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Female condoms and scrotal slings

Bernadette Whelan takes a cool look at new contraceptives

It is remarkable that scientists are still incapable of providing foolproof ways to have sex without getting pregnant. It's possible for astronomers to measure echoes which trace the origins of the universe, for deserts to be made fertile, but it isn't possible to develop a fully effective way to stop a sperm fertilising an egg.

Contraceptive technology seems to have stood still. Hormone doses in the pill have got a little smaller, latex in condoms a fraction thinner, but the choices have basically remained the same. For most women, in spite of occasional cancer scares, the pill comes out as the most reliable and hassle-free method. But even the pill only clocks in an efficacy rate of between 93 and 99 per cent. That means that if 100 women use the pill for a year, we should expect between one and seven to get pregnant. The condom and the diaphragm are even worse, offering 85 per cent protection against pregnancy and requiring a considerable measure of self-composure.

Under these circumstances it's hardly surprising that the Royal College of Obstetricians and Gynaecologists estimates that one in three pregnancies are unplanned, or that 70 per cent of unplanned pregnancies are to women who claim to have used contraception at the time of conception.

In September, a new contraceptive hits the market - the female condom, known as Femidom. It sold out within a week in France, and manufacturers hope the same thing will happen here. Femidom is being marketed as the first barrier contraceptive under a woman's control that provides protection against sexually transmitted infections, including HIV. You might think from looking at it that it will provide protection against sex itself. Most women, and men for that matter, like their contraceptive to be discreet and invisible. The female condom, however, is anything but.

The female condom is basically a polyurethane sheath, a couple of inches longer than a male condom and about three times as wide. It works on much the same principle, but instead of fitting over a man's erect penis, it fits into a woman's vagina. It looks like a stretched version of the male variety but with a ring at either end. One, at the closed end of the sheath is used to insert the condom - in much the same way that a tampon is inserted. The other, at the open end, hangs outside the vulva.

Femidom has been heralded as an adventurous stride into the future of contraception. In fact, it's more of a blast from the past. Female condoms were introduced by birth control pioneer Marie Stopes in the 1930s. Stopes' devices were marketed for 'women whose husbands do not want to use the sheath'. They didn't catch on in the thirties and it's unlikely that they will fare much better now. Family planning organisations bravely insist that the device 'widens the choice for couples using contraception', but even they don't sound convinced that there is a vast market for something that has been described as a plastic windsock, and a freezer bag.

The female condom sums up the primitive character of contraceptive technology. Other new methods in the pipeline are not much of an improvement. The two most likely to be launched in Britain are simply new ways to deliver the same hormones that are currently used in the pill. They may be more user-friendly to women who find it difficult to remember to take an oral contraceptive every day, but they won't benefit women who can't tolerate hormonal methods.

The 'intra-vaginal ring', dubbed the 'ring of confidence', is likely to be available late next year. It was developed by the World Health Organisation but will be manufactured and marketed by Roussel UK, who also produce RU486, the abortion pill. The ring is made of firm, but flexible, polyurethane impregnated with the hormone on which the progestogen-only pill (mini-pill) is based. It's easy to insert and, as with the female condom, one size fits all. Britain will be the first country to use it.

The third expected new method, Norplant, is the nearest the contraceptive manufacturers have got to a form of reversible sterilisation. Six flexible rod-shaped capsules, each 1.3 inches long, are placed under the skin of the upper arm where they continually release hormones. The injection takes about 10 minutes, and is carried out under local anaesthetic. Once the rods are in place they last for five years. If you decide you want to get pregnant, you simply have them removed. Biodegradable implants which do not require surgical removal are being investigated.

At least these seem to have more promise than the scrotal sling - a male-orientated method under investigation in India. Even if this one works, it's hard to imagine any man touching it with a barge-pole let alone his dick. It looks like a polyester jock-strap with the front missing, and works on the principle that to remain fertile a man's testes need to be cooler than his normal body temperature. That is why in normal circumstances a chap's balls hang away from his body. The scrotal sling employs this principle in reverse. After being strapped too close to the body, the increased temperature, combined with the effect of an electrostatic field created by the polyester, brings down his sperm count. A research paper published in the journal Contraception claims that it is effective after three months of constant wear.

Some might say that it's about time men took the responsibility for contraception, and strapping a bloke's knackers to his belly is a small inconvenience compared to pregnancy. But do you know a man who'd wear the sling for three minutes, never mind months?

One little egg, once a month can hardly be the most difficult problem with which science has to grapple. Fifty years ago America brought the West's scientists together to create the nuclear bomb. The best technology and science, and half a million people, were employed because it was seen as an international priority.

By contrast, the authorities do not see developing contraception as a priority. Because women's primary role is still defined as that of wives and mothers, effective contraception is an optional extra rather than a basic need. No matter that for a woman, failed contraception can mean the total disruption of her life.

The British government has declared the intention to reduce the number of unwanted pregnancies - a Manhattan project on contraception would be a good place to start.
Reproduced from Living Marxism issue 47, September 1992

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