Attempts by humans to control their own fertility have included abstinence, contraception, induced abortion, surgery such as vasectomy or hysterectomy, and infanticide. "Birth control" is a term coined in 1914, and at that time it meant voluntary control of conception by mechanical or chemical means, or by both. Today, hormonal, barrier and natural birth-control methods are also recognized as techniques of contraception.
Before WWI, a few Canadians advocated birth control as a health measure, but organized groups to foster it did not appear until the 1920s. Like groups in Britain and the US, they argued that every child should be wanted and nurtured. Birth control could free women from debilitating annual pregnancies and reduce the incidence of illegal abortion. It could improve marital relations, maternal and child health, and family welfare. Canadian advocates did not, however, make the claim that it was the panacea of social problems caused by poverty.
Supporters were, generally, educated men and women. Some were inspired by the Social Gospel, and some were feminists. Their occupations were varied, and their political biases ranged from socialism to conservatism.
Under the 1892 Criminal Code, birth control was obscene, "tending to corrupt morals." Unless an accused could prove that its advocacy had been "for the public good," he or she was liable to serve a 2-year jail sentence. Contraception was opposed by pronatalist business, religious, and political interest groups. Their attacks on the "birth controllers" were frequent and often defamatory.
Nevertheless, by the 1920s, international research in human sexuality was creating interest in Canada, the 1892 law was being questioned, and family size among those in higher socioeconomic brackets was shrinking. Informed couples could limit their fertility by "under-the-counter" purchases of commercially made contraceptives, or with materials for homemade methods. High fertility persisted among the less educated poor, however, and the birth controllers urged that contraception should be free for all who wanted it.
Politicians quoted the law to evade the issue, but scattered groups of determined volunteers made referrals to a few courageous physicians or provided information themselves to married women. The first advocacy organization in Canada was formed in Vancouver in 1923, and the first birth-control clinic was started in Hamilton in 1932.
From 1930 onwards a birth-control program for low-income women was also provided by a philanthropist, A.R. Kaufman of Kitchener, Ontario. From his Parents' Information Bureau (PIB), clients could obtain simple contraceptives by mail order and could get referrals to selected physicians for diaphragms and for contraceptive sterilization.
When one of the PIB field workers, Dorothea Palmer, was arrested in 1936 in a predominantly French-speaking, low-income suburb of Ottawa, Kaufman's lawyers won her acquittal, arguing that her work was not for profit but "for the public good." The PIB was soon helping 25 000 clients a year. The landmark verdict reassured other advocacy groups, but until the 1960s they were unable to match the popularity of Kaufman's program.
After WWII and the baby boom, public acceptance of birth control increased rapidly. In 1955 SERENA (Service de régulation des naissances) was started in Lachine, Québec, by Gilles and Rita Breault to teach "natural methods" of birth control. SERENA is a faith-based group that advocates a largely Christian perspective on birth control. These natural methods are based on small changes in the body that may be associated with ovulation. The growth of other volunteer groups was speeded by news stories of the birth-control pill and the plastic IUD (intrauterine device), and by word of the world population "explosion."
In 1963 the Canadian birth-control activists Barbara and George Cadbury organized a federation of the Vancouver, Winnipeg, Hamilton, Toronto and Ottawa birth-control societies and arranged for its membership in the International Planned Parenthood Federation (IPPF). Its objectives were "responsible parenthood" and population education. New groups in Edmonton, Montréal and Calgary joined, but the PIB and SERENA refused invitations.
The Canadian federation was first titled Canadian Federation of Societies for Population Planning, but in 1967 it changed its name to the Family Planning Federation of Canada and in 1975 to Planned Parenthood Federation of Canada (PPFC). Member groups in Vancouver and Winnipeg won United Way grants. Since 1967 the Québec government has financed instruction for French-speaking trainers and service providers, and has also provided funds to SERENA. Early in 1969 the BC government granted funds to the Family Planning (now Planned Parenthood) Association of BC.
