History of contraception

The history of contraception or history of contraception is one of the disciplines of medical history that studies the evolution of contraception over time . 1

Separation of sexuality and reproduction

The origin of birth control and contraception must go back to the discovery by our ancestors of the association between the practice of sex and the possibility of pregnancy in the case of women fertile . Although in general the confirmation of fertility was favorably considered – to the extent that infertility was considered a curse or punishment – , 2 it was desired to control the reproduction and in any case to adapt it to the most favorable moment, to facilitate or to prevent it depending Of very varied socioeconomic circumstances. In that long historical transit, the separation of sexuality and reproduction began, which began in the eighteenth century with the practice of marriage for love – in which not only descended – and the generalization of contraceptive methods . 3

Sigmund Freud wrote in 1898 :

Theoretically, it would be one of the greatest triumphs of mankind if the act responsible for procreation could be raised to the level of voluntary and intentional conduct and thus separate it from the imperative of satisfying a natural impulse. 4

Neo-Malthusianism: sexuality and conscious procreation

The neo – Malthusianism had special boom in the late nineteenth century and early twentieth extending its influence during the first half of the twentieth century. The neo – Malthusianism is an update of the demographic theory , social and population of Thomas Malthus considers correct population theory of Malthus , which indicates that the population grows at geometric rate and resources arithmetically so it would come to a catastrophe Malthusian or exaggerated population growth that would have to be avoided – 5 but disagree on measures to control population growth .

The neo – Malthusians considered unlimited reproduction as a problem that particularly affects the poorer classes with large extended families, as the condemnation of the misera. The social and individual awareness raising is the limitation of the birth rate as necessary to avoid overpopulation – de facto the separation between sexuality and reproduction and the defense of free motherhood -, conscious procreation , promotion of family planning , use And diffusion of contraceptive methods (mainly preservative and diaphragm ) as well as the practice of abortion considering inadequate the traditional repressive or destructive obstacles of Malthusianism: sexual repression, chastity, delay of marriage, famines, epidemics and wars. 6 7 8

The dissemination and generalization of contraceptive methods in the second half of the twentieth century has consolidated the real possibility of separation of sexual practices and reproduction . Referring to Fig.

Religion and sexuality

Main article: Religion and sexuality

The relationship between religion and sexuality is varied in different religions. It is key the consideration that can occur of different facts: the marriage , the homosexual practices , the adulterio , etc. For some, like Michel Foucault , the control of sexuality is one more form of social control.

Catholic Church: prohibition of contraception

The Catholic sexual morality has been restrictive in the use of contraception because it argues that the ends of marriage are two: mutual aid and procreation. Above all, it is based on the fact that sexual intercourse must be unitive and procreative, that is, open to life (which does not mean that in every relationship a child should be sought). This is why Catholic doctrine defends and promotes natural methods for the regulation of fertility. Except in heretical ramifications such as Manicheism and Catharism , this principle has been reaffirmed numerous times: encyclical Arcanum Divinae Sapientiae de León XIII ; encyclical Casti connubii of 31 December of 1931 by Pius XI in which any type of contraception is rejected; Encyclical of Paul VI Humanae vitae of 1968 against abortion and birth control . 10 11

Anglican Church: legitimacy and tolerance of contraception

The Anglican Church at the Lambeth Conference of 1930, presided over by Cosmo Gordon Lang , declares it legitimate to resort to contraception not only by continence, but also by other means, albeit to a limited extent. Subsequent statements, such as the Lambeth Conference of 1958 and the National Council the Churches of Christ, 1961 in United States , corroborate and need this position that places no restriction on the use, at the time of the last Contraceptive methods: the pill and intrauterine device (IUD). 12

Prohibition of contraception

Not only was contraception prohibited in Catholic Spain, and in other Catholic countries, but was prohibited in the United States. UU. From 1873, with the Comstock Law (see in: Comstock Law ), the use of mail was prohibited not only for objects, but for information on contraception. Contraception was also banned in many states. Nurse Margaret Sanger , founder of the American Birth Control League (now Planned Parenthood), had to take refuge in England not to be prosecuted for sharing information in written form. American soldiers were the only ones who did not have access to condoms during World War I. Even a doctor giving oral information about contraception to his patient was prohibited; Such a ban continued in the state of Connecticut until 2001 for married couples (date of the Judgment Griswold v. Connecticut, see : Griswold v. Connecticut ). For the entire population, ie married or not, the prohibition lasted until 1972 (the Eisenstadt v. Baird ruling).

