción: La anticoncepción ha sido protagonista de gran parte de la historia del ser humano. Desde que se separó la reproducción de la sexualidad, además de para prevenir enfermedades de transmisión sexual, los métodos anticonceptivos han sido utilizados como herramienta de control de natalidad, variando su presentación a lo largo de la historia, influenciada por procesos socioeconómicos y culturales. Método: Se realizó una revisión narrativa en las bases de datos biomédicas: Scielo, Pubmed, Dialnet, CUIDEN y Google Scholar. La búsqueda bibliográfica se realizó entre los meses de Agosto y Diciembre de 2021. Resultados: Las estrategias de búsqueda iniciales identificaron un total de 48247 artículos. Una vez aplicados los criterios de exclusión, se seleccionaron 19 artículos de revista (6 en Scielo, 3 en Pubmed, 2 en Dialnet, 2 en CUIDEN y 6 en Google Scholar) y 2 libros. Conclusiones: Los recursos y la cultura de la sociedad han sido condicionantes de la sexualidad y la reproducción en cada momento histórico. En el s.XX se inició la lucha por el derecho y libertad de la mujer sobre el control de la natalidad, implementándose así la planificación familiar, que, desde entonces, proporciona información sobre los métodos anticonceptivos y facilita su acceso de forma libre y confidencial.(AU)

Introdução: A contracepção tem desempenhado um papel central em grande parte da história humana. Desde a separação da reprodução da sexualidade, para além da prevenção de doenças sexualmente transmissíveis, têm sido utilizados métodos contraceptivos como instrumento de controlo da natalidade, variando na sua apresentação ao longo da história, influenciados por processos socioeconómicos e culturais. Método: Foi realizada uma revisão narrativa nas bases de dados biomédicas: Scielo, Pubmed, Dialnet, CUIDEN e Google Scholar. A pesquisa bibliográfica foi conduzida entre Agosto e Dezembro de 2021. Resultados: As estratégias iniciais de pesquisa identificaram um total de 48247 artigos. Uma vez aplicados os critérios de exclusão, foram seleccionados 19 artigos de revistas (6 no Scielo, 3 no Pubmed, 2 no Dialnet, 2 no CUIDEN e 6 no Google Scholar) e 2 livros. Conclusões: Os recursos e a cultura da sociedade têm condicionado a sexualidade e a reprodução em cada momento histórico. No século XX, começou a luta pelos direitos e liberdade das mulheres sobre o controlo da natalidade, implementando assim o planeamento familiar, que, desde então, fornece informações sobre métodos contraceptivos e facilita o acesso livre e confidencial aos mesmos.(AU)

The Comeback of the IUD in Twenty-First Century USA.

From 1995 to 2014, intrauterine devices (IUDs) rose from ranking 10th (out of 11) among contraceptive methods to being the fourth most popular, outnumbered only by the pill, sterilization, and condoms. In 1995, the IUD had been largely abandoned by American doctors; two decades later, major medical associations promoted it as a "first line" method for prospective users of all ages. This paper explains the rapid and dramatic increase in intrauterine contraception by exploring three influential factors from the 1970s-1980s - the Dalkon Shield disaster, the lack of innovation in contraceptive research and development, and the moral panic over teen pregnancy in America - that created circumstances by the early 2000s in which health care providers became more receptive to long-acting reversible contraception. Key thought leaders in obstetrics and gynecology took it upon themselves to rehabilitate the IUD in the court of medical opinion and succeeded in securing professional approval of the device as the initial step in its resurrection.

Update on Novel Hormonal and Nonhormonal Male Contraceptive Development.

BACKGROUND: The advent of new methods of male contraception would increase contraceptive options for men and women and advance male contraceptive agency. Pharmaceutical R&D for male contraception has been dormant since the 1990s. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has supported a contraceptive development program since 1969 and supports most ongoing hormonal male contraceptive development. Nonhormonal methods are in earlier stages of development. CONTENT: Several hormonal male contraceptive agents have entered clinical trials. Novel single agent products being evaluated include dimethandrolone undecanoate, 11ß-methyl-nortestosterone dodecylcarbonate, and 7α-methyl-19-nortestosterone. A contraceptive efficacy trial of Nestorone®/testosterone gel is underway. Potential nonhormonal methods are at preclinical stages of development. Many nonhormonal male contraceptive targets that affect sperm production, sperm function, or sperm transport have been identified. SUMMARY: NICHD supports development of reversible male contraceptive agents. Other organizations such as the World Health Organization, the Population Council, and the Male Contraception Initiative are pursuing male contraceptive development, but industry involvement remains limited.

