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How Can Public Health Benefit from Legalization of Contraception

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Table of Contents

  • Discussion
  • Conclusion
  • References

Public health has made many accomplishments that have aided the welfare of the general population, one of which includes contraception. Contraception is an option used to prevent pregnancy as it allows individuals greater autonomy in regards to family planning [1]. Family planning becomes crucial as it “is the act of making a conscious plan about the number and timing of children’s birth” [2]. Thus, the legalization of contraception has given women the opportunity to “postpone childbirth” and to avoid any unplanned pregnancies [3]. It has enhanced the physical and mental well-being of the family by reducing the chance of a dangerous termination of a pregnancy. Thus, since the early 1900s there was a strong social movement in Canada to fight for contraception, facing challenges to obtain its legalization.

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Discussion

Before the 1800s, it was believed that birth control was based on traditional methods which included “abstinence, coitus interruptus, folk beliefs, and medicinals passed down from generation to generation” [4]. Throughout the early 19th century, women and physicians began to understand the importance in developing scientific methods to prevent pregnancy due to socio-economic constraints. As society became increasingly industrialized, contraception increased women’s autonomy by allowing them to take part in the workforce [4].

During the 1840s, Charles Knowlton proposed douching as a method for contraception while other barriers such as condoms, cervical caps, sponges and pessaries became more accessible later [4]. In 1892, the federal government passed a law in the Criminal Code stating it is illegal to commercialize birth control [2]. However, officials did not realize the adverse negative health effects this had on the population, causing practitioners to aid to make a stance for the public. Initially, practitioners were viewed as the individuals who treated patients, not individuals who educated the population [4]. This led to practitioners to obtain a medical license causing them to compete with other medical experts to gain patients. As a result, practitioners were trying to detract midwives, so they would not lose their female patients [4]. This detraction led to a few physicians to take on the issues female patients had about contraception. There was a increased momentum in the birth control movement in Britain and the United States which encouraged the Canadians movement in the 20th century [4]. An important individual of the birth control movement in Canada was Alvin Ratz Kaufman who was an industrialist and philanthropist who also established the Parents’ Information Bureau in 1935 where he would inform individuals about birth control and sent nurses to supply individuals with condoms and contraceptive jelly [2]. One of his workers, Dorothea Palmer was charged in 1936 due to her spreading information about the use of contraceptives in an impoverished locality in Ottawa. When this case came to court, it had a large public support which led to the case to be overruled as Palmer was trying to do good for the public [2]. This led to the Parent’s Information Bureau to continue to provide the public with information about birth control, even though contraception was not legalized in Canada. As a result, “Elizabeth Bagshaw, one of Canada's first female doctors, championed the notion that women should have the right to prevent pregnancy. She established Canada's first family planning clinic in Hamilton, Ontario in 1932” [2].

By 1960, the first birth control pill was made available in Canada which was given to patients for “therapeutic and not for birth control reasons” [2]. Later, the Canadian Medical Association worked with other organizations which led the Canadian Public Health Association to make a statement indicating the benefits of family planning and the effects it has on those with a lower socio-economic level [2]. By 1969, contraception use became legal and was removed from the Criminal Code which gave individuals the right to prevent child-bearing [2].

The public health benefits to the legalization of contraception aided not only women but the entire family. When looking at the pregnancy rates in Canada, teen pregnancy is “a key indicator of young women’s sexual and reproductive health and overall well-being” [5]. From 2001 to 2010, the trend indicates teenage pregnancy has declined by 20.3% [5]. In Canada, about one-third of pregnancies are “mistimed or undesired” [6]. With the use of contraceptive methods, it allows women to have a child, when they are ready for it. For example, the Pill gave women the opportunity to begin a family later where “the average age for first birth in 2003 was 28, up from 1983 average age of first birth at 25” [7]. This allowed women to “achieve higher professional status, make more money and live outside of a traditional nuclear family structure more often than they did 20 years ago” [7]. Thus, allowing women greater agency to control their reproductive decisions to pursue other endeavours.