Robert W. Prittie led the cause in Parliament; and with informal support from the Anglican, Presbyterian, United and Unitarian churches, and later the Canadian Home Economics Association and the Salvation Army, the PPFC pressed the Canadian government to remove contraception from the Criminal Code. The Canadian Medical Association and other respected national voluntary organizations joined the campaign. The Canadian Conference of Catholic Bishops stated that it would not oppose the amendment. The law was changed in 1969.
Beginning in 1971, with grants from Health and Welfare Canada (now Health Canada), the PPFC also undertook to act as the catalyst for government-funded birth-control information and services across Canada. Its advocacy and service organizations multiplied, and in response, some provincial governments began to offer their own programs. The PPFC also raised money for the IPPF. After 1976 the federal government's assistance for non-governmental birth-control services diminished. Only small sustaining grants to the PPFC and SERENA remained. Birth-control education and services are political issues, and since the 1970s a variety of public and privately owned programs have emerged to help provide services. In 2005 the Planned Parenthood Federation of Canada changed its name to the Canadian Federation for Sexual Health (CFSH), in order for the name to more clearly reflect the aims of the group. The federal government no longer provides funds to faith-based groups such as SERENA, or non-profit organizations like the CFSH.
The Canadian government began to meet requests for help from developing countries and made grants also to the IPPF and the United Nations Fund for Population Activities. These forms of international birth-control assistance continue. SERENA also developed a network of groups in France and abroad.
A variety of groups and governmental agencies inform Canadians of the benefits of education for responsible sexual activity and pregnancy. The Public Health Agency of Canada (PHAC) is responsible for providing broadly accessible evidence-based information about reproduction and sexuality. The age-appropriate information is designed to be available to all Canadians regardless of ethnic, cultural or religious backgrounds. The PHAC mandate is to develop effective and inclusive sexual health education. The Public Health Agency of Canada developed the first "Guideline for Sexual Health Education" in 1994, with revisions in 2003 and 2008. The amount of readily accessible public information about sexuality and birth control has risen dramatically in the last decade, especially with the preponderance of Internet services across North America.
Abortion became a legal right for Canadian women in 1988 and is now considered a medically necessary service. Dr. Henry Morgentaler, who had been repeatedly charged with providing abortions, challenged the right of the government to prohibit abortion services in Canada. Prior to 1988 the Canadian Criminal Code had been used to charge medical doctors and others who provided elective abortions. Although abortion is now technically legal in Canada the accessibility of services varies by province, with British Columbia and Ontario having multiple facilities, while Saskatchewan and New Brunswick have only a few facilities.
Overall abortion rates in Canada have dropped annually with fewer abortions performed in 2005 than in 2004 and 2003. The number of births among young women under age 20 has also dropped. Despite public awareness of preventing sexually transmitted infections by the use of condoms, among young men age 15 to 19 condom use does not seem to have increased significantly, but there has been a slight increase in condom use by young women. Condoms are less likely to be used as teenagers get older; for example, more 15- to 17-year-olds use condoms than do 18- or 19-year-olds.
Methods of birth control described as natural appear to vary in popularity. The temperature method involves taking the body temperature first thing in the morning and noticing the temperature rise that accompanies ovulation. Some forms of natural birth control involve monitoring the amount and type of cervical mucus and associating ovulation with a particular type of sticky or slippery mucus. These natural birth-control methods are most effective in a monogamous relationship, and the woman must pay close attention to small changes in her body caused by the menstrual cycle. Natural birth-control methods have been reported as approximately 80% effective. Modern additions to more traditional proponents of this method include groups or individuals that want to avoid using or consuming products containing hormones, some vegetarian or animal-rights advocates who object to the use of sheepskin condoms, and people who only want to use organically manufactured products who object to latex condoms.
New methods of birth control are continually being developed. There are hundreds of different kinds of birth-control pills, as well as transdermal patches that deliver hormones via a plastic patch adhered to the skin, moulded plastics containing hormones that are placed in the vagina, and hormonal implants placed under the skin to release hormones into the bloodstream. Other birth-control methods are developments in the barrier method, such as a condom for women designed to be placed in the vagina before sexual intercourse. The advantage of the female condom is that it does not appear to inhibit sensation the same way as the male condom and is also less prone to breakage.