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CHAPTER I THE PROBLEM AND ITS SETTING

BACKGROUND OF THE STUDY

Sterilization is still the most widely used method of fertility regulation in the world. the method currently provides contraception for some 223 million couples. For many women in developing countries sterilization is the first method of contraception that they will use. This new book,written and published by engender health, a non-profit organization for women's health with it's head quarters  in New York' is a scholarly review of contraceptive  sterilization from a global perspective. It is more than just a reference book although it serves well as one. it contains a large number of very clearly laid out tables  covering such issues as the worldwide prevalence of both male and female sterilization,the characteristics of female sterilization users and the current legal  status of sterilization by country. The tables are interesting and useful but it is the emphasis on sterilization in the context of the broad meaning of reproductive health that makes this more than j just a reference book. This books reviews current trends,and speculates on future trends in the prevalence of sterilization around the world. it highlights a decline in sterilization prevalence in Asia  and an increase in Latin America an d sub-Saharan Africa. his change in incidence is a result of demographic,policy and pro gramme factors. the book cites clear examples illustrating each of these factor. The number of couples in Latin American countries seeking seeking to limit their family size has increased since 1960's,and more and more couples are seeking female sterilization. In India a decline in sterilization incidence coincides with a government policy of abolishing the method-specific contraceptive targets which characterized the country's family planning pro grammes in the 1970's. In Indonesia the  the  decline in sterilization incidence is probably due to an increased availability of long -acting and highly effective but reversible methods of contraception,particularly  contraceptive implant. With a through reading, some fascinating facts about sterilization come to light. The highest prevalence of female sterilization in the world is in Puerto Rico (48.7% of women of reproductive  age who were ever in a union are sterilized). and yet most of us associate Puerto Rico with the development of the combined oral contraceptive pill. Male sterilization continues to be  much less  used but still  represents  an important family planing method (42 million men have undergone vasectomy). One of the most interesting chapter is the one on law and policy. the tables give a great deal of detail on the legal status of female and male sterilization. Oral contraceptives, or birth control pills, have been used by more than 60 million women worldwide, and are considered by many to be the most socially significant medical advance of the twentieth century. The birth control pill is a tablet taken daily by a woman to prevent pregnancy. The birth control pill does this by inhibiting the development of the egg in the woman's ovary during her monthly menstrual cycle. During a woman's menstrual cycle, a low estrogen level normally triggers the pituitary gland to send out a hormone that initiates development of an egg. The birth control pill releases enough synthetic estrogen to keep that hormone from being released during the monthly cycle. The birth control pill also contains a second synthetic hormone, progestin, which increases the thickness of cervical mucus and impedes development of the uterine lining to further prevent pregnancy. Studies have shown that the birth control pill is 99% effective in preventing pregnancy. The results of studies on the safety of the birth control vary. Some studies show that its use increases the risk of certain types of cancer, while others show that risk to be minimal. There are also claims that the birth control pill increases risk of stroke and heart attacks. Manila (AFP) says that more than 80% of Filipinos support and almost half believe that government should limit the number of children a couple can have, according to a survey released. The findings come despite a widespread campaign by the dominant Roman Catholic Church opposing a draft law that would make family planning services more widely available in the Philippines. The survey of 1,200 adults conducted in late October found that 82% believed that that government had a duty to provide information services and materials on artificial contraception, said Pulse Asia research group. The survey also found that 44% believe that the government should pass a law specifying the number of children. The survey, which has a margin of error of 3%, did not ask them that the limit should be. Additionally, 93% those surveyed said that Family Planing is important both for families and to country. The compendium than proceeds to describe natural family planning, which is considered a morally that means of poverty birth “on the other hand, the same reasons of an anthropological under justify recourse to periodic abstinence during time of the woman's fertility. Rejecting contraception and using natural methods for regulating birth means choosing to base interpersonal relations between the spouses on mutual respect and total acceptance with positive consequences also bringing about a more human order in society. Vatican City (AFP)- The contraceptive pill is polluting the environment and is in part responsible for male infertility, a report in the Vatican newspaper L'O sservatore Romano said. The Church strongly opposes and against the promotion of contraceptives as a primarily tool for population control. On contraceptives being harmful, Likhaan, a woman NGO strongly supporting the passage of the bill, cities facts and figures backed by Scientific and medical studies, says contraceptives drugs and devices are among The model List of Essential Medicines listed and recommended for countries use by the World Health Organization “ because they satisfy the priority health through the most efficacious, safest and most cost-effective way. The oral contraceptive pills, injectable, copper-T, IUD, and condom are in this list .” Like all drugs; Lkhaan says, contraceptives also have their respective side effects and contraindication. However, the preside risks of health and harm associated with contraceptive use are very slim, compared to other everyday activities, and lower than the risks of an actual pregnancy and everyday activities. STATEMENT OF THE PROBLEM This research study aims to answer this following questions: 1)What is contraceptives? 2)What are the different materials of contraceptives? 3)Are you using contraceptives? 4)In using contraceptives, have you feel any side effects? 5)Do you believe that in using contraceptives has advantages? 6)Do you have any idea that using contraceptives can cause serious disease? 7)Are you sure that contraceptives can prevent pregnancy? 8)Are you aware of the different views of the religious of the contraceptives? 9)Do you know the effectiveness and failures of the contraceptives on preventing pregnancy? 10)What particular contraceptives you are using?