Building Community and Transforming Knowledge: Histories of Women's Health Practitioners and Community-Based Health Services in 20th-Century Alberta, Canada.

As new government health policy was created and implemented in the late 1910s and the late 1960s, women patients and health practitioners recognized gaps in the new health services and worked together to create better programs. This article brings the histories of the district nursing program (1919-43) and local birth control centres (1970-79) together to recognize women's health provision (as trained nurses or lay practitioners) as community-based and collaborative endeavours in the province of Alberta. The district nursing and birth control centre programs operated under different health policies, were influenced by different feminisms, and were situated in different Indigenous-settler relations. But the two programs, occurring half a century apart, provided space for health workers and their patients to implement change at a community level. Health practitioners in the early and late twentieth century took women's experiential knowledge seriously, and, therefore, these communities formed a new field of women's health expertise.

Twins Support the Absence of Parity-Dependent Fertility Control in Pretransition Populations.

A conclusion of the European Fertility Project in 1986 was that pretransition populations mostly displayed natural fertility, where parity-dependent birth control was absent. This conclusion has recently been challenged for England by new empirical results and has also been widely rejected by theorists of long-run economic growth, where pre-industrial fertility control is integral to most models. In this study, we use the accident of twin births to show that for three Western European-derived pre-industrial populations-namely, England (1730-1879), France (1670-1788), and Québec (1621-1835)-we find no evidence for parity-dependent control of marital fertility. If a twin was born in any of these populations, family size increased by 1 compared with families with a singleton birth at the same parity and mother age, with no reduction of subsequent fertility. Numbers of children surviving to age 14 also increased. Twin births also show no differential effect on fertility when they occurred at high parities; this finding is in contrast to populations where fertility is known to have been controlled by at least some families, such as in England, 1900-1949, where a twin birth increased average births per family by significantly less than 1.

Contraception and Catholicism in the Twentieth Century: Transnational Perspectives on Expert, Activist and Intimate Practices.

This special issue uses Catholicism as a thread to bring together five contributions to the transnational history of contraception. The articles, which cover examples from Western and East-Central Europe, East Africa and Latin America, all explore the complex interplay between users and providers of birth control in contexts marked by prevalence of the Catholic religion and/or strong political position of the Catholic Church. In the countries examined here, Brazil, Belgium, Poland, Ireland and Rwanda, Catholicism was the majority religion during the different moments of the long twentieth century the authors of this special issue focus on. Using transnationalism as a perspective to examine the social history of the entanglements between Catholicism and contraception, this special issue seeks to underscore the ways in which individuals and organisations used, adapted and contested local and transnational ideas and debate around family planning. It also examines the role of experts and activist groups in the promotion of family planning, while paying attention to national nuances in Catholic understandings of birth control. The contributions shed light on the motivations behind involvement in birth control activism and expertise, its modus operandi, networking strategies and interactions with men and women demanding contraceptive information and technology. Moreover, through the use of oral history, as well as other print sources such as women's magazines, this collection of articles seeks to illustrate 'ordinary' men and women's practices in the realm of reproductive health.

The Contraceptive Pill in Ireland c.1964-79: Activism, Women and Patient-Doctor Relationships.

The twentieth-century history of men and women's attempts to gain access to reproductive health services in the Republic of Ireland has been significantly shaped by Ireland's social and religious context. Although contraception was illegal in Ireland from 1935 to 1979, declining family sizes in this period suggest that many Irish men and women were practising fertility control measures. From the mid-1960s, the contraceptive pill was marketed in Ireland as a 'cycle regulator'. In order to obtain a prescription for the pill, Irish women would therefore complain to their doctors that they had heavy periods or irregular cycles. However, doing so could mean going against one's faith, and also depended on finding a sympathetic doctor. The contraceptive pill was heavily prescribed in Ireland during the 1960s and 1970s as it was the only contraceptive available legally, albeit prescribed through 'coded language'. The pill was critiqued by men and women on both sides of the debate over the legalisation of contraception. Anti-contraception activists argued that the contraceptive pill was an abortifacient, while both anti-contraception activists and feminist campaigners alike drew attention to its perceived health risks. As well as outlining these discussions, the paper also illustrates the importance of medical authority in the era prior to legalisation, and the significance of doctors' voices in relation to debates around the contraceptive pill. However, in spite of medical authority, it is clear that Irish women exercised significant agency in gaining access to the pill.

'There Are No Other Options?': Rwandan Gender Norms and Family Planning in Historical Perspective.

