**3. Generalities**

learned in a slow but effective way. Being a learning process through communication between people, culture is a process that precedes and succeeds the components of a society. Thus, it is considered a historical phenomenon, but in another view, the cultural aspects being abstract are kept within the people and, in this sense, can be considered a psychological phenomenon.

The process of learning culture is a slow, continuous, unconscious process that begins at birth and continues throughout life. The culture of a society leads people to think, feel, and act per cultural standards. Cultural pattern is the orientation provided by the complexities and cultural traits that are valued in different ways. It is also in Piovesan's words the paths followed by the customs, ideas, beliefs, and attitudes of a population group. It is possible to consider that in all cultures, therefore in all societies, there is a standard in relation to health, which is composed of concepts grouped in medical knowledge that are characterized by traits, characterizing the behavior of society, at various levels in relation to health. Concepts are derived from medicine based on scientific learning or on empirical learning based on

Cultural trait is the least definable element (Kroeber) or identifiable (Herskovits) of culture [1]. Abortion should be considered a component of the standard of health of all cultures.

Abortion is the process by which a dead fetus is expelled from the mother's womb. It is a process that occurs with all animals spontaneously. In human societies, it is a process that often occurs in women spontaneously or is carried out in a manner provoked by pregnant women in all cultures, a trait that is considered in a different way as determined by the legislation or the religiosity of the people. What varies is how different societies and consequently how

Regarding whether spontaneous abortion occurs independently of the desire of the woman, we must help some inconvenience and take care that it is not repeated. Spontaneous abortion

Prolonged abortion can be performed by the oral route through drugs or medications or by

Medicine considers that abortion is one of the events of obstetrics that occurs in a safe way, if the measures prescribed by the medical sciences are taken. Despite this, examining the determinations found in the different societies will lead to findings about countries where there is practically a total liberation for the realization of this event and countries in which the realization is penalized by the death of the woman and of those who carried out the abortion. Thus, an event of intimacy of the woman and of who should proceed to the abortion, in the most

Family planning is a set of actions that help men and women plan for the arrival of their children, as well as prevent unwanted pregnancies. It is a project for couples to have offspring per their intentions and also the increase in world population that is worrying everyone has a

analogical knowledge.

280 Family Planning

**2. Definition and indications**

performing surgical procedures.

differentiated societies, the doctor has no shelter.

diverse cultures determine how women should be followed.

occurs in women of all social groupings regardless of existing knowledge.

Countries through legislation established by the government punish or liberate abortion. At the same time, the doctrine of various religions considers it to be a totally unwanted behavior. A cultural trait that turned into a medical fact is penalized by jurists and priests. Considered a medical act of which presents very little risk to the woman.

As a cultural trait, abortion on many occasions is not obeyed and not even penalized by women or society. This is because there are many reasons for women seeking abortion whether biological or social.

Among these reasons is rape, that is, the sexual act by violence and without the permission of the woman, which in almost all the countries of the Western world and countless of the Eastern world is considered a reason for the punishment of the man, as well as for allowing the woman to resort to abortion in order not to generate the fetus. In addition to rape, other reasons are considered for abortion.

Among the biological reasons are life-threatening or health-related injuries, such as the most relevant ones. The current knowledge of medicine is so developed that if abortion is used to save a woman's life, it is almost abandoned. The emergence of diseases produced by viruses leading to the birth of fetuses with abnormalities, such as anencephaly, that will produce harmful effects on the life of the newborn is also considered. In some countries, incest is remembered [2].

On the other hand, many social reasons are forgotten by many societies that consider, with greater weight, the position of several churches, among them more narrowly Catholic.

Among these social reasons, it is possible to enumerate at once the desire of the woman not wanting the birth of a child, which can occur through several factors: the lack of knowledge of the father; the disappearance of the father; the father's attitude in not recognizing the child; the lack of acknowledgment of childbirth by the woman's family, even causing expulsion from her home; the financial impossibility of the family to support another child; the impossibility of giving pause to a livelihood or future improvement activity; and finally the failure in the process of birth control.