REVIEW OF RELATED LITERATURE

CONTRACEPTIVE EFFECTS A woman with an IUD in her uterus is able to ovulate, and at least on occasion, fertilization can occur. How, then, does the device exert a contraceptives effect? Win the 1930's physicians thought the device's motions within the uterus simply scraped loose an implanted blastocyst ( the early cell developing from a fertilized ovum ). Since then much evidence has accumulated indicating that this is not the contraceptive mechanism. Today the following ideas, or perhaps combinations of them, seem to be the most probable explanations of the contraceptive effect. One possibility is that an intrauterine foreign body causes, by reflex neurological processes, a speedup of the egg's movement through the fallopian tube. Consequently, even if an egg were fertilized, it would reach the uterus before the endometrium had completed preparation to accept it. Implantation could not occur and the pregnancy would terminate. A second possibility is that endometrial tissues react to the UID in a way that causes them to accumulate substances called cytotoxic compounds  that  interfere with the actual implantation process or attack the blastocyst directly. A third possibility is that the IUD's presence stimulates production of cellular exudate's  that interfere with the ability of large numbers of  spermatozoa to migrate  into the  fallopian tubes or to cause fertilization if they should happen to encounter an ovum. Regardless of how a device exerts its  contraceptive effect, a correlation  between  its mass and the occurrence of pregnancy with the device in the uterus (called “in place”)  has  often been noted. The greater the quantity of  matter (its mass) in a device is, the lower the pregnancy rate is. Drs. Jaime Zipper of Santiago, Chile, and Howard Tatum of The Population Council, New York, and others have presented evidence from research that it is not mass but surface area and surface composition that largely determine efficacy. These investigators found that the addition to an UID of a winding of fine copper wire made it an even more efficient contraceptive. Such an addition would, of course, be an increase in surface area as well as a change in surface chemical composition. These findings and those of other researchers support the idea that an IUD's contraceptive effect is cause by accumulation of cytotoxic substances on the endometrial surface that interfere with implantation. Interfering substances may be produced as a result of contact between the IUD and endometrial surfaces; the more contact there is, the more interfering substance is produced. If this is so, IUD's with largest surface contact and with a surface of copper should have the lowest failure rate. This has been verified by studies to date. With this being considered, devices have been designed to facilitate maximum endometrial contact. The shield is a large-surface-area type but contains no copper. Dr's. Zipper and Tatum worked with a T-shaped device, since it would conform to the uterine cavity's configuration, giving a high degree of surface contact, the T's horizontal bar spanning the dome, or fundus, and the vertical bar lying in the uterus's long axis. It was shown, on the basis of 7 months of observation, that adding a winding of fine copper wire to the vertical bar of plastic T could reduce its failure rate to zero. This value was achieved with a copper surface of 200 square millimeters. The rate of spontaneous expulsion also was reduced as a result of the adding of copper, but other annoying side effects, often produced by all currently used IUD's, were not alleviated. They remain significant detractors of IUD utility. Another copper-wound IUD called the Cu-7 is under investigation by G. D. Searle and Company. It is a plastic 7 with varying amounts of copper wire wound onto the 7's vertical bar. Since the copper in such devices is gradually absorbed into the human system, the Food and Drug Administration is requiring a long period of testing and observation before considering approving them for general use. (Charles William Hubbard ,.pg.53) THE EFFECTS OF USING CONTRACEPTIVES All the different forms of birth control have one thing in common. They are only effective if used faithfully. Birth control pills will work only if taken every day; the diaphragm is effective only if used during every episode of sexual intercourse. The same is true for condoms and the cervical cap. Some methods are automatically working every day, no matter what. These methods include Depo Provera, Norplant, the IUD, and tubal sterilization. There are many different ways to use birth control. They can be divided into several groups: By mouth (oral)—Birth control pills must be taken by mouth every day. Injected—Depo Provera is a hormonal medication that is given by injection every three months. Implanted—Norplant is a long-acting hormonal form of birth control that is implanted under the skin of the upper arm. Vaginal—Spermicides and barrier methods work in the vagina. Intra-uterine—The IUD is inserted into the uterus. Surgical—Tubal sterilization is a form of surgery. A doctor must perform the procedure in a hospital or surgical clinic. Many women need general anesthesia. The methods of birth control differ from each other in the timing of when they are used. Some methods of birth control must be used specifically at the time of sexual intercourse (condoms, diaphragm, cervical cap, spermicides). All other methods of birth control must be working all the time to provide protection (hormonal methods, IUDs, tubal sterilization). Many social practices reduce the birth rate — delaying marriage, imposing taboos on the frequency of marital intercourse, and prolonged breastfeeding, for example. Contraception, however, is usually taken to mean deliberate resort to practices to prevent sexual intercourse resulting in the birth of a child, or, more strictly speaking, to preclude conception. Methods can be divided into ‘natural’ — those not requiring any apparatus — and ‘artificial’ means. The latter can be subdivided, though not entirely, into barrier and chemical methods locally applied to the genitals; intrauterine; surgical; and the more recent hormonal contraceptives. Magical prescriptions, of dubious efficacy, for the prevention of pregnancy have also proliferated. Refraining from sexual intercourse may have been an underestimated element in attempts to restrict family size. A modification is indulgence only when the woman is believed to be infertile: however, the relationship between menstruation and ovulation was not reliably established until 1929, and many previous calculations of a ‘safe period’ were seriously in error — though, due to variation in the cycles of individual women, even an inaccurate idea may have been occasionally effective in delaying if not preventing conception. The independent discoveries of the Japanese K. Ogino and Austrian Hermann Knaus enabled more effective calculations, but nonetheless the ‘rhythm method’ is widely known as ‘Vatican roulette’ (as the only method, apart from abstention, approved by the Catholic Church) because of its unreliability. Recently developed devices, however, now enable extremely precise pinpointing of the actual period of fertility through hormonal analysis of the female urine. Another possibility occurring to the ingenious very early in human history was the practice of coitus interruptus, whereby the man withdraws and ejaculates outside the vagina (cf. Onan — Genesis 38: 9). To think of this method means that a connection must be made between