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barrier to sperm penetration, rendering them inactive. Some recent reports have indicated that these substances, if absorbed, may have some detrimental effects. However, with convincing evidence still lacking as to their danger, it is your author’ s current opinion that these methods may be employed with safety if used appropriately. Some ladies may be sensitive to the chemicals involved. Others decline their use because of inconvenience. Nevertheless, if faithfully used, these methods are effective for most couples in preventing unwanted pregnancy. All of the mechanical and chemical methods of birth control have some “failures,” sometimes associated with a failure to use them properly. Nonetheless, occasions of fertility may happen, making none of these methods completely “fool proof.” Two other more controversial forms of birth control are the “pill” (oral contraceptive) and the IUD (intrauterine device). These methods have some harm associated with their use. The oral contraceptives or birth control pills utilize a combination of synthetic estrogen and progesterone. Synthetic female hormone substitutes produce a “pregnancy-like” effect over the hypothalamus and pituitary gland, inhibiting several hormone cycles that produce ovulation. Breast tenderness, headache, high blood pressure, visual changes, depression, nausea, menstrual spotting, lack of menstruation, an increased risk of thrombosis or clotting of the veins, even stroke and heart attack— these are some of the hazards associated with the available birth control pills. All these symptoms and risks are detailed in the drug package inserts. The potential side effects should be carefully scrutinized by potential users. Smokers, particularly, have a very high risk, at least five times greater than the nonsmoker for thrombotic complications associated with the pill. Increasing controversy over hormone therapies should make consumers more uncertain of its use, even for short periods. The IUD (called an intrauterine device) is becoming more popular in underdeveloped countries. A carefully performed pelvic examination is required for its insertion. Barring complications, it may stay in the uterus for a long time, However, the IUD operates differently from any other form of contraception. It does not prevent fertilization of the egg, but rather makes a fertilized egg that arrives in the womb unwelcome. Preventing implantation of this multi-celled “child,” the IUD actually performs a “microabortion” when it acts to prevent pregnancy. From ethical and religious standpoints, more and more concerned Christian ladies avoid this means of family planning. Medical complications frequently result, with increased vaginal bleeding, infection of the womb lining (endometritis), migration of the IUD through the womb into the pelvic cavity, and the increased risk of tubal pregnancy. In spite of their widespread use by public health officials, my clinic has always discouraged IUD use for contraception.