Latest revision as of 18:04, 21 July 2018

620

The reproductive period ¹ (or in women the childbearing period ¹) begins at puberty ². Menstruation ³ — the appearance of the periods ⁴ or menses ⁴ in women — also begins at puberty. The first period is called the menarche ⁵ and menstruation ceases with the menopause ⁶, which is also sometimes called the climacteric ⁶. In practice, the reproductive period is often made to start, by convention, at 15 years or at the minimum age at marriage (504-1) and, for some, to end at 45 or 50 year. The temporary absence of menstruation, be it normal or pathological, is called amenorrhea ⁷. Pregnancy amenorrhea ⁸ occurs after a conception, and post-partum amenorrhea ⁹ after a confinement.

• 1. The terms reproductive ages or fecund ages are also used.
• 3. Menstruation, n. - menstruate, v. - menstrual, adj.
• 6. Menopause, n. - menopausal, adj. The expression change of life is used as a synonym for menopause in colloquial language.

621

The capacity of a man, a woman or a couple to produce a live child is called fecundity ¹. The lack of that capacity is called infecundity ² or sterility ²; inability to conceive ³ and inability to procreate ^10★ are the main, but not the single causes of sterility. Used alone, sterility usually carries the connotation of irreversibility, but occasionally temporary inability to conceive ^4★ and temporary sterility ⁵ are distinguished from permanent inability to conceive ^6★ and permanent sterility ⁷. Among women we distinguish primary sterility ⁸ where the woman has never been able to give birth, and secondary sterility ⁹, which arises after one or more children have been born.

• 1. Fecundity, n. - fecund, adj. An alternative meaning of the term implies the ability to conceive, rather than to produce a live child. The terms sub-fecundity and sub-fecund mean either that the capacity to produce a live child is below normal, or that the probability of conception is low.
• 2. Sterility, n. - sterile, adj. Infecundity, n. - infecund, adj.

622

The term temporary sterility (621-5) is used even in instances where a woman’s inability to conceive is not the result of a pathological condition.Women are said to have sterile periods ¹ in each menstrual cycle ², because generally conception can occur only during a few days around the time of ovulation ³. The period of sterility that extends from conception (602-1) to the return of ovulation after a delivery, which includes pregnancy (602-5) and is influenced by the duration of breastfeeding ⁴, is called the nonsusceptible period ⁵, particularly in mathematical models of reproduction. Temporary sterility is also used to refer to the occurrence of anovulatory cycles ⁶ (i.e., menstrual cycles in which ovulation does not occur) or to abnormal periods of amenorrhea. The sub-fecundity ⁷ of very young women is commonly called adolescent sterility ⁸; it would be better to talk about adolescent sub-fecundity ⁸.

• 5. The period between delivery and the return of ovulation is often called the period of post-partum sterility.
• 6. Also called anovular cycles.

623

Fertility ¹ and infertility ² refer to reproductive performance rather than capacity, and are used according to whether there was actual childbearing or not during the period under review. When it concerns the complete reproductive period, the term total infertility ^3★ may be used while permanent infertility ⁴ may extend from a certain age or marriage duration to the end of the childbearing years. Voluntary infertility ^5★ is used when the absence of procreation corresponds to a decision of the couple (503-8). It should be noted that in many Latin languages, the cognates of fertility and fecundity are used in a sense diametrically opposite to that in English. Thus, the French fécondité and the Spanish fecundidad are properly translated by fertility, and fertilité and fertilidad by fecundity.

• 1. Fertility, n. - fertile, adj.
• 2. Infertility, n. - infertile, adj.
  Childlessness, n. - childless, adj. : refer to the state of a women, man or couple who have been so far infertile.

624

The fertility (623-1) of couples will depend upon their reproductive behavior ¹. A distinction is drawn between planners ², couples who attempt to regulate the number and spacing (612-1*) of their births, and non-planners ³, couples who make no such attempt. Family planning ⁴ has a broader meaning than family limitation ⁴ which refers to efforts not to exceed the number of children wanted ⁵. The terms birth control ⁶ or fertility regulation ⁶ are not restricted to the activities of married persons.

• 4. A classification according to family planning status distinguishes couples who have not tried to regulate the number and spacing of their children from those who have tried to do so.
• 5. Unwanted births or unintended births are distinguished from unplanned births that may have occurred at a time that was not intended, and perhaps outside of wedlock.