emission of semen and conception. Another method requiring no appliances is anal intercourse. Barrier methods Barrier methods have a long history. Egyptian papyri describe pessaries and vaginal douches, which could have been effective. The pessaries both formed a barrier, and consisted of substances either spermicidal, or likely to slow sperm motility, while the douches could have altered the chemical balance of the vagina, rendering conception less likely. Many other societies are recorded as having had similar devices capable of lowering the probability of conception. The, condom or male sheath, was quite a late development. It became more widely used following the discovery of the vulcanization of rubber in the 1840s, which also led to the development of various forms of occlusive cap for female use. These required, to be most effective, careful fitting — indeed, the first were custom-made for each individual. The most commonly used type is the ‘Dutch cap’ or diaphragm, invented by the German physician Wilhelm Mensinga of Flensburg in the 1870s, a domed rubber cap with a metallic spring in the rim, which comes in a range of sizes and is easier to fit than similar devices. Used conscientiously, with spermicide, and left in for several hours following intercourse, it has a success rate of around 95% in preventing pregnancy. The smaller cap, covering only the cervix, has had its advocates. Rubber itself tends to destroy sperm. Using sponges for birth control dates back probably to the eighteenth century, a method particularly efficacious if the sponge is soaked in some spermicidal or sperm-weakening substance, such as vinegar, olive oil, or even soapy water; modern sponges, for a single use only, are permeated with spermicide. The recently-promoted female condom, covering the entire interior surface of the vagina, has a longer history than often realized, and is primarily a protective against sexually transmitted disease. Spermicides The nineteenth century also saw the commercial development of chemical contraceptives, usually in the form of pessaries for insertion into the vagina. In theory these contained a spermicidal substance (though some worked because the greasy agents hindered the sperm), but in the unregulated industry of contraceptive manufacture, the unreliability of these products led to the belief (as with condoms) that the law required one ‘dud’ in every box. In Britain the issue of an ‘Approved List’ of effective products by the National Birth Control Association (later the Family Planning Association) led to improvement in standards, though spermicidal activity as measured in laboratory circumstances and in practice can still differ widely. Chemical contraceptives currently come as creams and jellies (specifically for use with a barrier method), pessaries, and foam and are recommended to be employed in conjunction with a barrier method. IUD As far as can be ascertained, the intrauterine device in its modern form dates back to the experiments of Gr̈afenburg and other German gynaecologists before World War I, although the British obstetrician C. H. F. Routh claimed in the 1870s that women were using uterine pessaries intended for gynaecological conditions for contraceptive purposes. Early IUDs were made of gold or silver; modern ones are made of plastic or copper. They work, it is believed, by irritating the uterus so that implantation of the fertilized ovum does not take place. The method has fallen into some disfavour following the highly damaging effects of the Dalkon Shield, which became apparent during the 1970s. Sterilization sterilization may be regarded as a contraceptive method, but unlike other methods it cannot be reversed, or not with any substantial probability of success. In women ligating the Fallopian tubes was originally a relatively major abdominal operation, carried out under general anesthesia. More recently, sterilizations have been performed using a laparoscope, inserted through a small incision, to locate the tubes so that they can be cauterized; this can be done as an outpatient operation. Vasectomy is a much less serious operation. The Pill The greatest advance in contraceptive technology in the twentieth century was the female contraceptive pill. Ever since the discovery of the sex hormones and steroids there were hopes of a contraceptive which could be taken orally or injected. The earliest combination birth control pill, developed in the late 1950s, contained both oestrogen and progestin, and was taken for 21 days followed by a 5-day break during which menstruation occurred. It caused the suppression of ovulation and the thickening of the cervical mucus, hindering sperm from entering the uterus. The sequential pill (1965) consisted of oestrogen-only pills taken for the first 16 days of the cycle and combination oestrogen-progestin pills for the final five days, inhibiting ovulation but having no effect on the cervical mucus. The minipill, conversely, contains only progestin, is taken without breaks, and works by the constant production of thick cervical mucus which blocks the entry of the sperm. There are a number of other variations, and hormonal contraceptives are also given as implants or injections (e.g. Depo-Provera) with long-term efficacy. Related developments are the ‘morning after’ pill, a post-coital contraceptive, and the so-far unfulfilled hope of a ‘male pill’. The Pill came into general use in the 1960s. It is an extremely reliable contraceptive method (97-99%) and has the important qualities of being totally detached from the genital organs, not requiring any dexterity to fit, and being unintrusive on the sexual act. This rendered it popular with both doctors and the general public. Side-effects, ranging from mild to extremely serious, and the implications for the dissemination of sexually transmitted disease of a reliable non-barrier method of contraception, have dimmed the initial glowing enthusiasm it generated, but it is still one of the most widely used methods of birth control. (http://www.answers.com/topic/birth-control) MAJOR COMPLICATIONS OF THE PILL Thrombotic disorder. The forming of clots is the most dangerous effect of the Pill. If a clot is the legs, it causes phlebitis, with swelling and pain. The incidence is 1 per 1,000; higher with higher estrogen doses (50mcg or more).at times the swelling or pain is not present, and sudden death can occur by pulmonary embolism, when a clot travels ti the lung. This is the most frequent cause of sudden death in young woman. If the clot lodges in the brain it causes a stroke, which may be deadly or may just leave the victim half paralyzes or unable to speak or see. Women in the Pill have a 400% in crease in the number of strokes. When we realizes the number of millions of women on the pill, we get an idea of the magnitude of the problem. The term “Promiscuity-Pill-Principle” (P-P-P) was coined by a team of medical investigators in Jacksonville, Florida in 1976. it refers to the added dangers of combining the Pill with promiscuity. Pap test in these young women revealed precancerous changes in the cells of the nick of the womb. These are not only secondary to the birth control pill, but also to the inflammatory changes associated with repeated and chronic vaginal infections that go hand in hand with promiscuous sexual behavior. The price of so-called sexual freedom includes the increase incidence of vaginal infections, venereal disease, and infestations by fungus (monilia)and trichomonas. What's more, the fact that a body maybe large enough to engage in sexual intercourse is no