172 EDITORIAL History of Contraception Saadia Sultana In primitive societies, perhaps, a couple had 6 to 8 children in total. Around half of these offspring perished before they might reproduce, & the population grew very sluggishly. Mothers lactated for 3–4 years, and gestations were physiologically According to Aristotle, “If you would understand a n y t h i n g , o b s e r v e i t s b e g i n n i n g a n d i t s development”. History can never be unwritten, but familiarity with the past can enlighten the contemporary issues. Societal/religious attitudes, o f te n re p re s s e d t h e a c k n o w l e d ge m e nt o f complications related to fertility. Globally, people were blinded by the beliefs which were not pertinent to this crucial situation of twentieth century explosion of population. The society has faltered in searching for organizational & technical solutions to control fertility rate even in the west. Scientific ideas were not entirely exploited, identified technologies went unapplied, and recent resources that might have made prominent differences were held back. Only forthcoming history will decide whether these interruptions, will verify a crippling, or the mortal setback to cultured living. The imbalance between diffusion of contraceptive awareness/regulations and the means to treat disease has produced a burst in global inhabitants which is hard to accommodate. It has, now, contributed to excessive discriminations in affluence and individual misery. The human fertility controlling factors/treatments are not certainly more problematic to comprehend than the cure of bacterial illnesses, i.e. IUD insertion/tubal ligation are simpler than instrumental delivery or appendicectomy. Valuable understandings into contemporary malfunctions can be achieved by observing the history of 'fertility-control' practices. spaced. With urban civilization, puberty started at an earlier phase of life and breastfeeding was reduced in duration or additional food introduced earlier. Hence the fertility improved. Without artificially restraining fertility, if a couple starts relationship when the female is above twenty & continues till menopause, she can expect to procreate around 10- 11 children. Therefore, ultimately, all human cultures have to implement some limits on family size. Written archives of contraceptive remedies and techniques of abortion are present in the Latin writings of Pliny Elder (23–79 AD), the Egyptian Ebers Papyrus (1550 BC),) and Dioscorides (58–64 AD), and the works of Soranus (Greek-Gynaecology, 100 AD). Throughout 10th century, while the blossoming of A ra b i c m e d i ca l p ro fe s s i o n , a d i ve rs i t y o f contraceptive endorsements was mentioned, predominantly in the writings of Al-Razi (Rhazes, 923 /924 AD,), Avicenna (Ibn Sina, d. 1037 AD) and Al- Abbas (The Royal Book 994 AD). 2. Reasonable & conceivably effective (honey, lactic acid, alum, pepper etc. used as barriers in the form of pessaries (Dioscorides, Ebers Papyrus) 1. Those that nowadays are recognized to be unsuccessful, appeared practical at the time e.g., wiping after vaginal intercourse (Soranus). 3. Manufacturing vaginal pessaries from the animal's dung, e.g. crocodiles (Papyrus), mice (Pliny) or elephants (Rhazes). Jewish references of contraception were closer to few modern approaches e.g. “cohabit with a sponge.” The prevalence of a common method of 'coitus interruptus' for ancient and contemporary societies differs; both old & modern references are fairly common in Islamic, Christian & Jewish manuscripts. The only biblical reference (Genesis 38:7) about c o i t u s i n t e r r u p t u s i s v a g u e . O n a n i s m (masturbation/withdrawal), abortion and additional co nt ra c e p t i ve p ra c t i c e s , re c e i ve d g ro w i n g condemnation. Nonvaginal intercourse as fertility- control method is rarely conversed, nevertheless it The earliest scholars refer to 3 general groups of methods: Correspondence: Prof. Dr. Saadia Sultana Professor of Obstetrics & Gynaecology Islamic International Medical College Riphah International University, Islamabad E-mail: saadia.sultana@riphah.edu.pk Received: November 02, 2019; Accepted: December 01, 2019 Department of Obstetrics & Gynaecology Islamic International Medical College Riphah International University, Islamabad the foot, or the wooden pestle/rice grinder. 1. Podalsky E. Medicine Marches On. Harper, New York. 1902. 