A personal history of the progress in contraception during the past 60 years.
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Biomedical subjects
Publications and source records attributed to H Lehfeldt.
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Felix A. Theilhaber, a physician, was born in Germany in 1884 and died in Israel in 1956. He was a pioneer sexologist, demographer, and sportsman and an early Zionist. Theilhaber was an original thinker and a prolific writer. He fought courageously against the pervasive reactionary and antisocial attitudes in the Germany of his time and campaigned actively, in his public addresses, books, pamphlets, and papers, for sexual reform, especially for liberalization of abortion and legalization of contraception. He founded the Society for Sexual Reform (Gesex) in 1913 and was cofounder and sexologic adviser of one of the first birth control and sex advisory clinics in Berlin (1930), operating under the patronage of the Gesex. In 1925, he founded the Coalition for Reform of the (Germany) Criminal Law, and in 1928, the periodical Sexual Hygiene. Among 20 books authored by Theilhaber are The Decline of the German Jews (1911), Das Sterile Berlin (1913), and Goethe, Sexus and Eros (1929). After his emigration to Israel in 1935, he continued his writings and later founded a Health Insurance Company in Tel Aviv, acting as its medical director. He has left a great legacy for sexology.
Conception may occur as early as 10 days postabortion. Therefore, immediate postabortum insertion (IPI) of an IUD reduces the danger of exposure to an unwanted pregnancy in the interval and offers better protection against repeat abortion than delayed insertion. Patient motivation to use contraception appears to be highest at the time of termination of an unwanted pregnancy. Complication and pregnancy rates of IPI are comparable with postmenstrual insertion. No serious complications are on record in the world literature; particularly, no cases of infection or perforation have been reported. These facts make IPI not only an acceptable but a highly advisable technique of family planning. In 1977, the American Food and Drug Administration rescinded its earlier prohibition and approved the IPI method. Nulliparous women should be inserted with a copper device, parous women with a Lippes loop.
Of two-hundred-sixty women seeking cervical cap contraception, exactly half subsequently used the Prentif cavity rim cap as their sole method of contraception. The one year continuation rate for these exclusive cap users was 56.7 per hundred. No major side effects related to the use of the Prentif cap were observed in the course of this study, involving 918 women-months in year 1. Pregnancy and dislodgement of the cap during use were the principal reasons for discontinuation of exclusive use, with gross rates of 19.1 and 12.9 per 100 at one year, respectively.
The IUD is an excellent and very effective contraceptive method. As contraception and coitus are separated, this technique is acceptable to many couples. It provides prolonged protection and cannot be "forgotten" like the Pill, the diaphragm, or the condom. Its pregnancy rate is 2 per 100 women per year. The greatest clinical experience exists with the Lippes loop. The loop should be the method of choice for parous women, the Copper-T for the nullipara and nulligravida. Regularly menstruating women should be advised to use additional contraceptive protection (condom, diaphragm, coitus interruptus, foam) during the week of highest fertility. This will make the IUD as effective as the Pill. Physicians prescribing this method should be available 24 hours per day for their patients, as emergency situations such as P.I.D., ectopic pregnancy, septic abortion--rare as they are--would need prompt attention.
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