Birth control has always been sought in ancient civilizations for more than 4000 years. In Egypt, the Berlin papyrus refers to fumigation that prevented pregnancy and the Ebers papyrus indicates procedures that prevented a woman from becoming pregnant for 2–3 years. The Old Testament refers to the "coitus interruptus" method adopted in Europe in the nineteenth century and to this day adopted by poorer and less enlightened layers throughout the world.

The abandonment of unwanted children was practiced among the Greeks as well as among the Romans. Chinese were organized on farms for the reception of children who remained until they were sacrificed [3].

Beside infanticide, different, less bloody procedures have always been adopted by various societies.

The Safe Period method proposed by Ogino and Knaus, as well as the Basal Temperature method and the Ovulation method, is reasonably effective; as advantage, it does not need prescription and is accepted by religions. The disadvantage is that it requires a prolonged period

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The male mechanical device, known as condom or more popularly as small shirt, has moderate efficacy; as advantages, it does not need prescription and is low cost and as disadvantages

The female mechanical device known as diaphragm has a high efficacy if the use is accompanied using spermicide; has an advantage that requires only a brief medical education; and as disadvantage has the impossibility of not being able to be employed by all women. It has

Vaginal shower comprising the washing of the vagina soon after performing the sexual act proves to be practically ineffective; has the advantage of using sanitary facilities when they are nearby; and has the disadvantage of interrupting the love colloquy. It has a very high risk

Interrupted coitus, which consists of the interruption of sexual activity, has a much-discussed efficacy; as an advantage, can be realized at any time; and as disadvantage, reduces the sexual

Hormonal female contraception is based on the use of progestogen and/or estrogen to interfere in the ovulation, ovule transport, and nesting process, controlling the birth rate. Various

The oral progestogen is highly effective; has the advantage of being a single dose; and has the disadvantage of having a prolonged effect. It has a risk of failure, but a long-term medical

Implants in various modalities are easy to implant and to remove, either subcutaneously or intramuscularly. It has high efficacy, with the advantage of slow release of progestogen, but with the disadvantage of facilitating irregular menstruations. They have low risk of

Very common pills are prescribed either as a single monthly dose or with other doses. The efficacy is high, with the advantage of having no estrogen effects and with the disadvantage of presenting intermenstrual bleeding. They have risk of failure as well as

Injectable steroids are given at intervals ranging from 1 to 6 months. They have very high efficacy and advantage of simple application, but with the disadvantage of presenting menstrual

In this study, the effects of different methods of birth control, among those prescribed in the last years, were not found to be totally efficient, although some of them were highly viable in

satisfaction of the couple. It has a risk of moderate failure and no medical risk [4].

are the strong motivation to use. It has a risk of low failure and no medical risk [4].

of abstinence, and it has a risk of low failure and no medical risk [4].

relatively low risk of failure and no medical risk [4].

of failure and no medical risk [4].

avenues are used for its employment [5].

disorders and increase in body weight [5].

controlling the birth rate of the women who used them.

risk [5].

failure [5].

medical risk [5].

Reali [3], citing Karl Martius, reports that among primitive peoples who inhabited Brazilian jungles, there was the habit of the Crowned, Purus, and Botocudos Indians to undergo bleeding to avoid pregnancy and to suffer blows in the womb to expel the existing fetus. Among the Pauamari Indians, Prance observed the practice of abortion using leaves of plants such as "Mabi kiri dadi (head of water snake) and Koaka-makha da-di," rubbed in the womb of pregnant women. The missionary couple Morgan found among the Indians of the Denis tribe located on the banks of the Juruá River in northern Brazil the use of a potion elaborated with Curarea Tecunarum that produces a contraceptive effect for 2 years.

Popular medicine has among its indications different bottles to produce contraceptive effect, still sought today by populations further away from the developed centers.

Even the most advanced societies that were guided by empirical methods were unconcerned with the situation of population growth. With the expansion of Christianity, the use of contraceptive methodology, almost always a product without a scientific endorsement, was being abandoned to resurface in the eighteenth century after the knowledge of Malthus' work. The work of Thomaz Robert Malthus came to light in London in 1798 under the title "Essay on the Principle of Population …" Malthus was an important English economist of the late eighteenth and early nineteenth centuries. It was of great importance in the study of population growth in developing the so-called Malthusian theory. He was also a clergyman, university professor, demographer, and scholar. In his theory, Malthus affirmed that while the production of goods grew in arithmetic reason, the world population grew in geometric reason.