625

Family planning implies a concern with planned parenthood ¹ or responsible parenthood ¹, i.e., the desire to determine the number and spacing of births in conformity with the best interest of each couple, or of society. The number of children expected by a couple may differ from the desired number of children ² and/or intended number of children ² reported by the couple in a survey. Even if these goals are not revised, they may be exceeded as a result of contraceptive failures ³ ; the frequency of the latter depends on contraceptive effectiveness ⁴ which has two aspects. Theoretical effectiveness ⁵ or physiological effectiveness ⁵ indicates how reliable a method is when used all the time according to directions. Use effectiveness ⁶ measures its reliability when used in everyday situations by a given population. Reasoning in terms of residual fecundability (638-7), use effectiveness is usually measured by the contraceptive failure rate ⁷ which relates the number of unintended conceptions to the length of exposure to the risk of conceiving.

• 2. In other terms, birth expectations differ from reproductive intentions. A distinction is made between desired family size, the number of children a woman, man or couple wants to have, and the ideal family size which they envision for their society. Intended family size may be lower than desired family size.
• 3. Unplanned births are often opposed to planned births.
• 4. 5. and 6. Efficacy is a synonym for effectiveness in these expressions.
• 4. Not to be confused with the demographic effectiveness of a family planning program (see 626-7), or of a method in a population.

626

A family planning program ¹ seeks to introduce and diffuse birth control in a group of potential users ² or in a target population ². Teams of fieldworkers ³, including canvassers ³, motivators ³ and distributors ³, attempt to reach and convince the population to use contraception or abortion. The success of the program can be measured by the proportion of new acceptors ⁴ in the target population, or by the acceptance rate ⁴; for the acceptors of contraception, the continuation rate ⁵ after a certain lapse of time and its complement, the termination rate ⁶ or drop-out rate ⁶ are also computed. Estimates of the numbers and proportions of births averted ⁷ reflect the demographic effectiveness (625-4*) of the program. Contraceptive prevalence in a population is estimated by the proportion of current users ⁸ of contraception from a relevant universe, such as married women of reproductive age.

• 8. Special surveys of knowledge, attitudes and practice of contraception have been called KAP surveys in abbreviation.

627

Contraception ¹ refers to measures which are taken in order to prevent sexual intercourse ² or coitus ² from resulting in conception; the term covers contraceptive sterilization (631-1). Birth control methods ³ is used in a broader sense than contraceptive methods ³ to include induced abortion (604-2). Abstinence ⁴ from coitus, particularly periodic abstinence (628-4) is often included among contraceptive or birth control methods.

• 1. Contraception, n. - contraceptor, n.: one who practices contraception. Contraceptive, adj. : used for contraception.
• 4. Abstinence, n. - abstain, v.

628

A distinction is frequently drawn between appliance methods ¹ of contraception and non-appliance methods ². One principal non-appliance method of contraception is coitus interruptus ³ or withdrawal ³. Another non-appliance method of contraception is periodic abstinence ⁴ or the rhythm method ⁴, in which coitus is avoided during the period when the woman is believed to be fecund and takes place only during the so-called safe period ⁵ of the menstrual cycle. The basal body temperature method ⁶ refers to the method in which the woman keeps track of her temperature to identify the safe period.

• 1. Appliance methods include not only barrier methods which are used to prevent the union of the sperm and ovum, but also methods using other contraceptive devices such as the intra-uterine device (629-10) and other types of contraceptives such as the pill (630-4).
• 4. The term natural family planning methods has been applied collectively to cover the rhythm method, the basal body temperature method, and other techniques like cervical mucous method which attempt to identify stages of the woman’s ovulatory cycle.

629

The barrier methods which are more commonly used alone or in combination include the condom ¹ or sheath ¹, used by men, and the cervical cap ² or pessary ², the diaphragm ³, tampon ⁴ or sponge ⁴, contraceptive jelly ⁵, suppository ⁶, foam tablets ⁷ and douche ⁸ with or without spermicide ⁹, used by women. There are various types of intra-uterine devices ¹⁰ (abbreviated to IUD ¹⁰), including the loop ¹⁰, the coil ¹⁰, the copper T ¹⁰, etc.

630

Oral contraceptives ¹ are a method of hormonal contraception ² or contraception by steroids ³. These inhibit ovulation by regular ingestion of the pill ⁴, or by injections or implants.

631

Sterilization ¹ results from various surgical procedures: on the male, vasectomy ² or occlusion ^3★ involves tying and cutting the vas deferens; on the female tubal ligation ⁴ and salpingectomy ⁵ or tubectomy ⁵ involve interventions on the fallopian tubes. Hysterectomy ⁶ or excision of the uterus, also involves sterilization of the woman.

• 4. and 5. Various procedures are used to gain access to the Fallopian tubes, such as laparotomy, colpotomy or laparoscopy.

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