Birth Control The term birth control refers to the volitional (自觉的) control of the number and spacing of children in a famil

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问题                                          Birth Control
    The term birth control refers to the volitional (自觉的) control of the number and spacing of children in a family. It encompasses the wide range of rational and irrational methods that have been used in the attempt to regulate human fertility, as well as the response of individuals and of groups within society to the choices offered by such methods. Birth control has been and remains controversial. The U. S. reformer Margaret Sanger coined the phrase in 1914~1915 and, like the social movement she founded, the term has been caught up in a quest for acceptance, generating many synonyms, family planning, planned parenthood, responsible parenthood, voluntary parenthood, contraception, fertility regulation, and fertility control.
    Human reproduction involves a range of activities and events, from sexual intercourse through birth, and depends as well on a series of physiological interactions, such as the timing of ovulation within the menstrual cycle. The visible events are central to the transmission of life and have been subject to social and religious control. The invisible factors in human reproduction gave rise early on to speculation and in modern times have become the topic of scientific investigation and manipulation. New knowledge relevant to birth control has diffused at different rates through various social groups and has not always been available to those with the greatest need. Hence, the conflicts and controversies surrounding birth control have been complex and impassioned. The disagreement over birth control arises in part from the debate over what is natural and what is artificial (and, to some, unacceptable).
    In 1790 a Venetian monk, Gianmaria Ortis, concluded that human population growth could not continue indefinitely. Malthus’ work a few years later stimulated more discussion and also provided the intellectual clue that inspired Charles Darwin’s theory of biological evolution through the survival of the fittest. In 1798 Thomas Malthus wrote An Essay on the Principle of Population. It posed the conundrum (大难题) of geometrical population growth’s outstripping arithmetic expansion in resources. The debate about human numbers remained academic, however, until the 1950s, when a surge in population occurred as a result of the comparative peace and prosperity following World War Ⅱ.
    In Malthus’ time world population was under 1,000,000,000, and when Sanger and Stopes opened the first birth control clinics population was still less than 2,000,000,000. In 1960 global population surpassed 3,000,000,000, and the next 1,000,000,000 was added in a mere 15 years. In the 19th century the population of industrialized nations rarely grew by more that 1 percent per annum, but in the 1960s and ’70s many developing countries exploded at a rate of 2 to 3 percent per year.
    Rapid population growth has several economic consequences. It requires heavier investment in education, health, and transport merely to maintain these services at their previous level; yet, the working population has a higher burden of dependence to support, making both individual and national saving more difficult. Although population growth is not the only problem dividing rich and poor countries, it is one important variable that has widened the gap in growth in per capita income between developed and developing nations. Advocates of birth control see it as a means to prevent the personal and social pressures that result from rapid population growth.
    There is a marked relationship between patterns of reproduction and the risk of death to the mother and her child. Maternal deaths and infant mortality are up to 60 percent higher among girls under 15 than among women who have a child in their early 20s. The risk of death to the mother and her child rises again in the second half of the 30s. Maternal and infant mortality is lowest for the second and third deliveries. The risk of certain congenital abnormalities is also greater in older women. Therefore, patterns of sexual abstinence and birth control, which concentrate childbearing in the age group 20—35 and limit family size to two or three children, have a direct impact on public health.
    At the same time, it must be recognized that patterns of human reproduction have been finely tuned over millions of years of evolution and the postponement of childbearing until the later 20s or 30s also increases the risk of certain diseases. In particular, cancer of the breast is more common in women who postpone the first birth until the later 20s or older. In the Western world, the risk of the death to women in childbirth is approximately one in 10,000, but in developing countries, where half the children born are delivered by traditional birth attendants, it is often 10 times as high. As the number of births worldwide rises, a greater number of women are likely to die having children. Simple access to birth control may be expected to reduce high death rates.
    National family planning movements have emphasized the right of the individual to determine family size as well as the contribution family planning can make to national and global population problems. Some methods of birth control may involve no person other than the individual or couple. But most methods require manufacture, distribution, promotion, counseling, and in some cases financial subsidy.
    Modern mankind can never return to the way of life that characterized most of human evolution. Settled agriculture and, to an even greater extent, urban living have irrevocably altered natural, finely tuned patterns of human reproduction. New social and artificial restraints on fertility must replace high infant mortalities and the invisible but important physiological controls that once limited family size. The variables that encourage small families are still not fully understood, but they include urbanization, educational and employment opportunities for women, and easy access to family planning services. In a traditional agricultural society children bring hope of economic rewards to their parents at an early stage by sharing in the work that is necessary to support the family, whereas in modern industrial societies the care and educating of children represent long years of heavy expenditure by the parents. This switch in the cost of children may be the most important factor determining the adoption of family planning.
    Western societies took more than a century to reach zero population growth and adjust to the rapid expansion of population that accompanied their industrialization. Most of the changes that occurred in patterns of family planning took place before public family services were established and at considerable emotional and physical costs to many couples. By contrast, the majority of the governments of contemporary Third World countries have established national family planning policies and actively encourage the use of public family services. The World Fertility Survey shows that more couples in developing countries desire small families than actually achieve their goals.
    Although consensus has not been reached on the range of birth control methods society should offer to individual members, the right of couples to determine the number and spacing of their children is almost universally endorsed, while the possibility of coercive family planning is almost as widely condemned. Throughout the world, awareness of the advantages and disadvantages of specific methods of birth control, thoughtful judgments about ethics, and further evolution in medical and scientific knowledge will continue to be important to the welfare of the family, of individual nations, and of the entire globe.
As shown by the World Fertility Survey, ______ couples in developing countries actually achieve their goals of small families.

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解析 文章第十自然段最后一句说世界生育状况调查表明在发展中国家只有较少数的夫妇生育子女少。
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