A methodology to avoid conception and, therefore, to produce the desired family planning was developing until reaching the recognition as a scientific area. From the second half of the twentieth century, especially in the 1960s, there was a population explosion. With an adaptation concerning historical conditions, it became known as the neo-Malthusian theory. This theory focuses on the population growth of underdeveloped countries; such growth would lead to scarcity of natural resources, as well as worsening poverty and unemployment. To avoid these setbacks, neo-Malthusians proposed effective birth control policies.

The Control of Birth was then sought with greater intensity. Procedures to prevent pregnancy began to be sought. Methods from the safe period resulted from the publication of two surveys conducted in 1923, alone by K. Ogino in Japan and by H. Knaus in Poland, to the process of the intrauterine device or the pills based on progesterone and estrogen, the most sought after 1950 that are intensively studied to verify the efficacy, the advantages, the disadvantages, the risk of failure, and the medical risk.

Without intending to deepen the various processes used in birth control, most of the most widely used methods will be judged by analyzing their advantages and disadvantages as well as the risks of failure and injury to women's health.

The Safe Period method proposed by Ogino and Knaus, as well as the Basal Temperature method and the Ovulation method, is reasonably effective; as advantage, it does not need prescription and is accepted by religions. The disadvantage is that it requires a prolonged period of abstinence, and it has a risk of low failure and no medical risk [4].

Beside infanticide, different, less bloody procedures have always been adopted by various

Reali [3], citing Karl Martius, reports that among primitive peoples who inhabited Brazilian jungles, there was the habit of the Crowned, Purus, and Botocudos Indians to undergo bleeding to avoid pregnancy and to suffer blows in the womb to expel the existing fetus. Among the Pauamari Indians, Prance observed the practice of abortion using leaves of plants such as "Mabi kiri dadi (head of water snake) and Koaka-makha da-di," rubbed in the womb of pregnant women. The missionary couple Morgan found among the Indians of the Denis tribe located on the banks of the Juruá River in northern Brazil the use of a potion elaborated with

Popular medicine has among its indications different bottles to produce contraceptive effect,

Even the most advanced societies that were guided by empirical methods were unconcerned with the situation of population growth. With the expansion of Christianity, the use of contraceptive methodology, almost always a product without a scientific endorsement, was being abandoned to resurface in the eighteenth century after the knowledge of Malthus' work. The work of Thomaz Robert Malthus came to light in London in 1798 under the title "Essay on the Principle of Population …" Malthus was an important English economist of the late eighteenth and early nineteenth centuries. It was of great importance in the study of population growth in developing the so-called Malthusian theory. He was also a clergyman, university professor, demographer, and scholar. In his theory, Malthus affirmed that while the production of goods grew in arithmetic reason, the world popula-

A methodology to avoid conception and, therefore, to produce the desired family planning was developing until reaching the recognition as a scientific area. From the second half of the twentieth century, especially in the 1960s, there was a population explosion. With an adaptation concerning historical conditions, it became known as the neo-Malthusian theory. This theory focuses on the population growth of underdeveloped countries; such growth would lead to scarcity of natural resources, as well as worsening poverty and unemployment. To avoid these setbacks, neo-Malthusians proposed effective birth control

The Control of Birth was then sought with greater intensity. Procedures to prevent pregnancy began to be sought. Methods from the safe period resulted from the publication of two surveys conducted in 1923, alone by K. Ogino in Japan and by H. Knaus in Poland, to the process of the intrauterine device or the pills based on progesterone and estrogen, the most sought after 1950 that are intensively studied to verify the efficacy, the advantages, the disadvan-

Without intending to deepen the various processes used in birth control, most of the most widely used methods will be judged by analyzing their advantages and disadvantages as well

Curarea Tecunarum that produces a contraceptive effect for 2 years.

still sought today by populations further away from the developed centers.

societies.

282 Family Planning

tion grew in geometric reason.

tages, the risk of failure, and the medical risk.

as the risks of failure and injury to women's health.

policies.

The male mechanical device, known as condom or more popularly as small shirt, has moderate efficacy; as advantages, it does not need prescription and is low cost and as disadvantages are the strong motivation to use. It has a risk of low failure and no medical risk [4].