assurance that the mind will be able to handle it. Mental problems, behavioral aberrations, ans an increased suicide rate sum up the psychosomatic aspects of the P-P-P principle. A case that further illustrates this point appeared in a medical magazine in England the same year. It is the story of D.H., a 20-year-old English girl, who had been taking the pill for two years. She slept with her boyfriend at a girl friend's house; in the morning she got up to take a bath while her boyfriend stayed in bed listening the radio. “He heard the bath running, but after 10 minutes began to think that it was going on for rather a long time. He got up to investigate and found the bedroom door open. To his alarm, the bath was running over and his girl friend was slumped head downward in the bath with her legs and buttocks outside, dead from a stroke. We do not have to go to another country to find women who have proven with their lives the dangers of the pill. In October 1978, D.P. A beautiful 17-years-old girl died in Charlotte. North Carolina from a stroke as a result of taking the pill. It really does not matter whether the chances of dying from stroke are increased 200% or 400%; what matters is that women ought to know that the dying is only one of the consequences of having a stroke. The majority of strokes do not cause death; more frequently they cause paralysis of varying degrees, blindness, inability to talk, and other neurologic disorders. A twenty-seven-year-old woman is recovering on the West side of Cleveland, after suffering a stroke in the summer of 1978, a consequence  of taking the Pill. Drug companies do not want this information made public, but the fact are there for the record. The clot-forming capabilities of the Pill are well known to physicians. This fact makes surgery on women on the Pill more dangerous, since formation of clots after surgery is four times more common. Discontinuing the Pill four to six weeks prior to surgery does not make any difference since the clot-forming effects of the Pill persist four months after it is stopped. Administration of a blood thinner (Heparin) or mechanical stimulation of the circulation in the veins is recommended after surgery in these patients. If the clot forms in one of the vessels of the intestine, the clot interferes with the local circulation of blood and makes that portion of the intestine die. The removal of a part of it by major surgery becomes necessary to save the woman's life. Besides forming cloys, the pill makes arteries temporarily decrease in size (vasospatic reaction); this decrease makes the affected part receive less blood and accounts for minor strokes, painful red hands with cold temperatures (Raynaud's syndrome), intestinal ulcers, or colitis, depending on which artery is affected. Myocardial infarction (heart attack) is more frequent in pill takers. Women who take the pill have a 400% increase in heart attacks. This figure only includes non-fatal heart attacks. There are no good figures showing how many women have fatal heart attacks. It is not easy to get answers from dead women. As many pill-peddling outlets as there are with poor records make it impossible to research this data. This is aggravated by the usual practice of many physicians who give a prescription for the pill, which is refillable for a whole year. How is the doctor to check whether the patient never returned because she died or because she changed doctor? It becomes alarmingly serious if the pill user also smokes: the annual death rate from heart attack alone increases 15 times among pill users on their thirties. Hypertension. From 5% to 20% of women on the pill develop high blood pressure. Nobody can predict which women is going to develop the severe form which leads to malignant hypertension, stroke, and even renal failure. After three years of pill ingestion, all women shows a rise in the systolic blood pressure of about 20 millimeters of mercury. Post-pill amenorrhea. Sometimes the pill has worked so well in depressing and actually replacing ovarian function that the ovary does not work again even after the pill is discontinued, resulting in sterility of up to six months in 1% to 2% of the users. Many of these will undergo “abortions” without even being pregnant. The Oxford-Family Planning Association contraceptive study in England, which includes over 17,000 women, has presented some figures on this topic. Gallbladder disease. The formation of gallstones takes time. It is after two years of usage that women on the pill show up with gallstones. After five years of use they have increased their chances of having gallstones by more than 200%. Hepatoma. The development of a very rare type of liver tumor is becoming more frequent. Most of the time the tumor is benign---that is, not a cancer ---but it can cause and has caused death through bleeding. Congenital defects. Reports during the 1960s showed that miscarriages, occurring just after the discontinuation of the pill, had more congenital defects than could have been expected (Carr, 1970). The most frequent form of defect was polyploidy, which is a severe abnormality incompatible with life. Women on the pill should discontinue taking it if they suspect being pregnant. Carcinoma. The association of the pill with cancer of the lining of the uterus (endometrium) is so obvious that one type of pill has been removed from the market because of it (sequentials). Fortunately, the number of women developing cancer is small; for that reason this property of the pill is not stressed by the pill Peddlers. (The Doctor and Christian Marriage.,pg.53) OTHER SIDE EFFECTS 1.Nausea and vomiting 2.Breakthrough bleeding. This requires the unhealthful step of increasing the hormonal content of the pill to override a recalcitrant ovary that still wants to do its thing. 3.Psychic depression. A small proportion of women on by despondency, tension, and changes in sex desire. 4.Alterations in menstrual flow and amenorrhea. We have mentioned this earlier. 5.Breast changes. Very important in teenagers and young women. Artificial hormones cause the breast to develop and age. (The Doctor and Christian Marriage.,pg.53) HOW EFFECTIVE ARE THE CONTRACEPTIVES IN PREVENTING PREGNANCY AND HOW OFTEN DO CONTRACEPTIVES FAIL? There are two measurements. Method effectiveness and user effectiveness. Method effectiveness measures the number of times pregnancy occurs when the method is  used exactly the way it is supposed  to be used. An example of this  would  be  to take a contraceptive pill, without fail, every single day for  the 20 days required in a particular month. If, in spite of this, she gets pregnant, that would be a method failure. Let's take a woman, however, who forgets to take one or perhaps two pills during the month and then gets pregnant. This would be an example of  user effectiveness. Dr. Robert Hatcher of Emory University has created tables showing the approximate number of pregnancies during their first year of use. He gives two rates: one for the method when used correctly and consistency, and the other as the average  U.S. Experience among 100 women who wanted no more children. One group used the method exactly correctly every single time on a year. The other group was the more realistic actual average U.S. Experience. There was a significant difference. Planned Parenthood's Alan Guttmacher institute reported on 10,000 women getting abortions. Of these, 57.5% said they were using a contraceptive the month they became pregnant. In a similar study in 1987 the figure was 51.3%. the highest percent was in teenagers.

