'j October 11, 1970 THE DAILY TAR HEEL P&-,e Three . n n (?TI o OMtLCIfliM 0 0 0 -Eleplhaelrs 3 A booklet designed to help prevent unwanted pregnancies and venereal disease will be available Monday from 2 to 5 p.m. in suite B of the Student Union. - Published and distributed by ECOS, Inc., the booklet, entitled "Elephants and' Butterflies...and Contraceptives," wUl be sold for 25 cents. - The booklet was compiled this summer by a group of medical students. They are: Thomas Blush, University of California; Donald Rollins, University of South Dakota; Richard Mier, University of Chicago. Also contributing was Dr. Takey Crist, assistant professor in the Department of Obstetrics and Gynecology of the UNC School of Medicine. -' The booklet was scheduled to appear at the beginning of the semester, under the copyright Qf the Carolina Population Center. However, due to mistakes in the content and the tone of the booklet, the first printing was withheld and destroyed. The first printing of 10,000 copies was funded primarily by the Population Center with a total budget of S3,000. Produced by the Student Union Print Shop and by the University's Duplicating Services, the first version of the booklet was to made available without cost to any student wishing a copy. The covers of the first booklet were salvaged to help reduce the cost of the second printing. The 1 0,000 copies of the revised version were produced by a printing company in Burlington, N.C., at a cost of S2300. Funds for the second printing consisted of advance orders from the Carolina Population Center, fraternities, sororities, dormitories and other student organizations, and from anonymous contributions. The 24-page booklet is based on a Medical Student Summer Research Project sponsored this summer by the Population Center. Funds from the project came from a Rockefeller Foundation Grant. The book's authors said their summer project involved three stages of activity : -Evaluation of the student population of the University of North Carolina at Chapel Hill, "our target population." -pre-testing the booklet and formulation of booklet tone and content. printing and distribution of the booklet. The authors used Dr. Karl Bauman's 1968 survey of the University's student community and other sources to determine why there is inadequate contraceptive practices among UNC students. Lack of facilities for obtaining contraceptives was the main reason for the booklet. Secondly, students may not know enough about reproductive physiology and contraceptive outlets. In addition, lack of motivation or psychological deterrents is noted. Lining fully developed from about day-1 5 through day 28 ., (7 Bleeding from day-l through day-5 . , : - j " N l"" I I U Q ( Q i n n r Perfect 28-day cycle 0 0 0 AflML G out ira Uterine lining built up from day-6 through about day-13 (t? U)l Ovulation usually occurs between day-12 and day-16 FEMALE ORGASM The psychological and physical stimulation necessary for successful orgasm is much more difficult to assess in the woman than in the man. In general, during sexual intercourse, the penis is inserted in a thrusting manner into the vagina and the massaging sensation evokes the appropriate nerve reflexes that culminate in female orgasm. This is, however, a gross oversimplification. Not only are the anatomy and sensory areas more complex in the woman, but the traditional role of women as passive, submissive The Menstrual Cycle in a diagram from "Elephants and Butterflies." (reprinted by permission of ECOS, Inc.) 1 Clinic- Aids' 'Sexually I Active ' "It is our job as physicians not to decide ' .what is good or bad, but to decide what is necessary. If an unmarried girl who has r -established a sexual relationship and seeks contraceptive information comes to a physician, she is not asking for advice about morality, instead, she is asking for medical help. 1 "Girls who have never had a sexual Experience but seek contraceptives because they plan to do so may benefit from counseling. "The problems included in dealing with young sexually active women include getting them to assume the responsibility that goes along with their desire for sexual freedom." This is the opinion of Dr. Takey Crist of the Health Education Clinic in the N.C. Memorial Hospital and one of the authors of "Elephants and Butterflies." The clinic was formed in May of this year as a part of the Obstetrics and Gynecology Department. It functions as a place where UNC women interested in obtaining information on contraceptives, help with female personal and abortion counseling can go. "The people working in the clinic are interested individuals who like to deal with young people and give them information when they seek it," Crist said. Crist feels that the clinic is much more than just a place to obtain contraceptive information. He feels it is a place where