829 



sioner, the pill has failed in India because illiterate peasant women 

 cannot be persuaded to take one daily."^ 



THE INTRAUTERINE DEVICE (lUD) 



A contraceptive device employed widely, especially in India, is the 

 intrauterine device, or lUD, This is a plastic or metal object inserted 

 in the uterus, and left there for as long as contraception is desired. The 

 device comes in several shapes, such as a spiral, a double coil, a loop, 

 a ring, and a bow. As in the case of the pill, precisely how it works is 

 not known. Different theories hold that it may interfere with implan- 

 tation of the embryo after conception, or that it interferes with fertili- 

 zation by stimulating the ovum to travel through the fallopian tubes 

 very quickly. 



One of the drawbacks of the lUD is that it may be spontaneously 

 expelled, often without the wearer's knowing it. This happens to 

 roughly 10 percent of the women who have had the device inserted, and 

 is more likely to happen to young women who have had no children 

 than to those who have had several. Other disadvantages are menstrual 

 bleeding and pain, which are normal when the lUD is first inserted, 

 but may continue thereafter, necessitating the device's removal. If the 

 lUD is retained, and if the discomfort subsides, the device is second 

 only to the pill in effectiveness. 



, From the standpoint of the LDCs, the big advantage of the lUD is 

 the fact that it does not require the sustained motivation or the educa- 

 tion associated with daily use of the pill. Once inserted, it can theo- 

 retically be forgotten. Strictly speaking, however, this is not the case, 

 because it must subsequently be checked by a physician or a paramedi- 

 cal technician. Furthermore, there may be the discomfort already 

 mentioned. 



India also furnishes the foremost example of country where the 

 lUD— specifically, the Lippes loop ^"* — was used on a large number of 

 women. Results were mixed: Half the women dispensed with their 

 loops because of excessive pain, nausea, and bleeding. Even with better 

 medical attention, others are now reluctant to try them.^°^ 



STERILIZATION 



Sterilization is the most reliable form of contraception. It is a far 

 easier procedure in the case of the male than that of the female. A 

 vasectomy takes 15 or 20 minutes, and involves cutting and tying off 

 the vas deferens, so that sperm is eliminated from the male ejaculate. 

 The sterilization of a woman is an internal surgical operation, and 

 hence entails greater risks. The abdomen is opened, and a section of 

 each of the fallopian tubes is removed, so that ova cannot pass through. 



Formerly the fact that sterilization was considered an irreversihle 

 procedure caused some hesitancy on the part of people who contem- 

 plated it. But a reversal operation is now possible in both men and 



,„^^^'^''"® Sterling. "India's Birth Control Progress." Washington Post. (September 30, 

 1970) J editorial page. 



M» Named for its inventor. U.S. physician Dr. Jack Lippes. 



^^ Sterllns. "India's Birth Control Progress " op. cit 