In hindsight, if contraceptive methods were not legalized in Canada, the effects would be detrimental for the pregnant women who would resort to dangerous practices to end their pregnancy. Undesired pregnancy have been associated to harmful behaviours including “smoking and late initiation of prenatal care, as well as adverse pregnancy outcomes such as post-partum depression, low birth weight and preterm birth” [6]. It can lead to an increased population of unhealthy children where the health expenditure could have been higher than one’s ability to pay. However, there are still groups who are against contraception due to the morality of preventing the birth of a child causing there to be stigma behind this issue [8].

The use of contraception such as condoms can potentially prevent sexually transmitted diseases (STDs) [4]. Examples of STDs include gonorrhea, chlamydia, HIV and more [9]. Initially, when condoms were introduced and legalized, there was a rapid decrease in the rates of gonorrhea through the 1980s and 1990s [9]. However, by the late 1990s, the rate of gonorrhea began to increase again as resistance started to decrease as advances in contraception were made [9]. This meant that improvement are needed in order to improve the population’s health.

Conclusion

Contraception’s legalization in the late 1960s has had a lasting impact in family planning. It enhances women’s agency and the well-being of the mother-to-be and the fetus . Yet, there are still improvements necessary to strengthen public health. Initially, physicians’ saw themselves as “healers rather than educators” which is why many of them did not educate the public [4]. Therefore, by “increasing the education and exposure to abortion during residency” to those in a family medicine training program, the residents have the ability to educate the public about contraception [10]. Another issue is that based on one’s socioeconomic status it can play an important role in whether one can access health or not. Therefore, women who want to access contraception would have to pay “out of pocket or have additional private health insurance” due to the items they want to acquire are medical devices like copper intrauterine devices (IUDs) instead of drugs [6]. The requirement to pay out of pocket can lead to those living in impoverished conditions unable to obtain inadequate health and information which can cause restricted access to contraception.

The advances in contraception are still seen to be a contentious issue within morality and the stigma associated in cultures [11]. Overall, contraception has made a large impact for women in gaining autonomy and has led to the enhancement of family planning. Without this achievement, more public health concerns would have occurred which could cause major health deficits to the well-being of the family. Even though, contraception had a successful implantation, adjustments are still needed to be made to make it accessible for everyone.

References

  1. Baron M, Potter B, Schrager S. A Review of Long-Acting Reversible Contraception Methods and Barriers to Their Use. Wisconsin Medical Journal. 2018Oct;117(4):156–9.
  2. History of family planning in Canada [Internet]. Canadian Public Health Association | Association Canadienne de Santé Publique. [cited 2019May24]. Available from: https://www.cpha.ca/history-family-planning-canada
  3. Tshiswaka-Kashalala G, Koch SF. Contraceptive Use And Time To First Birth. Journal of Demographic Economics. 2017Jun;83(2):149–75.
  4. Liu KE, Fisher WA. Canadian physicians' role in contraception from the 19th century to now. Women's Health. 2002Mar;24(3):239–44.
  5. McKay A. Trends in Canadian national and provincial/territorial teen pregnancy rates: 2001-2010. The Canadian Journal of Human Sexuality. 2012;21(3/4):161–75.
  6. Metcalfe A, Talavlikar R, Prey BD, Tough SC. Exploring the relationship between socioeconomic factors, method of contraception and unintended pregnancy. Reproductive Health. 2016Mar22;13:1–8.
  7. Granzow K. The Imperative to Choose: A Qualitative Study of Women's Decision-Making and Use of the Birth Control Pill. Social Theory & Health. 2008Feb;6(1):1–17.
  8. Weitz TA. Rethinking the Mantra that Abortion Should be “Safe, Legal, and Rare.” Journal of Women's History. 2010Oct;22(3):161–72.
  9. Choudhri Y, Miller J, Sandhu J, Leon A, Aho J. Gonorrhea in Canada, 2010–2015. Canada Communicable Disease Report. 2018Feb1;44(2):37–42.
  10. Myran DT, Bardsley J, Hindi TE, Whitehead K. Abortion education in Canadian family medicine residency programs. BMC Medical Education. 2018Jun1;18(1):1–8.
  11. Camobreco JF, Barnello MA. Democratic Responsiveness and Policy Shock: The Case of State Abortion Policy. State Politics & Policy Quarterly. 2008;8(1):48–65.

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