Contraception is the use of any process, device or method that prevents conception and may be used either before or after (postcoital) coitus.
There are five categories of contraceptives.
Oral contraceptives, also known as 'the pill', are drugs containing chemicals that are structurally similar to the natural hormones estrogen and progesterone. They prevent ovulation and, when taken according to instructions, they are almost 100% effective.
Spermicides, or chemicals that kill sperm, are inserted into the vagina prior to intercourse and may be used alone or in combination with other contraceptive methods. Douching should not be used in place of a spermicidal foam, cream, jelly, et cetera, as it is not effective enough to be considered a viable method of contraception.
Physical or Barrier
Intrauterine contraception devices (IUDs) are plastic or, more rarely, metal objects placed inside the uterus to prevent the fertilised egg from implanting itself in the lining of the uterus. Their effectiveness is slightly less than oral contraception, but the statistics are still encouraging.
Diaphragms are pieces of rubber edged with a spring that are used to cover the cervix. They are used with chemical spermicide. Related to this is a cervical cap. A sponge impregnated with spermicidal jelly can be put up the vagina a few hours prior to intercourse.
Lastly, a condom can be used. A condom is a tube-shaped barrier made of rubber or other membranes that is placed over an erect penis to contain the ejaculate. There are many different kinds of condoms and when used properly, they are a good and reliable means of conception. They are even more effective when used with a spermicide, and they are also good for lowering the risk of contracting STDs.
Natural methods are used by abstaining from intercourse for certain periods of time during, before or after ovulation. The rhythm method uses a calendar to keep track of supposedly infertile days, and in practise has proved to be failure. Other natural methods involve checking ovulation by taking temperatures or observing changes in the cervical mucus.
People also try the 'pull-out' method, but it too has a high rate of failure because the pre-ejaculatory fluid may contain sperm.
For women, tubal ligation is the most common surgical solution for contraception. It involves the surgical division and subsequent ligation of the fallopian tubes and does not interfere with the enjoyment of sex after the surgery.
For men, the most common surgical solution is the vasectomy. It involves cutting and ligating the vas deferens so that sperm can no longer travel from the testicle to the urethra. After the surgery, tests are required to check for sperm in the ejaculate and there is no promise of successful contraception until after two consecutive tests find no sperm. In theory, a vasectomy can be reversed, but it only works in a very small percentage of cases. As with tubal ligation, there is no change in sexual enjoyment post-surgery.
There are three options for postcoital contraception:
- abortion: the voluntary termination of a pregnancy for other than medical reasons.
- intrauterine device: for five days following unprotected coitus, an IUD can be inserted to avoid implantation.
- emergency contraceptive pills (ECPs): drugs that prevent ovulation or fertilisation and perhaps even post-fertilisation implantation of an embryo.
Contraception and House
- In Sleeping Dogs Lie, a clinic patient who does not speak English comes in with her daughter as an interpreter. Her daughter explains that her mother needs contraception for her premenstrual syndrome, but House realises the mother has a cold and that it is the daughter who wants birth control.
- In Deception, a clinic patient comes in complaining that her contraceptive jelly is causing a rash and House sees that she is using fruit jelly.
- In Need to Know, the patient is taking birth control pills despite being on fertility medication because she doesn't want a second child though her husband does.
- In Alone, the patient is revealed to have recently had an abortion and has internal bleeding from the use of birth control pills.
- In Mirror Mirror, House informs Cuddy that he's switched her birth control pills with a placebo. During a conversation with Foreman, he says 'no one's going to be happy here... and Cuddy's going to end up pregnant.'