A Brief History of Safe Sex

Roe McDermott

Ireland’s road to making contraception accessible has been a rocky one, but now Irish medical health care Providers are pushing for safe, affordable and reliable contraception to be available to all. We look over the history of contraception in Ireland, and how LARCs have increased in popularity.

Birds do it, bees do it – but for god’s sake don’t ask them how to do it safely! Despite living in a culture that’s all about promoting sexual empowerment and open discourse about sex, the conversation tends to stop short when the focus moves from sexy to safety.This is something we have to change...

As most of us have probably experienced at some stage in our lives, when the topic of contraception comes up between new lovers, too often it is addressed during pre-coital fumbling – and rarely refers to anything other than condoms and the Pill. Despite their popularity and dominance in popular discourse, these short-acting methods of contraception are not the best, most reliable, or convenient forms of contraception. So sure, let’s talk about sex, baby – but while we're at it, let’s also talk about how there is now a form of contraception that's ready and waiting to take the stress out of sex...

It helps to remember just how far we have come in relation to contraceptive methods, in a relatively short space of time. Indeed, in Ireland in particular, we have gone through a period of rapid and wonderfully positive and liberating change, which has empowered young women to take control of their sex lives – to an extent that makes you feel it'd be crazy not to!

Reliable contraception is a new thing. But, of course, contraception itself is as old as the hills. While the propogation of the species was a far more imminent concern for our ancient ancestors, there were always lovers who desperately wanted to avoid conceiving a child – and who went to considerable lengths to do so!

In ancient Greece, for example, numerous plants and herbs were ascribed contraceptive qualities. In some cases, the link may even have been a genuine one, as in the case of Silphium – a plant which grew on a small strip of land in modern Libya. Unfortunately it could not be successfully cultivated elsewhere. As a result, it was in very high demand and became literally more valuable than silver – before the plant was finally picked into extinction. Other herbs used by the Greeks included willow, pomegranate, myrr, rue and Queen Anne's Lace – which is still used for contraceptive purposes in India today.

Many rather crude forms of 'barrier' contraception were attempted. One of the earliest documented descriptions of birth control was found in the Ebers Papyrus from 1550 BC, advocating the use of honey, acacia leaves and lint to be placed in the vagina to block sperm. In 200 BC, in Rome, they used a bronze pessary to block the cervix. But the device was a crude one that carried health risks.

In the 18th century, the famous Italian seducer Casanova wrote of using a lambskin condom. Early versions of the IUD appeared in the late 19th Century. And in the opening decades of the 20th Century, the contraceptive sponge became popular. Made of rubber, the sponge was attached to a string and inserted into the vagina, forming a barrier which it was hoped the sperm could not circumvent. Needless to say, the results were rather mixed!

Various religious groups had been opposed to contraception. Notably, in an Irish context, this included the Catholic Church, with the result that the Criminal Law Amendment Act of 1935 made it a criminal offence to sell or to import contraceptives. It took decades for these laws to be reversed – indeed younger generations may be shocked at just how recently contraception became widely available here.

It was as late as 1971, when the then-Senator Mary Robinson – later President of Ireland – attempted to introduce the first bill to liberalise the law and make contraception accessible, in the Seanad. In the event, she was prevented from even discussing it. Her proposed bill came at a time when feminism was becoming a major political movement here, and on May 22, 1971, a group of Irish feminists travelled to Belfast by train and returned to Dublin laden with contraceptive devices, highlighting the absurdity of the law in the Republic. This historical protest inspired Rough Magic theatre company’s recent musical, The Train.

The pace of progress remained painfully slow. Also at the beginning of the 1970s, a very different sort of case was reported in the Irish national newspapers. A mother of four (including twins), Mary McGee, had suffered severe complications both during and after her three pregnancies. She was advised by her doctor that her life would be in danger if she conceived again, and therefore that she should use contraceptives. She was advised to combine an IUD with Staycept jelly. However, posted to her from the UK, this preparation was seized by customs, as its importation was deemed to be in breach of the 1935 law.