The female mechanical device known as diaphragm has a high efficacy if the use is accompanied using spermicide; has an advantage that requires only a brief medical education; and as disadvantage has the impossibility of not being able to be employed by all women. It has relatively low risk of failure and no medical risk [4].

Vaginal shower comprising the washing of the vagina soon after performing the sexual act proves to be practically ineffective; has the advantage of using sanitary facilities when they are nearby; and has the disadvantage of interrupting the love colloquy. It has a very high risk of failure and no medical risk [4].

Interrupted coitus, which consists of the interruption of sexual activity, has a much-discussed efficacy; as an advantage, can be realized at any time; and as disadvantage, reduces the sexual satisfaction of the couple. It has a risk of moderate failure and no medical risk [4].

Hormonal female contraception is based on the use of progestogen and/or estrogen to interfere in the ovulation, ovule transport, and nesting process, controlling the birth rate. Various avenues are used for its employment [5].

The oral progestogen is highly effective; has the advantage of being a single dose; and has the disadvantage of having a prolonged effect. It has a risk of failure, but a long-term medical risk [5].

Implants in various modalities are easy to implant and to remove, either subcutaneously or intramuscularly. It has high efficacy, with the advantage of slow release of progestogen, but with the disadvantage of facilitating irregular menstruations. They have low risk of failure [5].

Very common pills are prescribed either as a single monthly dose or with other doses. The efficacy is high, with the advantage of having no estrogen effects and with the disadvantage of presenting intermenstrual bleeding. They have risk of failure as well as medical risk [5].

Injectable steroids are given at intervals ranging from 1 to 6 months. They have very high efficacy and advantage of simple application, but with the disadvantage of presenting menstrual disorders and increase in body weight [5].

In this study, the effects of different methods of birth control, among those prescribed in the last years, were not found to be totally efficient, although some of them were highly viable in controlling the birth rate of the women who used them.

It is evidenced that women who have used failed redundant methods of birth control and therefore failed to avoid pregnancy have the only recourse, if they do not really wish or cannot give birth for biological, social, or psychological reasons, to resort to abortion.

These legal measures and the other measures liberating the realization of abortion began to undergo a pressure of the doctrines of the religions, as of the action of the priests of diverse

Abortion and Family Planning

285

http://dx.doi.org/10.5772/intechopen.71772

From the 1960s, a series of proabortion demonstrations led government officials to worry about these women-generated movements. With the development of scientific knowledge from the end of the 1970s, with new techniques of artificial fertilization, and with concern for population increase, a direction of the light of science has taken the path to prevent this advance. Thus, methods, techniques, uses, and even superstitions were reminded to avoid

In the United States of North America, the guiding country of scientific education for less developed countries, there were movements so that abortion would not be penalized, as in Europe. From 1966 to 2009, 47 countries of the World Health Organization approved more

Preventing abortion facilitates birth while the release of abortion has the reason to prevent birth. It was not possible to calculate in what numbers these facts occur, but analyzing theo-

The woman and the doctor decide about having/performing an abortion. These are the characters who, per the culture of the society in which they live, may have the freedom to perform it in a lawful, correct, and safe manner or hidden in the penumbra, in an illicit, much more insecure and incorrect way. However, whoever decides to allow or punish, the one who offers the condition of accomplishing it is the society through legislation leading to imprisonment or the church through sin, into the Catholic religion reaching

In fact, not all religions consider abortion as a violation of their dogmas, as not all societies

Rodrigues Torres [2] presents a work comparing legislations of several nations in the twenty-

**B.** abortion allowed at the request of the woman, with a certain time of gestation (from 90 days to 24 weeks): the United Kingdom, The Netherlands, Sweden, Romania, Denmark, Latvia, Czech Republic, Slovakia, Greece, Hungary, Belgium, Bulgaria, France, Germany,

**C.** abortion allowed because of life-threatening risk for pregnant women: the United Kingdom, Denmark, Sweden, Latvia, Poland, Slovenia, Austria, Czech Republic, Slovakia, Romania,

Thus, in various areas of the world, there are diverse opinions about abortion.

first century. The picture he presents regarding abortion is as follows:

Lithuania, Estonia Portugal, Slovenia, Austria, and Italy;

liberal legislation on abortion, in contrast to 11 that have hardened it [8].

churches.

pregnancy and to avoid birth.

excommunication.