HOW DOES “THE PILL” WORK? The combination pill has three functions. One is to thicken the mucus plug at the opening of the cervix. This can act as a barrier mechanism to prevent sperm entrance. The main function of the pill is to prevent ovulation. If there is no egg, there can be no fertilization. A third function is to harden the lining of the womb. If fertilization does occur, this can and, at times, does prevent implantation at one week of life resulting in a micro-abortion at that time.

DANGERS OF INTRAUTERINE DEVICES The three main ill effects of IUD's are: excessive bleeding, perforation of the uterus, and pelvic inflamatory disease (PID). Coincidentally, these are the three main complications of induced abortion. The UID acts as a foreign body within the cavity of the uterus and therefore the menstrual periods tend to be prolonged and heavy. This can be a serious problem in Third World centuries where malnutrition and anemia are common. The foreign body either introduces new infection or causes latent infection to flare up, causing chronic pelvic inflammation and sterility. When the UID is poked into the uterus in a “blind” operation, it is not uncommon for it to perforate the uterine wall and come to lie free in the abdominal cavity. Sometimes the UID is “lost” and the difficulty is to discover whether it has fallen out or gone up higher. There have been several reports of two IUDs floating about within the abdomen, a tribute to the persistence of the doctor and the trusting faith of the patient. The worst complication, if that is the right word, is death. The cause of this tragedy, of which large numbers have been reported, is that the IUD fails, the patient becomes pregnant, she often miscarries in the second trimester and the foreign body within the uterus causes an overwhelming infection (septicemia). Because of similar disasters the manufacturer of the original Dalkon shield, A.H. Robins Ltd.,was swamped with so many claims for damage that it went bankrupt. In 1988 a jury Minnesota awarded a woman $ 8.75 million damages against G. D. Searle Co. ,manufacturer of the popular Copper-7 IUD. A reasonable person might wonder why IUDs are not banned, but the IPPF and similar contraceptive organizations still keep using them, especially in illiterate woman. Few governments or medical bodies would have the courage to confront the contraceptive moguls. Can IUDs cause cancer? Even though it is well recognized that “chronic irritation” is one cause of cancer, not many doctors know that the answer to the question is: Yes. The cancer of the endometrium can take on a bizarre appearance., reflecting exactly the shape of the IUD. Dr. Ober stated that “we now know of 12 cases in which polyethylene IUDs seem to have either initiated or promoted the development of a uterine cancer.” In primitive communities this diagnosis might never be made, even if the cancer cause death. That dangers associated with methods of preventing pregnancy where realized by a clever young woman researcher in England a few years ago. Dr. Valerie Beral wrote an historic article in which she stated: “there were more deaths at ages 25-44 in England and Wales from adverse effects of OC use than from all the complications of pregnancy, delivery and the puerperium combined.” Therefore she recommended that the standard term and concept, “maternal mortality,” should be replaced by “reproductive mortality.” Maternal mortality is defined differently in different countries. In general, though, it means maternal deaths during pregnancy. And a variable time after delivery, sometimes 6 weeks, or 3 months, or even 12 months. The major cause of “maternal mortality” in my own country is---road accidents! In some American cities it is gunshot wounds. But most people assume it refers only to obstetric deaths. Therefore it is important to determine the facts when we hear the common statement by the FPA or the various abortion societies, “Contraception is safer than pregnancy, “ or “abortion is safer. . .” For one thing “maternal mortality” figures always include deaths from induced abortion, ectopic pregnancies appendicitis, trauma, etc. and therefore they must necessarily always be higher than abortion deaths alone. In the United States, Dr. Sachs took up Dr. Beral's term and reported from the Center for Disease Control, Atlanta, Georgia: “By 1975 pregnancy prevention was responsible for nearly as many deaths as pregnancy itself.” (The Doctor and Christian Marriage.,pg.53) WHAT'S WRONG WITH CONTRACEPTION? This is the key question. If artificial contraception is wrong in essence we may not use it, even if it were to make us all healthy and wealthy. The ethical assessment of any human action depends on three factors: the act itself (this is objective judgment), the intention (the subjective judgment), and the circumstances. Considering this last factor, if there were, say, duress or ignorance or State intervention in the conception decision, the moral fault might be diminished or even absent. Assessing a person's intentions is quite impossible for any second party. Only God can read the human heart. But it would be fairly safe to assume that for most people using contraception their ignorance, or fear, or social pressure would probably reduce their level of culpability to minimal, or even nil. On the other hand, for Catholics this excuse might not be acceptable. The least educated section of the laity