In America, and to a much less extent in Europe, there can be a lot of angst when an aerospace engineer wears the wrong shirt on television. Women have a great deal of power in western nations, so much so that they can overwhelm science breakthroughs with cultural Gerrymandering.

In rural India it is much different, community attitudes about masculinity and femininity have translated into deep-rooted discriminatory practices against girls and women. Women often lead very restricted lives and men are the decision makers yet family planning programs overwhelmingly focus on women. If women lack decision-making power there is no point in Westerners protesting it in London and New York City and hoping for change in 20 years. 

When it comes to birth control it's smarter to take the subtle road, finds a new study, using street theater and puppet shows to provide information about contraceptive methods, couple communication and decision-making related to family planning and women's reproductive rights. 

"Our study is one of the first to suggest that a relatively small adjustment in family programs can change perceptions about women's rights," says study co-author Rebecka Lundgren, MPH in the Institute for Reproductive Health at Georgetown University. 

The family planning options in this study were made available through Ministry of Health clinics and facilities operated by non-governmental organizations. One such method included in the program was the Standard Days Method®, developed and tested at Georgetown, where couples abstain from sexual intercourse on days 8 through 19 of the woman's menstrual cycle.  Basically, a week after the woman's period starts she needs to not have sex for 12 days. Georgetown says it is 95% effective when used correctly. 

Obviously, unlike a birth control pill the Standard Days Method requires agreement by the couple rather than the woman alone and continual female-male communication. 

"We found that when women and their partners learned about the Standard Days Method, the method was readily adopted, resulting in women being able to meet their need for family planning and, rather surprisingly, to meet self-efficacy needs beyond reproduction -- such as being able to leave the home to visit friends or shop -- a dual effect," says Victoria Jennings, Ph.D., director of the Institute for Reproductive Health at Georgetown University and co-author of the new paper.