**4. Legislation**

retically there is no denying that possibility.

consider it to be an infraction of their legislation.

**A.** prohibition of abortion, without exception: Malta;

Medical abortion should only be performed by a physician in full exercise rights and knowledge, with the consent of the woman, without religious, ethical, or legal obstacles, and preferably during the first 12 weeks of gestation. The importance of this procedure has led the World Health Organization to make a publication on safe abortion that is already in a second edition [6].

Among so many events that worry those who care for health, abortion is highlighted by the difficulty in presenting appropriate measures to minimize its effects on the population. The problem of abortion presents a difficulty in promoting dialogs, since there are contradictory opinions. In the different societies, ideal values are found in relation to abortion, that is, its fulfillment in conditions necessary from the point of view of health and always complying with ethical and legal precepts. Yet the pattern of behavior shows that many times this ideal has not been attained and abortion is carried out in contravention of health, ethical, and law precepts. With liberality in its realization, abortion has long been a concern of societies.

In searching for references to abortion, one already finds that the Hebrews had a code that even punished those who practiced abortion with the death penalty. In Greek mythology, there is a quotation about Aristotle who was in principle opposed to abortion and then agrees to this procedure if the embryo was lifeless. Hippocrates—father of medicine—indeed the forerunner of medical ethics, was an oath-maker that doctors must follow, in which abortion practice is barred. The oath of Hippocrates held in the era before Christ is "I will not give the woman any abortive substance." In the Hammurabi Code, abortion is also punished. In Sparta, abortion was prohibited because of the need for men to take charge of internal security and to provide armies to intervene in times of war.

The issue of abortion became hot when St. Augustine spoke on the subject and then St. Thomas Aquinas differentiated the fetus formed from the fetus in formation. In the Roman Empire, the issue of abortion was also discussed [3].

Since the eighteenth century, despite the small interest that abortion caused in societies, its practice was deprecated, mainly because scientific knowledge had in the seventeenth and eighteenth centuries launched new foundations leading the fetus to be recognized as an autonomous entity accepting affirmations to echo the law.

With the French Revolution and the emergence of new nations, wars, plagues, and geographical discoveries, new changes occurred in the Western world, population growth slowed, while the need to maintain more effective armies increased. The life of men became valuable and motherhood was a patriotic activity [7].

The idea of a large family led governments in the nineteenth century to protect births for eminent political and ideological reasons, and with that direction, the population grew. After World War II, scientific knowledge revealed techniques and methods that allowed man to live longer. Even so, nations like France, Germany, and Spain have taken more restrictive measures to abortion.

These legal measures and the other measures liberating the realization of abortion began to undergo a pressure of the doctrines of the religions, as of the action of the priests of diverse churches.

From the 1960s, a series of proabortion demonstrations led government officials to worry about these women-generated movements. With the development of scientific knowledge from the end of the 1970s, with new techniques of artificial fertilization, and with concern for population increase, a direction of the light of science has taken the path to prevent this advance. Thus, methods, techniques, uses, and even superstitions were reminded to avoid pregnancy and to avoid birth.

In the United States of North America, the guiding country of scientific education for less developed countries, there were movements so that abortion would not be penalized, as in Europe. From 1966 to 2009, 47 countries of the World Health Organization approved more liberal legislation on abortion, in contrast to 11 that have hardened it [8].

Preventing abortion facilitates birth while the release of abortion has the reason to prevent birth. It was not possible to calculate in what numbers these facts occur, but analyzing theoretically there is no denying that possibility.

The woman and the doctor decide about having/performing an abortion. These are the characters who, per the culture of the society in which they live, may have the freedom to perform it in a lawful, correct, and safe manner or hidden in the penumbra, in an illicit, much more insecure and incorrect way. However, whoever decides to allow or punish, the one who offers the condition of accomplishing it is the society through legislation leading to imprisonment or the church through sin, into the Catholic religion reaching excommunication.

In fact, not all religions consider abortion as a violation of their dogmas, as not all societies consider it to be an infraction of their legislation.

Thus, in various areas of the world, there are diverse opinions about abortion.