Factors of the contraceptive boom of century XX

Before the general mass use of contraceptive methods in the second half of the twentieth century, scientific and social advances were made in the defense of information and access to contraceptive methods – since the beginning of the 20th century, Margaret Sanger figures in the United States and Marie Stopes in United Kingdom -. Among the factors that have intervened in the widespread use of contraceptive methods in virtually everyone found: 9 13

  • Success in reproduction : during the 20th century extraordinary success has been achieved in human reproduction , with a high survival of the born children and an extraordinary increase in life expectancy . Thanks to the extension of medical services linked to reproduction ( gynecologists , midwives , pediatricians …), hygienic habits, improvement in food, generalization of antibiotics and other medicines. 13
  • Technical development and dissemination of effective contraceptive methods : the emergence of the contraceptive pill , the accessibility of the condom and the widespread use of the intrauterine device , as well as all other contraceptive methods allowed a wide range of options with high contraceptive efficacy and cost Which can be considered relatively low.
  • Claiming female sexuality : the struggle for equality of feminism includes a dual claim: on the one hand the possibility of full enjoyment of sexuality – sexual health – and on the other, the demand for control of reproduction with sanitary and socioeconomic guarantees – health Reproductive system . The family planning has gone hand in hand for the dissemination and education on the use of contraceptive methods .
  • Control playback
  • Control of reproduction by parents : in developed societies, possible parents practice a fertility controlled by a double motive: on the one hand the reproductive individuals themselves want to enjoy all stages of life without being forced to a constant reproductive effort; On the other hand, these parents want economic, educational, social and psychological security conditions for their descendants, who demand sufficient income, some emotional and social stability and a small number of descendants. Referring to Fig.
  • Control of institutional and social reproduction : reproduction control can be encouraged by governments or institutions through policies birth ( one – child policy in China , promoting family planning in India , promoting birth aids, etc. ). In addition there are some associations and groups antinatalist defending in some cases non – radical reproduction ( childfree , movement voluntary human extinction ) and other control promotion excessive population growth cutting – positions Malthusian or neo – Malthusian – ( Optimum Population Trust ). In front are those who defend or promote birth or birth ; Whether from religious or nationalist positions – who use population growth as a weapon of strategic interest. 14 15 9 13

History and development of contraceptive methods

Old texts on contraception

Throughout history there are numerous testimonies about contraception. 16 17 14

  • Papyrus of Petri , of 1850 a. C. , is the first medical text that is known. There are some contraceptive prescriptions; one of them advised the use of excrement of crocodile mixed with a paste which served as a vehicle used safely as a pessary inserted into your vagina ; Another recipe consisted of an irritation of the vagina with honey and natural sodium bicarbonate .
  • Ebers Papyrus , is considered the second most important text; Contains the first reference of a cap of medicated yarn: … crumble with a measure of honey, moisten the yarn with it and place it on the vulva of the woman . 14
  • Talmud , book of the Hebrew tradition ; Mention is made of the practice of using moch (generic term for cotton, which in this particular case refers to a tampon) for sexual intercourse, in Judaism there has been much discussion about the ways and situations allowed for the use of moch And other contraceptives.
  • History Animalium ( 5th century BC ), book of Aristotle , is the first Greek reference on contraception: Some prevent conception by smearing the part of the matrix in which the semen falls with cedar oil or a lead ointment with Incense mixed with olive oil . 14 18
  • Sun Ssu Mo , Chinese text where the oldest mention is found: … take some oil and mercury and fry without stopping and take a pill as big as a yuyuba on an empty stomach and prevent pregnancy forever . 18
  • Coitus interruptus , is mentioned in both the Bible and the Muslim tradition:
  • Bible , 38: 9-38: 10, Genesis : And when Onan knew that the offspring were not to be his, it happened that when he came to his brother’s wife, he poured out on the ground, because he did not give offspring to his brother . 19 18
  • The Muslim religion is not opposed to contraception, coitus interruptus appears first as contraceptive method mentioned in the oldest Muslim traditions.