This article surveys the evolution of Rwandan family planning practices from the nation's mythico-historical origins to the present. Rwanda is typically regarded as a patriarchal society in which Rwandan women have, throughout history, endured limited rights and opportunities. However, oral traditions narrated by twentieth-century Rwandan historians, storytellers and related experts, and interpreted by the scholars and missionaries who lived in Rwanda during the nation's colonial period, suggest that gender norms in Rwanda were more complicated. Shifting practices related to family planning - particularly access to contraception, abortion, vasectomies and related strategies - are but one arena in which this becomes evident, suggesting that women's roles within their families and communities could be more diverse than the historiography's narrow focus on women as wives and mothers currently allows. Drawing upon a range of colonial-era oral traditions and interviews conducted with Rwandans since 2007, I argue that Rwandan women - while under significant social pressure to become wives and mothers throughout the nation's past - did find ways to exert agency within and beyond these roles. I further maintain that understanding historical approaches to family planning in Rwanda is essential for informing present-day policy debates in Rwanda aimed at promoting gender equality, and in particular for ensuring women's rights and access to adequate healthcare are being upheld.

Family Planning Advice in State-Socialist Poland, 1950s-80s: Local and Transnational Exchanges.

This paper scrutinises the relations between different models of family planning advice and their evolution in Poland between the mid-1950s and the late 1980s, focusing on their similarities and dissimilarities, conflicts and concordances. From 1956 onwards, the delivery of family planning advice became a priority for both the Polish Catholic Church and the party-state, especially its health authorities, which supported the foundation of the Society of Conscious Motherhood and aspired to mainstream birth control advice through the network of public well-woman clinics. As a consequence, two systems of family planning counselling emerged: the professional, secular family planning movement and Catholic pre-marital and marital counselling. We argue that reciprocal influence and emulation existed between state-sponsored and Catholic family planning in state-socialist Poland, and that both models used transnational organisations and debates relating to contraception for their construction and legitimisation. By evaluating the extent to which the strategies and practices for the delivery of birth control advice utilised by transnational birth control movements were employed in a 'second world' context such as Poland, we reveal unexpected supranational links that complicate and problematise historiographical and popular understandings of the Iron Curtain and Cold War Europe.

The 'Converted Unbelievers': Catholics in Family Planning in French-Speaking Belgium (1947-73).

This paper looks at the journey of eleven counsellors in marital counselling centres in French-speaking Belgium, from the creation of the centres in 1953, to the 1970s, when contraception became legal, and abortion became a public issue. At the time of Humanae Vitae, groups of volunteers, working within Catholic organisations where counselling took place, began to structure their activity around Carl Rogers's ethics of client-centred therapy, placing their religious ideology in a secondary position to focus on the problems experienced by the couples and women they were receiving in the centres. These were often challenges they were experiencing themselves in their own lives. The reiteration of the Catholic orthodox view on contraception through Humanae Vitae marked a gap between the counsellors and the Church. This contribution questions the identity-related tension of Catholics working in conjugal counselling centres and the type of commitments they made to both the conjugal centres and the Church in a moment where family planning was debated both in the Church and politically.

We Must Not Allow a Contraception Gap: Planned Parenthood's Campaign for New Birth Control and Feminist Health Activism in the 1990s.

In 1990, Planned Parenthood Federation of America launched a nationwide public relations drive called the Campaign for New Birth Control in reaction to reports that Americans were being deprived of contraceptives available in other parts of the world. This article will use Planned Parenthood's Campaign for New Birth Control as a case study of how reproductive rights activists organized around emerging contraceptive technologies in the late twentieth century. It will discuss how Planned Parenthood tried to rally a diverse range of constituencies around the notion of a "contraception gap." This construct was based on the presumption that developing new contraceptive technologies was unmistakably feminist because it gave women more options to control their fertility. However, other actors involved in the New Birth Control campaign believed the "contraception gap" was an inappropriate strategy for mobilizing broad support for birth control innovation.

Reproductive Politics in Twentieth-Century France and Britain.

This special issue adopts a comparative approach to the politics of reproduction in twentieth-century France and Britain. The articles investigate the flow of information, practices and tools across national boundaries and between groups of experts, activists and laypeople. Empirically grounded in medical, news media and feminist sources, as well as ethnographic fieldwork, they reveal the practical similarities that existed between countries with officially different political regimes as well as local differences within the two countries. Taken as a whole, the special issue shows that the border between France and Britain was more porous than is typically apparent from nationally-focused studies: ideas, people and devices travelled in both directions; communication strategies were always able to evade the rule of law; contraceptive practices were surprisingly similar in both countries; and religion loomed large in debates on both sides of the channel.

Who Was Afraid of Pregnancy Tests? Gestational Information and Reproduction Policies in France (1920-50).