might be able to say in defense, “We didn't know any better. We never had any guidance in homilies or episcopal statements.” but those theologians and educators who advocate contraception will eventually have to answer the question: “Why did you not listen to the teachings of my Popes?” it will be a difficult problem for them to cope with before the Throne of Grace. This leads us to the most important consideration, the act itself. The nature of contraception can be assessed by considering first the generic or overall concept of this act; and then each individual type of contraceptive must be examined to see how it conforms to the three main virtues in marriage---love, justice and purity. The essence of contraception is that it divorces the sex act from its fertile nature. Note that the phrase is no: “from pregnancy.” With any single act of intercourse it is quite impossible. Nevertheless, on the one hand marriage rights extend only to normal intercourse, whether fertile or not; and on the other ewe may not separate the love-giving and the life-giving elements of sex. It is obvious from the design of the Creator, the anatomy and physiology of the reproductive organs, that these two elements, love and life, are inseparable. The donation of both each spouse to the other must be simultaneous because they are inherent in the nature of the act. This is not simply a cold analytical approach. Its importance can be seen in the in vitro fertilization (IVF) analogy. Contraception offers sex without babies. IVF means babes without sex. Each may be undertaken in love but each is wrong for the reason, the separation of intercourse from fertility. This provides an interesting anomaly---one act aims to abolish fertility, the other to enhance it. All contraceptives act either through altering the essential nature of intercourse or by deranging the reproductive system in various ways such as by suppressing ovulation, killing off the sperm, destroying the function of cervix, uterus or tubes, and so on. Marriage rights do not permit us to do these things. It is often assumed that marriage is carte blanche for any form of sexual activity, but this is not so. These rights are limited only to normal vaginal sex and preliminaries leading up to it. (The Doctor and Christian Marriage.,pg.53) SIDE EFFECTS OF IUD Dangerous side effects of intrauterine contraception are rare. They are the possible consequences of uterine perforation, namely, gut strangulation and peritonitis. Two annoying but nondangerous side effects that account for discontinuation of the method by most women are bleeding during menstruation and pain. For 1 to 4 months after insertion and sometimes longer, most recipients report an increase in duration and amount of their menstrual flow. The increase can be distressing. Sometimes this excessive bleeding persists, succeeding menstruation remain between periods also may occur. Pain is often reported as a simultaneous occurrence with the increased bleeding. The pain may be felt as cramping or low backache. It usually disappears in three or four cycles and is often made tolerable by aspirin. An IUD is removed because of side effects, especially pain, more often from women who have not borne a child. Such woman is referred to as a nullipara. A nulligravida is a woman who has never been pregnant. (Family Planing education.,Charles William,.pg.55.,) ADVANTAGES OF IUD There are several advantages of intrauterine conception. Pregnancy, severe infections involving the uterus, and certain tumors are the only reasons usually encountered for withholding a device, other than a woman's physiological inability to retain one. The method is unrelated to sexual activity, no interruption of the sex act being required with the use of it. The failure rate is the lowest of all nonsurgical means except the pill. Once the device is inserted, the only action required of the wearer is to check for loss at the end of each menstrual period during the first year's use. When a woman is instructed in IUD technique, she must be made to realize that a device is only effective when it is in the uterine cavity. If it is expelled, another device must be reinserted by a physician; she cannot do it herself. There are cases recorded in which women have found the expelled device, washed it off, and put it back into the vagina, thinking that was where it belonged. Proper insertion is easy and is usually done just after the conclusion of menstruation, or actually during the menstrual flow to be sure that the IUD is not being put into an already pregnant woman. If it were, the risk of abortion would be great. Every family planning clinic has been faced with requests for IUDs from women who were already pregnant. Their physicians are always alert to this possibility, realizing that some of these woman may be hoping that IUD insertion will cause them to abort. Removal of a device also is usually; merely pulling on the string will bring a Lippes loop or Saf-T-Coil out. It maybe necessary to remove any device at intervals for cleaning or replacement. Although all are corrosion resistant and do not retain tissue fragments or mucous exudates to any bothersome extent, IUDs do often become coated to varying degrees with a whitish, hard material that is probably mainly calcium carbonate. It has, in fact, been routine practice their IUDs after 2 to 3 years of use. (Family Planing education.,Charles William,.pg. 58.,)