Mary McGee took a case to the Supreme Court, arguing that her constitutional rights were denied by a law which prevented her from importing and using contraceptives. In 1973, four judges of the Supreme Court decided in her favour and the provisions of the 1935 law were declared unconstitutional. It was a breakthrough moment, which allowed the use of contraceptives by married couples in Ireland for the first time.

It took seven years for politicians to finally, successfully introduce the Health (Family Planning) Bill 1980, which allowed people to purchase contraception from a pharmacist – but only if they had a prescription from a practicing doctor. Though the bill did not require people to be married to access contraception, many doctors who followed the teachings of the Catholic Church could deny young or single people prescriptions. It wasn’t until 1985 that the Health (Family Planning) (Amendment) Act allowed condoms and spermicides to be sold to people over the age of 18 without a prescription – but, again, only in pharmacies.

Following further agitation and controversy, the law was changed again, with the introduction of the Health (Family Planning) (Amendment) Act 1992, which allowed the sale of contraceptives to anyone over the age of 17 and the Health (Family Planning) (Amendment) Act 1993 – which effectively ushered in the modern era, where contraception is regarded as a human right for all adults.

Fast forward to 2016, and LARCs are now being espoused by medical professionals as the best option for young women, given their reliability in preventing unwanted pregnancies, but also their cost effectiveness. From bans on condoms to medical healthcare providers succesfully saving us money on our sexual escapades? My, oh my – how far we’ve come...

The arrival of the contraceptive pill was one of the great breakthrough moments for women. It liberated them from the threat of pregnancy, with a high degree of success. But the pill is not a failsafe method. In relative terms, it is better suited to very organised, very reliably habitual people.

But no matter how regimented you are in your approach to your personal life, any method that requires a young woman, with a busy social life, to take a tablet every day carries a significant risk factor.

The biggest risk with any form of contraception is user error. As a result, the pill has a failure rate of 5% a year – which reflects the simple fact that it is easy to forget to take it.

That element of individual unreliability is eliminated with long-acting reversible contraception. LARCs are a range of highly effective, contraceptive methods that are designed to last for an extended period of time. They include the hormonal IUS; copper IUD; contraceptive injection; and contraceptive implant. They are a great method for young women with a busy lifestyle – whether as a result of work, play or travel.

With a success rate of over 99%, they are clearly the most effective form of contraception available. And yet they are only used by a minority of younger women in Ireland, with current estimates at 15%. All of the indications are that a higher use of LARCs, especially among young women, would result in a smaller number of crisis pregnancies. It is something that every sexually active young woman would do well to think about...

Long Acting Reversible Contraception: The Backstory

Since the 2000s, awareness of LARCs has been growing, thanks to a push from medical practitioners who espouse their safety and reliability.

In fact, LARCs like IUDs and implants have been available for many years, but early complications with these methods, meant that they attracted controversy and negative opinion. Over the years, however, the different long-acting methods have undergone major changes and advancements that have resulted in them becoming hugely safe and reliable forms of contraception.

Modern IUDs were first introduced in the 1960s, and then only in the United States. By the '70s, there were over 17 models in development by 15 different companies. One model, the Dalkon Shield, had serious design flaws which led to various health complications, including infertility and even death. These design flaws were unique to the Dalkon Shield. However, public opinion of all IUDs soured and by 1986 there was only one model of IUD on the market in the United States and few women were using it.

However, in the early 2000s, the copper IUD and hormonal IUS were approved for sale. It was an important breakthrough. These long acting reversible contraceptive solutions gradually gained popularity, as more and more physicians were trained in how to recommend – and how to insert – them.

Condoms and the Pill may seem like cheaper options. However, despite their relatively late introduction to Ireland, long-term these new era LARCs actually prove to be the least expensive means of contraception, making them the perfect choice for younger women.

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