Though resulting from a long-term process, the need to manage pregnancies both medically and bureaucratically became a state concern, especially from the 1920s onwards. A woman's official obligation to notify the state of her pregnancy (and therefore to know it on time) goes beyond a matter of biopolicies and poses a range of contradictions. 'Pregnant or not?' - as an issue of knowledge - is a powerful tool for apprehending the tensions between individual freedom, privacy, institutional requirements and professional powers.In order to better understand the historical meaning of pregnancy diagnostics in mid-twentieth-century France, this paper combines three dimensions: uncertainty and its management; the informational asymmetry between institutional agents and women; and the diachronic dimension of gestation. Writing this history sheds more light on an apparent paradox: while knowing and notifying one's own pregnancy became a duty, the tools that could help women eliminate some doubt right from the first months of their pregnancy - in particular the innovation of laboratory diagnosis - was seen as a danger. When, in 1938, private laboratories began publishing advertisements for the laboratory test in the most widely-read newspapers, tending to reframe it as a commercial service, the anti-abortion crusade was increasing its propaganda and its political pressure. This crusade's legal victory proved incomplete, but for a long time some of the most conservative physicians recommended great parsimony in prescribing testing. Combined with reducing the legal time limit for notification, this conflict shows how the state injunctions towards women could look like a 'double bind'.

English Women Doctors, Contraception and Family Planning in Transnational Perspective (1930s-70s).

This paper explores the influence of English female doctors on the creation of the International Planned Parenthood Federation (IPPF) and the production and circulation of contraceptive knowledge in England and, to a lesser extent in France, between 1930 and 1970. By drawing on the writings of female doctors and proceedings of international conferences as well as the archives of the British Medical Women's Federation (MWF) and Family Planning Association (FPA), on the one hand, and Mouvement Français pour le Planning Familial (MFPF), on the other, this paper explores the agency of English female doctors at the national and transnational level. I recover their pioneering work and argue that they were pivotal in legitimising family planning within medical circles. I then turn to their influence on French doctors after World War II. Not only were English medical women active and experienced agents in the family planning movement in England; they also represented a conduit of information and training crucial for French doctors. Transfer of knowledge across the channel was thus a decisive tool for implementing family planning services in France.

The Right to Know? The Politics of Information about Contraception in France (1950s-80s).

In 1920 in France, a law was passed prohibiting abortion, the sale of contraceptives and 'anti-conception propaganda'. While contraception was legalised in 1967 and abortion in 1975, 'anti-natalist propaganda' remained forbidden. This article takes seriously the aim of the French state to prevent the circulation of information for demographic reasons. Drawing from government archives, social movement archives and media coverage, the article focuses on the way the propaganda ban contributed to shaping the public debate on contraception as well as lastingly impacting the ability of the state to communicate on the subject. It first shows how birth control activists challenged the legal interdiction against communicating about contraception (1956-67) without questioning the natalist obligation. It then shows how, after 1968, communication on contraception became a power struggle carried out by various actors (sexologists and feminist and leftist activists) and how the dissemination of information about contraception was thought of as a way to challenge moral and social values. Finally, the article describes the change of state communication policies in the mid-1970s, leading to the first national campaign on contraception launched in 1981, which defined information as a task that women should take on.

The politics of female pain: women's citizenship, twilight sleep and the early birth control movement.

The medical intervention of 'twilight sleep', or the use of a scopolamine-morphine mixture to anaesthetise labouring women, caused a furore among doctors and early 20th-century feminists. Suffragists and women's rights advocates led the Twilight Sleep Association in a quest to encourage doctors and their female patients to widely embrace the practice. Activists felt the method revolutionised the notoriously dangerous and painful childbirth process for women, touting its benefits as the key to allowing women to control their birth experience at a time when the maternal mortality rate remained high despite medical advances in obstetrics. Yet many physicians attacked the practice as dangerous for patients and their babies and antithetical to the expectations for proper womanhood and motherly duty. Historians of women's health have rightly cited Twilight Sleep as the beginning of the medicalisation and depersonalisation of the childbirth process in the 20th century. This article instead repositions the feminist political arguments for the method as an important precursor for the rhetoric of the early birth control movement, led by Mary Ware Dennett (a former leader in the Twilight Sleep Association) and Margaret Sanger. Both Twilight Sleep and the birth control movement represent a distinct moment in the early 20th century wherein pain was deeply connected to politics and the rhetoric of equal rights. The two reformers emphasised in their publications and appeals to the public the vast social significance of reproductive pain-both physical and psychological. They contended that women's lack of control over both pregnancy and birth represented the greatest hindrance to women's fulfilment of their political rights and a danger to the healthy development of larger society. In their arguments for legal contraception, Dennett and Sanger placed women's pain front and centre as the primary reason for changing a law that hindered women's full participation in the public order.