Religious views on birth control Religions vary widely in their views of the ethics of birth control. The Roman Catholic Church accepts only Natural Family Planning and only for serious reasons, while Protestants maintain a wide range of views from allowing none to very lenient. Views in Judaism range from the stricter Orthodox sect to the more relaxed Reform sect. In Islam, contraceptives are allowed if they do not threaten health, although their use is discouraged by some. Hindus may use both natural and artificial contraceptives. A common Buddhist view of birth control is that preventing conception is ethically acceptable, while intervening after conception has occurred or may have occurred is not. (www.ansers.com/topic/bithcontrol)

SIGNIFICANCE OF THE STUDY Some couples or singles nowadays have spent much time in using contraceptives without any knowledge about the effectiveness of it, “good or bad effects”, and the result of using it. They just became more dominant in using pills, IUDs, condoms, and the other contraceptive materials. They do not value the good and bad effects of it to their health. They looked contraceptives as not a danger to health. Thus, their ignorance about it has been hanging on them perhaps because of the issue about the population. This study aims to help and to let couples and singles be aware about the effects of using contraceptives. It will also help them know the different views of the Religious about contraceptives.

SCOPE AND LIMITATION The scope of this study covers the existing facts about the effectiveness of the contraceptives and its bad and good effects, specifically, the users of contraceptives.

This study is limited only to 10 clienteles from any part of Davao, Digos and Kidapawan City and no age limit unless they. The survey will be conducted to 10 clienteles coming from the their respected palces.

DEFINITION OF TERMS contraceptive adj. capable of preventing conception or impregnation; as,contraceptive devices and medications. effects n : property of a personal character that is portable but not used in business; "she left some of her personal effects in the house"; "I watched over their effects until they returned" Complication Com`pli*ca"tion, n. [L. compliasion: cf. F. complication.] 1. The act or process of complicating; the state of being complicated; intricate or confused relation of parts; entanglement; complexity.

CHAPTER II METHOD This chapter discusses the method of the researchers used in comprising the research design, research subjects, instrument used in the study, gathering of data and analysis.

RESEACH DESIGN The researchers in this study made used of the survey questionnaire in the conduct of the study. This will help the researchers to acquire data from the clientèles about the awareness of the community, especially to the youth and to the parents on the issue about the effects of using contraceptives.

RESEARCH SUBJECTS The clientèles that the researchers had given the questionnaires are not seminarians because the seminarians cannot answer this because I believe that they had never been experience using contraceptives.

INSTRUMENT The researchers had used the survey questionnaire in their study about the topic, the effects of using contraceptives. Each selected clientèles were given questionnaire to answer. The questionnaires are answerable only by yes or no and by simply checking the box provided in every after the questions.

DATA GATHERING PROCEDURE In data gathering procedures, the researchers had done the procedures by first making the questionnaire and distributed  it to the clienteles to conduct a survey. Then, the researchers collecting them afterwards.

DATA ANALYSIS From the data information gathered, the researchers have done the computation of percentage and the result is applied to analyze the data gathered. There were tabular presentations of the result, the explanation and analysis followed by demonstration of the results.

CHAPTER III PRESENTATION AND ANALYSIS OF FINDINGS This chapter presents the Presentation, Interpretation, Analysis of data gathered.

TABLE 1. DEFINITION OF CONTRACEPTIVE PREFERENCE TALLY TOTAL YES 10 10              NO 0 0           TOTAL 10 10

Table 1 shows that all of the clientèles are aware of what contraceptive is.

TABLE 2. DIFFERENT CONTRACEPTIVES PREFERENCE TALLY TOTAL YES 5 5              NO 5 5           TOTAL 10 10	Table 2 shows that five out of ten clientèles said yes and five said no about the awareness of the different types of contraceptives.

TABLE 3. USING CONTRACEPTIVES PREFERENCE TALLY TOTAL YES 4 4              NO 6 6           TOTAL 10 10

Table 3 shows that four out of ten clientèles said yes and six said no that they are using contraceptive.

TABLE 4. SIDE EFFECTS PREFERENCE TALLY TOTAL YES 3 3              NO 7 7           TOTAL 10 10	Table 4 shows that three of the clientèles said yes that they feel that the contraceptives have any side effects, and seven of them said that contraceptives have no side effects.

TABLE 5. ADVANTAGES OF CONTRACEPTIVES PREFERENCE TALLY TOTAL YES 8 8              NO 2 2           TOTAL 10 10	Table 5 shows that eight out of ten clientèles said yes and only two said no about the advantages of contraceptives.

TABLE 6. IDEAS THAT USING CONTRACEPTIVES CAN CAUSE SERIOUS   DISEASE PREFERENCE TALLY TOTAL YES 4 4              NO 6 6           TOTAL 10 10	Table 6 shows that four out ten clientèles said yes and six said no the ideas about using contraceptives can cause serious disease.

TABLE 7. CONTRACEPTIVES CAN PREVENT PREGNANCY PREFERENCE TALLY TOTAL YES 9 9              NO 1 1           TOTAL 10 10	Table 7 shows that nine out of ten clientèles said yes and only one said no that the contraceptives can prevent pregnancy.