coeds can go and discuss their problems openly with doctors, without the usual moral lectures, and receive help with whatever decisions they make. There is nothing comparable to the clinic in North Carolina, but throughout the country similar clinics have been established. The clinic is open every Tuesday from 8 a.m. to 12 noon. It works closely with the infirmary and there is easy referral to all services in the hospital, including marriage counseling and psychiatry. Appointments for the clinic can be made through the infirmary or through - "Central Appointments of the hospital. Stories by Terry Cheek and Lana Starnes Few publications undergo the degree of scrutiny, revision and analysis which has produced the booklet "Elephants and Butterflies...and Contraceptives." The authors pretested, prepared, reviewed, corrected and revised five drafts of the booklet before submitting it to the printer. Further improvements and corrections made the second printing not only a work of art, but a work of perfection. Two kinds of information are not necessarily equivalent. There are facts you need to know and there are facts you want to know.. "Elephants and Butterflies" contains an abundence of both kinds of information. It tells ypu the things we. all should. .know about contraceptives, including . information on where and how contraceptives may be obtained. In the words of the booklet's authors: "The book is frank, person-to-person, low-keyed, somewhat 'soft sell,' with very little vertical sermonizing. Our advocacy of effective contraceptive behavior, however, is overt and fairly strong-worded. "Honesty and frankness were virtues placed high on our list of priorities and a great effort was made to produce a text in which our readers would put faith," said the authors. The booklet avoids "cumbersome medical phrasing." Indeed, the text has about the same readability as that of a news magazine. The booklet begins with a synopsis of e.e. cummings' fairy tale entitled "The Elephant and the Butterfly." The body of the booklet is divided into 12 sections progressing from basic physiology to the medical and pharmaceutical services available in this area. The physiology section is divided into two parts. The first, "The Elephants," describes the physiology of the male and ends with a series of questions and answers. The second part, "The Butterflies," deals with the sexual function of the female and the menstrual cycle. A question and answer series is also included in "The Butterflies." The physiology section is illustrated with diagrams of the male and the female reproductive systems, a chart of the "perfect 28-day cycle" and a drawing of the anatomy and sensory areas of the female. The material of methods of contraception is by far the lengthiest portion of the booklet. "It is amazing," say the authors, "that in this age of sexual revolution there are so many unwanted pregnancies Let's be .reahsjticintercourse causes babies. , . "The inconvenience of contraception is a small price to pay to prevent the tragedy of an unwanted pregnancy," the authors say. The studies used in the medical students' research revealed that the UNC student population is sexually active-50 to 60 percent of those students surveyed were non-virgins. The researchers found that students here practice poor contraceptive technique. Thirty percent of all non-virgins tested used the rhythm method, withdrawal or nothing at all as their most frequent method and only about 40 per cent used an effective method such as the pill, foam or condoms "always." The section on contraceptives describes each contraceptive and gives information on the side effects, the availability, the reasons for failure, the effectiveness and the extent of use. The short section on pregnancy gives simple, to-the-point information on medical detection of pregnancy and lists the major indications of pregnancy. Abortions may be obtained at Memorial Hospital in Chapel Hill within the limits of the state law. Specific instructions and phone numbers are given in "Elephants and Butterflies" for anyone wanting to terminate her pregnancy. "There is help available," say the authors of the booklet. "Do not go to a butcher. Further, there is absolutely no safe way for you to abort yourself. There is nothing you can take, including birth control pills, quinine of other chemicals, that will cause abortion without killing or permanently maiming yourself in the process. "Hot baths, trauma to the abdomen, or strenuous exercise will do nothing. Insertion of a metal, plastic or wooden tube or a coat hanger into the uterus will more likely cause perforation, serious infection, sterility or even death than an abortion." "" The section on venereal disease uses a question and anwer format to present information on detection, medication and prevention of V.D. The section entitled "Medical and Pharmaceutical Services" will perhaps be the most useful part of the booklet in accomplishing the primary goal of the authors: to help prevent unwanted pregnancies among unmarried college students. This section is devoted to information where and how contraceptives may be obtained, including names and telephone numbers of people and organization to contact and fees for such services. Pregnancy testing and venereal disease clinic services and places where non-prescription contraceptives may be purchased are listed. Fees and prices are included. "I hope this booklet will help," writes Dr. Takey Crist, one of the booklet's authors. "It was written by students not to promote promiscuity, but rather, in recognition of the fact that young people are in fact risking pregnancy, and in hopes of increasing their individual and social responsibility. The language is theirs, the questions are theirs and the answers are theirs." edical Facts Show Need ror ooklet Exists ...In North Carolina last year there were 11,474 illegitimate pregnancies. Sixty per cent of them were born to mothers under 20 years of age. ...Over a million illegal abortions are performed annually in the U.S. ...In 1969 there were 165 therapeutic abortions performed at the N.C. Memorial Hospital. ...In September of this year there were 1,850 cases of gonorrhea reported in North Carolina. ...Gonorrhea has now become the most prevalent and communicable disease in the nation and by the most conservative estimates is clearly out of control. These facts, released by Dr. Takey Crist of the N.C. Memorial Hospital Health Education Clinic, reflect the great need that exists for adequate information concerning sex education, birth control, abortion and family responsibility. "Elephants and Butterflies" is a booklet written in response to this deficiency. It was written in an attempt to give students honest and factual information about sex, said Crist. The booklet was compiled this summer when Crist was wroking as preceptor for the N.C. Population Center in conjunction with the Medical Student Research Center. , Tne authors approached the task with what Crist calls a "tell it like it is" attitude and left no stone unturned in their search for all available information. Crist is optimistic about the acceptance of the booklet. "I think the students will like it and be proud of it. We like to think of it as something representative of what is typically Carolina." The need for sex education, Crist said, has become apparent. "Like it or not, we are living in a kind of sexual revolution.. Books, films, magazines and the TV media are exploiting sex for commercial purposes. Sex and love are often oversimplified, treating the, topic like a combination of learning to play tennis and buying life insurance," he said. "Societal norms, on the other hand, restrict the availability of accurate information about sex. Many people are unable to separate fantasy from fact, with tragic results," Crist said. The first reaction , of the "older" generation," Crist believes, will be one of shock, which he contends reflects their own inadequacy about sex information. "The older generation has invested in so much sexual shame that it is prepared to kill for it to protect it," Crist commented. "It has already been shown that parents have contributed unwittingly to their children's lack of responsibility with regards to contraceptive practices and sexuality by avoiding frank discussions of these issues and by handing their adolescent children over to a college in expectation that the college will teach them, or by denying their questions entirely on the assumption that it will take care of itself." Crist attended UNC where he lettered in football - and graduated with an undergraduate degree in philosophy. After finishing the UNC School of Medicine he served his internship in Charleston, S.C. Crist returned to N.C. Memorial Hospital in 1965 as a resident io obstetrics and gynecology. He is presently an assistant professor in the department and staff member of the Health Education Clinic. Crist, who was originally interested in becoming a general practitioner, entered the field of obstetrics and gynecology because he felt that the field would become a significant one with definite contributions to be made to medicine. O az Q H- 00 O Q z u o tu 3 rr m co - DC PILL IUD a c 100 o Q o o Q O LL) CO 5 O LU 90 LU X X o rr Q 80 70 Determining the effectiveness of different contraceptive methods has always been a problem. Contraceptive failure pregnancy may be the result of an ineffective method, such as withdrawal or douching, incorrect usage of an effective method, or occasionally, a method failure. Contraceptives and the percentage relation to avoidance of pregnancy. Diagram from "Elephants and Butterflies." (reprint by permission of ECOS, Inc.) j. j.. 1 A