The first written references to spermicides – vaginal receptors that could also be abortive – appear in Egyptian papyri in the year 1850 BC 20 Multiple substances have been used throughout history (sodium carbonate, vinegar, soap solutions …) In 1885 appear The suppositories of quinine , in 1937 will replace the vaginal contraceptive of phenylmercury acetate . In 1950 surfactants appear to be the main compound of spermicides or spermicides . twenty-one

Intrauterine device

It is considered to Hippocrates (fourth century BC) , the precursor of the IUD or ( IUD ) as it discovered the contraceptive effect arising from the placement of a foreign body in the uterus of some animals. But it will not be until 1928 when the German Richard Richter initiates modern intrauterine contraception which has since improved its effectiveness and duration. 22

Condoms or condoms

The condom is used both to prevent ” sexually transmitted diseases ” (or venereal) and to prevent unwanted pregnancies , ie as a contraceptive method . Already in 1880 they acquired great popularity and during century XX its use diffused by all the world. Its low cost, no side effects and double protection (contagion of diseases and as contraceptive) have supposed that it is possibly the most used contraceptive method. 2. 3

In Egypt, at least from 1000 BC. C. cloth covers were used on the penis. The legend of King Minos ( 1200 BC ) refers to the use of fish natatory bladders or goat bladders to retain semen. 24

The male condom also has a history in Greece and Rome where animal membranes were used ( intestine and bladder ).

The anatomical doctor and Italian surgeon Gabriel Falopio ( 1523 – 1562 ), collects in his book De morbo gallico a precursor of the condom , which consisted of a sheath made of animal gut and flax , which was fixed to the penis with a ribbon. Its aim was to prevent sexually transmitted diseases such as syphilis and gonorrhea .

Although the name of condon is attributed to the doctor and general of King Charles II of England is not backed by historians. It was in the nineteenth century that the word “condom” appeared for the first time in a book dedicated to syphilis, written by Dr. Turner in 1760.

In 1872 Indian rubber manufacturing began in Britain and was sold in pharmacies. The first female diaphragm appears in 1880. In 1993 begins the commercialization of the female condom .

In 2000, the British museum in London first exposed the world’s oldest preserved condoms, around 450 years old, which were found in excavations made in the 1980s at Dudley Castle in central England . The specimens exposed correspond to the sixteenth, seventeenth and eighteenth centuries. It is striking that these specimens are as fine as those that are currently manufactured industrially with latex. These condoms, made with animal intestines, are carefully sewn on one end, while the other end has a tape that allows them to be held tight once placed. According to experts, these condoms were intended for men who frequented houses of prostitution. They were not used as contraceptives but to prevent venereal diseases , especially syphilis . It is believed that before being used they were immersed in warm milk to soften.

In 2010 , Pope Benedict XVI admits the use of condoms in some cases, for example in sex with prostitutes . All this is collected in the book The light of the world. The Pope, the church and the signs of time. A conversation with the Holy Father , by the writer Peter Seewald . 25

Oral hormonal contraception

It is considered the Mexican Luis Ernesto Miramontes the inventor of the first oral contraceptive (synthesized in 1951 norethisterone ), whose patent obtained with Carl Djerassi and George Rosenkranz of the Mexican chemical company Syntex SA were also key contributions from Russel Marker and Gregory Goodwin Pincus . Margaret Sanger , through Planned Parenthood, secured funding to support the development of the pill. 26 27