TABLE 8. RELIGIOUS' AWARENESS ABOUT CONTRACEPTIVES PREFERENCE TALLY TOTAL YES 9 9              NO 1 1           TOTAL 10 10	Table 8 shows nine out of ten clientèles said yes that they are aware of the different views of the religious about contraceptives, and only one said no.

TABLE 9. AWARENESS OF EFFECTIVENESS AND FAILURES ABOUT CONTRACEPTIVES PREFERENCE TALLY TOTAL YES 7 7              NO 3 3           TOTAL 10 10	Table 9 shows that seven out of ten clientèles said yes that they are aware of the      effectiveness and failures of contraceptives and only three said that they are not aware.

TABLE 10. THE PARTICULAR CONTRACEPTIVES THEY USED TYPES OF CONTRACEPTIVE NUMBER OF PERSONS USING PILLS 2 CONDOM 2 IUD 1 NONE 5 TOTAL 10	The table ten signifies that half of the clientèles were using different types of contraceptives such as pill, condom, and IUD. Only half of the clientèles were not using contraceptives. TABLE 11. SUMMARY OF THE TABLES FROM 1 TO 10 TABLES YES NO TOTAL 1 10 0 10 2 5 5 10 3 4 6 10 4 3 7 10 5 8 2 10 6 4 6 10 7 9 1 10 8 9 1 10 9 7 3 10 10

10.1 2 0 2 10.2 2 0 2 10.3 1 0 1 10.4 0 5 5 PERCENTAGE 64% 36% 100%	The table 11 presents the summary of all the tables from 1 to 10 that shown in the previews pages indicating the perspectives of all the clientèles about the effects of using contraceptives. In table 1, it states that 100% of the clientèles knew what a contraceptive is. In table 2, it states that 50% of the clientèles knew the different materials of contraceptives and 50% also said that they do not know. In table 3, 40% of the clientèles are using contraceptives and 60% of them are not using. In table 4, 30% of the clientèles felt the side effects of contraceptives and 70% of them did not feel. In table 5, 80% of the clientèles believed that using contraceptives has advantages and only 20% of them did not believe. In table 6, 40% of the clientèles have an idea that using contraceptive can cause serious disease and 60% of them have no idea. In table 7, 90% of the clientèles were very sure that contraceptives can prevent pregnancy and 10% of them were not sure. In table 8, 90% of the clientèles were aware of the different views of the religious about contraceptives and only 10% were not aware. In table 9, 70% of the clientèles knew the effectiveness and failures of the contraceptives and 30% said that they don't know. The tenth question in the questionnaire is not anymore answerable by yes or no. The clientèles were asked to state the specific answer of what particular contraceptives they are using. 2 out of 10 clientèles said that they were using pills. 2 out 10 clientèles said that they were using condoms. Only one of them used the IUD method. Five out of the ten clientèles said that they are not using any types of contraceptive methods. Therefore, the researchers, as the result of this study shows, say that people need to know the effects of using contraceptives.

CHAPTER IV SUMMARY, CONCLUSION AND RECOMMENDATIONS

SUMMARY Contraceptive is the device, drug, or chemical agent that prevent conception. It is also define as voluntary prevention of impregnation. Almost majority in our society of today used the different types of contraceptives to prevent pregnancies. Nevertheless, contraceptives are not totally 100% effective. Thus they are only effective when if it used carefully. Base on the gathered data through the aid of the survey questionnaires, the survey have proved that they are all aware of what contraceptive is, and the different kinds of contraceptives. Contraceptives has good and bad effects. The good effects of using contraceptives is to prevent pregnancy. This method is established because of the growing population in our community today. Indeed, the survey affirmed that contraceptives has great advantages to prevent pregnancy. However, contraceptives can prevent pregnancy but based on the survey gathered, there were implications that using contraceptives has many side effects. Some users of the different kind of contraceptives had suffered of some illness such as skin allergies. Some clientèles answered the question difficultly because the question stated this way, in using contraceptives, have you feel any side effects? The researchers found out that the clientèles answered three yes and seven no, because three of the ten clientèles surveyed by the researchers only the users of contraceptives and they experienced the bad effects which was the so called illness such as skin allergies. Thus, the researchers conclude that the contraceptives was divided into two parts: the good and the bad effects which was clearly stated not only on the perspective of the researchers but also on the perspective of our clientèles.

CONCLUSIONS: Based on the findings of the study, the following conclusions are drawn: 1. Couples and Singles nowadays have a knowledge about contraceptives. 2. Contraceptives do have serious and harmful effects to the body of the users. 3. Contraceptives, even though have serious and harmful effects to the body, however, it have 	also good advantages. 4. Couples and Singles nowadays can totally sure that contraceptives can prevent pregnancy. 5. Couples and Singles said that even though they were involve in using contraceptives they 	still have ideas about the views of the Religious about contraceptives. 6. Couples and Singles said that are aware of the effectiveness of contraceptives and they are 	using its materials.

RECOMMENDATIONS: For the basis of the forgoing conclusions and findings of this research work. For this reason, we come up of this following recommendations:

1.The government must first discuss the effects and failures to people before they let them use it. 2.The users of it must first learn the aspects of what they are using. 3.Future research must be conducted for further validate result of this study because in this study not all were aware of the effects of contraceptives.