5. Kuczynski RR. Population movements. Oxford, New York. 1936 8. Curtis AH. Textbook of Gynaecology. Saunders, Philadelphia. Because of the unequal dissemination of 'death control' & 'birth control', global population is destined to multiply around 3 and 4 times between 1950 & 2050. Much of that increase continues to be determined by unplanned pregnancies. Around the world, the national family planning programs took enormous time to develop, and the response of developed countries in providing aid/technical assistance was irregular & delayed. It is now the vital obligation to have more focused approach of making people more knowledgeable about fertility control & to make birth spacing widely acceptable. Literature also witnessed abstinence as a means of contraception. The sentiments were expressed about 2 centuries ago in a letter by the famous Queen Victoria (born 1819). Victoria was to deliver 9 children before the premature death of Prince Consort. Like millions of common people, she would have benefited, if the '19th century history of contraception' had been different. Specifically, she never thought that she was hurrying ovulation by giving all her off-springs to a lactating nurse after birth. It was very difficult for the medical/political systems to extend altruism/selflessness to those stressed to regulate their fertility than to those suffering from diseases. Important developments, such as Intra uterine devices (IUDs) and oral/injectable contraceptives, developed more slowly than they might otherwise have done. 4. McDaniel WB. The medical and magical significance in ancient medicine of things connected with reproduction and its organs. Hist. Med. & Allied Sc. 3: 1948. 6. Malkin HJ. Observations on social conditions, fertility and family survival in the past. Proc. Roy. Soc. Med. 53: 1960. REFERENCES 2. Graham H. Eternal Eve. Heinemann, London, England. 1939. 3. Simmons A. Human infertility. New England Med. 1956. 7. Price FA Textbook of the Practice of Medicine. Oxford Medical Publications. 9. Historical Review of British Obstetrics and Gynaecology. Livingstone, London, England. 1800-1950. 'Massage abortion' is a cruel technique usually tried when the lady is 4-5 months pregnant. The method has been described in Thailand, Burma, Philippines, Malaysia, & Indonesia. Woman lies on her back, attendant tries to stabilize the uterus and at that moment presses it very hard with the hands, heel of Throughout the Middle Ages, 'induced abortion' & 'coitus interruptus' were acknowledged approaches of birth spacing in married people. In west, some couples managed to postpone conception and few babies were delivered in July/August, when the crucial harvest labour took place. In 1959, archaeologists, while unearthing the skeleton of a 25-year-old girl from a Gallo-Roman times (first century BC to fifth century AD) in Netherlands identified a bone stylet 10.5 cm long in her pelvis. It was interpreted as a lady who died due to an attempt to induce abortion. Mechanical abortion and embyotomy (to save the woman's life in childbirth), is cited in olden Jewish literatures. seems to have frequently been used in different cultures (550–850 AD). It was narrated by Jaabir ibn' Abdullah (Allah be pleased with him), “we used to practice 'Azl' (or coitus interruptus) at the time of Prophet Mohammed ملسو هيلع هللا ىلص, when the Quran was being revealed. (Sahih Muslim, Vol. 3, Book of Marriage, Hadith 3386). It was also mentioned at some places that the wife's permission is a prerequisite for its use as birth spacing method. Jaabir (Allah be pleased with him) reported: We used to practise 'azl during the lifetime of Allah's Messenger ملسو هيلع هللا ىلص. This (the news of this practise) reached Allah's Apostle ملسو هيلع هللا ىلص, and he did not forbid us(Sahih Muslim, Vol. 3, Book of Marriage, Hadith 3388). History is bursting with 'herbal preparations' (for delayed menstruation), and same is being practiced in modern-day culture. One unique ancient method was the herb named 'Silphion' transferred from the early Greek city - Cyrene. The plant was extremely precious and worth more than silver. No one is certain if it was an oral contraceptive/abortifacient. 'Silphion' was also shown on the Cyrene coins. Huge efforts were put to cultivate it in other areas of the Mediterranean, but remained unsuccessful, & the plant was picked to extinction. 173 JIIMC 2019 Vol. 14, No.4