The Enovid Pill was first tested in 1954 on 50 Massachusetts women . The large-scale test was conducted in 1956 in Puerto Rico , administered by EE. UU. , On a group of 225 poor and poorly educated women; Had a high dropout rate and side effects despite what was approved by the Food and Drug Administration ( FDA ) approved “Enovid” in 1957 as regulator of menstruation. In 1960 the FDA finally allowed its sale as a contraceptive although the medical package leaflet would not include information on the risks and side effects until 1978. /

The 9 of maypole of 1960 the FDA makes the proposed sale of the contraceptive pill in the United States will finally be adopted on June 23 of that year. 28 Its marketing and use became generalized in that same year and the following being considered one of the most significant advances in contraception that transformed the sexual life of women. 29 The pill, constantly improved, is still considered one of the most effective (99.5%) and safe alternatives among contraceptive methods . 30

Currently, millions of women use them worldwide, 19 percent of women between the ages of 15 and 44 use the contraceptive pill and more than 60 percent of women between the ages of 15 and 44 use contraception . 28 Their use, however, is unequal according to regions or countries, thus, 25% of women of childbearing age in the UK take it, but only 1% in Japan. In Spain the marketing and use of the contraceptive pill was legalized 7 of October of 1978 , more than 20 years after other countries Europeans .

The 9 of maypole of 2010 the 50th anniversary of the appearance of the contraceptive pill was held. 28

Hormonal subdermal contraceptive (subcutaneous implant)

The development of subdermal contraceptives or subcutaneous implants began in 1967 when the American Sheldon Segal and the Chilean Horacio Croxatto 31 proposed the use of subdermal polymer capsules for the slow and prolonged diffusion of an active contraceptive. Norplant , developed in 1983 in Finland , is the first brand of subcutaneous implant with levonorgestrel contraception active ingredient. 32 Jadelle and Implanon are the brands of second-generation implants. 33 34 35

Vaginal hormonal contraception

Since 2002 the vaginal ring has been commercialized , similar in its effect to the pill but more comfortable in its use, with less side effects, and with an efficiency of 99.7%. 36

Emergency contraception (postcoital contraception)

The emergency contraception has its beginning with the first administration of estrogen postcoital occurs in 1960 . 37 Since 1975, the so-called Yuzpe method ( Albert Yuzpe ), standard treatment for 25 years, has been replaced since the late 20th century by the so-called morning-after pill ( levonorgestrel and mifepristone ). 38 39 In 2009 the marketing of ulipristal acetate ( five days later pill) began . 40 41

Natural methods

The idea that there is a sterile period in women comes from antiquity, when it was thought that the most favorable time for conception were the immediate days before and after menstruation , a theory known today is incorrect. 42 In 1924 , Kyusako Ogino and Hermann Knaus uphold the modern theory of the fertile period, according to which the day of ovulation corresponds to the fourteenth day before menstruation. Since 1868 Squiere took into account the basal temperature and reported its descent during the menstrual period and its elevation before it. In 1926 Van der Velde established the temperature method in Germany , and the method based on mucus secretion, developed by Dorairaj , is a variant of ovulation.

Induced abortion

Main article: History of abortion

Until practically the end of the nineteenth century, the practices and concepts of contraception and abortion were closely linked due to the lack of awareness of the conception process: fertilization of the ovum by the spermatozoon (forming the zygote that will divide into the morula ) and posterior Implantation in the uterus 7 days later of the morula that has passed to the blastocyst stage 43 – up to where contraception is considered – and of the elimination, depending on the time of development, of the embryo or fetus – what is considered abortion – . 44 45

It is called induced abortion to abortion voluntary or abortion to disruption of vital embryo development. Unlike other contraceptive methods that act before implantation or fertilization, abortion is performed once the blastocyst has been implanted in the uterus . Abortion has historically been, and still is, one of the most widely used methods for birth control and population control . 46


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