Fertility Regulation

In the past two centuries the proportion of couples using some form of conscious pregnancy-prevention has risen from close to zero to about two-thirds. In European populations this radical change in behaviour occurred largely between 1870 and 1930 without the benefit of highly effective methods. In Asia, Africa and Latin America, the change took place after 1950 since when the global fertility rate has halved from 5.0 births to 2.5 births per woman. In this chapter we describe the controversies surrounding the idea of birth control and the role of early pioneers such as Margaret Sanger; the advances in contraceptive and abortion technologies; the ways in which family planning has been promoted by many governments, particularly in Asia; trends in use of specific methods; the problems of discontinuation of use; and the incidence of unintended pregnancies and abortions

Opção pela vasectomia e relações de gênero The option for vasectomy and implications for gender relations

Realizou-se um estudo qualitativo para conhecer o processo de decisão de casais pela vasectomia, as relações de gênero envolvidas e identificar as fontes de informação sobre o método. Foram feitas entrevistas semi-estruturadas com vinte casais que solicitaram a vasectomia no Ambulatório de Reprodução Humana do Centro de Assistência Integral à Saúde da Mulher, Universidade Estadual de Campinas. Para a análise dos dados, utilizou-se a técnica de análise do conteúdo. A maioria dos casais optou pela vasectomia como último recurso anticoncepcional, após ter utilizado outros métodos, nem sempre com sucesso. Os homens se auto-atribuíram a iniciativa de se submeterem à cirurgia dada a impossibilidade de criarem mais filhos. Pessoas significativas para eles foram as principais fontes de informação, suscitando interesse pelo método e afastando os temores. As relações de gênero desveladas oscilaram entre um modelo quase patriarcal, com o predomínio dos homens nas decisões da vida familiar, e um modelo ambíguo nas decisões reprodutivas, em que as mulheres haviam assumido a responsabilidade da anticoncepção até que, diante da inevitabilidade da esterilização, os homens consideraram que deveriam colaborar.<br>A qualitative study was performed to: investigate the process that leads couples to decide for vasectomy; characterize the gender relations involved in this process; and identify sources of information on vasectomy. Semi-structured interviews were conducted with 20 couples who had requested vasectomy at the outpatient clinic of the Center for Integrated Women's Health Care, State University in Campinas, São Paulo, Brazil. A structured form was used to collect social, economic, and demographic data. The content analysis technique was used for data analysis. The majority of couples opted for vasectomy as a last resort after attempting numerous other contraceptive methods, not always successfully. The emerging gender relations showed fluctuation between: (1) a more rigid, quasi-patriarchal model characterized by male predominance in the family's decision-making and (2) a more ambiguous model in relation to reproductive decisions, whereby women assumed responsibility for contraception until the situation became untenable, at which point men faced up to the unavoidable necessity of sterilization. At this point the male partners felt they should collaborate