Long-Acting Contraceptives Rationale, Current Development, and Ethical Implications

Abstract

International concern over rapid population growth in developing countries dates back to the 1950s. Research in and the use of modern long-acting contraceptives were emphasized by family planning managers and international agencies in the interest of reducing high fertility among populations presumed to be less than consistent users of contraceptive methods requiring repeated application were coitus-related or requiring extensive education and training. User-controlled barrier methods were given lower status. Contraception research began in the 1960s intensified in the early 1970s with the support of the US foundations and international agencies. The search was on for a contraceptive method which would be long-acting highly effective safe with few or no side effects fully reversible non-coitus related without need for continuing supplies with little or no need for user action after initial acceptance and inexpensive. In recent years however womens health advocates and others have urged a return to user-controlled methods with the goals of increasing womens autonomy reducing dependence upon the medical system and helping to prevent the transmission of HIV and other sexually transmitted diseases. Barrier methods such as the diaphragm condom and cervical cap are therefore receiving renewed attention while research priorities for contraceptive development have shifted toward finding new user-controlled methods. Sections discuss the development of new contraceptives including IUDs implant systems injectables and vaccines.