Dr Girija Wagh, Obstetrician, Gynecologist, IVF expertMD, FICOG, DIP ENDO, FICS
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Techniques or tools used to prevent pregnancy is called as contraception !!!
It’s indeed a tragedy when a couple decides to end an apparently normal pregnancy because the timing isn’t right. Various reasons are given such as recent marriage, consumption of medicines unknowingly or important career and social priorities. But what has been observed strikingly is, serious lack of knowledge about birth control measures.
Safe abortion methods are available, established and permissible by law, within the framework of the Medical Termination of Pregnancy Act of the country.
Yes, India has made termination of pregnancy legal, to protect women from stigma, injury and complications.
Unfortunately, this has resulted in increased abortions as these pregnancies were a result of ignorance.
The failure to use any protective methods, is not deliberate but many a times due to fear of complications or adverse effects.
This write up is an attempt to help couples make these decisions with confidence and to empower them with knowledge, which can help and guide them.
Pregnancy should be always be planned and a conscious decision. The “mother to be” should be healthy, physically and mentally prepared, to take on this responsibility and so should be the “father to be”.
Basic health checkup and vaccinations can be undertaken before planning a baby in order to protect the baby from infections and disorders. Pre-pregnancy healthy lifestyle, healthy diet goes a long way in preventing abnormalities in the baby.
This is because the earliest time the pregnancy is diagnosed is when a woman misses her periods.
By that time the neural tube( neural tube is the structure in the very early embryo from which the entire brain and the nervous system of the baby are formed as it grows ) of the baby is already formed. Deficiencies of nutrients have been identified to be responsible for birth defects in the fetus and also the improper formation of the placenta(the structure which supplies nutrition and protection to the baby while inside the womb ), which is the anchor of the baby, while in the mother’s womb.
Indian youth has access to condoms, uterine devices, pills and injectables as temporary birth control( contraceptive ) methods.
This method is also called the safe-period method of pregnancy prevention.
This is based on the fact that there is a window during the menstrual cycle of the woman during which she can conceive, as the ovum ( egg) which is released from the ovary and the sperms which are deposited in the woman’s body is capable of fertilization and formation of an embryo.
This window is called the fertile period and is from cycle day 10 to cycle day 20(the First day of the cycle is the first day of menses start). But identifying this period can be difficult in women with irregular cycles. Coitus interruptus or avoiding the deposition of the sperms or the male gamete inside the woman’s genital tract is practiced.
This has a high failure rate as there can be accidental spillage and also the pre-ejaculatory fluid is known to contain sperms. Natural methods fail as identification of the fertile window is difficult and also unpredictable. This can be identified by ovulation diagnosis kits or observing the changes in the cervical mucus which your doctor can guide you.
Methods such as the natural methods or barriers such as condoms and implants such as contraceptive devices can be non-hormonal methods of contraception.
Condoms are of two types such as the male condom or the female condom.
Female condoms are not freely available but male condoms are easily available and the government facilities, supply these freely.
Many medical stores have condom vending machines too.
Condoms are barrier methods of contraception wherein the man uses the latex made sleeve on to his erect organ to avoid contact of the semen with woman’s genital tract and can be disposed of without spillage. These also carry a liquid spermicide and offers to protect against pregnancy in case of a spillage.
The improper technique of use causes rupture of the condom. Failure to use one has been the cause of failure of this method.
Has to be used at every act of intimacy. The interruption in the sexual act and high failure rate makes it unpopular.
An inert method so does not cause any bodily changes. Protects against sexually transmitted infections.
Important tips? Please seek guidance for correct usage technique from a healthcare provider.
Copper IUCD or intra-uterine-contraceptive devices of various sizes, shapes, lifespans are available.
These are gently placed inside the womb and mechanically prevent the pregnancy from nidating.
These are inert and safe if properly used
Irregular bleeding, Infections, and pelvic pain may occur but are very rare.
A tubal pregnancy is a condition when the pregnancy gets implanted in the oviduct, instead of the womb ( uterus ).
This can be a life threatening condition if not diagnosed on time.
Women with recurrent pelvic infections, pelvic pain, irregular cycles, heavy menstrual bleeding, previous tubalpregnancy, structurally distorted uterus.
Best time is on the last day of the menstrual cycle.
Other times are also after delivery, immediately or after 6 weeks.
There also is a quick start method like for a pill which the doctor will guide you.
Insertion is an OPD procedure not requiring any anesthesia. Some cramps, pains, and discomfort are expected for a few days after insertion.
Rarely it may get displaced, may get imbedded and the woman may still conceive despite.
These are various formulations prepared synthetically and very similar to the naturally occurring hormones in our body. The principle behind using these is to elevate the levels of the hormones in such a way that it will prevent the usual cyclical events to prevent the ovulation and also cause changes in the womb lining and the cervical mucus to prevent pregnancy.
These changes are subtle and temporary as the amount of the hormones used in all the recent combinations are very low.
If the candidate is properly chosen, they are not. There are certain red flags using these formulations which the doctor can help you in choosing. In fact, there are some immediate and long-term benefits, such as reduced blood flow during menses, less menstrual pain, improved complexion, regular cycles, reduced incidence of ovarian and endometrial cancers in future and protection against evolving diseases such as polycystic ovarian syndrome and endometriosis.
Acidity, nausea, indigestions, headache, exaggeration of a migraine headache are seen in few women.
Has to be taken daily and if missed, can cause bleeding and increase the chances of unwanted pregnancy.
Yes, a slow release formulation of injectable hormone is available and is safe.
The disadvantage is that it causes irregular cycles but this is acceptable.
I pill is a popular brand of emergency contraception and consists of hormones.
It is a method of birth control, adopted in case of an unprotected sexual intimacy, to prevent pregnancy which may result due to that particular encounter.
Yes, “if consumed once” but many women today, consume it repeatedly and indiscriminately, leading to issues such as bleeding irregularities and bloating, which can be harmful.its better used after a consulting a healthcare provider and not over the counter, self administered or uner the guidance of a pharmacist .
Renu has married recently and missed her very first cycle.
She came for an abortion, as she did not want such an early pregnancy but had not used any birth control measure. When asked, both Renu and her husband Ajit said, they were not aware of any such (birth control) measures.
Please consult a gynecologist even before you get married, for guidance, family planning, and sexuality.
Anita was recently married and tested positive for pregnancy within 6 months.
Decided to continue the pregnancy being the first time.
At 4 months the baby was diagnosed with a defect which needs termination of pregnancy :
Plan pregnancy with proper pre-pregnancy guidance
Netra had gone for a business tour with her fiancé and did indulge into intimacy, thrice during the fortnight.
She took I-pills all the three times and has now reported with the absence of periods, increased weight gain and pain in the abdomen.
She needed to take treatment for 8 months, to resume her normal self.
Take guidance and do not self-medicate.
Sonali had irregular cycles and pain. She tested positive for pregnancy and her sonography showed a tubal pregnancy.
She had taken I-pill but it failed. She now needed to undergo a surgery to remove this pregnancy to prevent hemorrhage. (excessive bleeding) and the hospital wanted a blood relative to sign her consent and not the boyfriend as the situation was critical.
One can have a tubal pregnancy needing intervention. It is important that young couples are aware of these methods and come out of the belief that birth control is harmful. Proper choice, discussion, and guidance with the doctor can go a long way in reducing unnecessary physical harm and frustration.
Dr. Girija Wagh, MD (Obstetrics & Gynaecology), FICOG, FICP, Diploma (Endoscopy, Infertility), Fellowship of Indian College of Ob-Gynec, Women health care specialist, Academician, Acclaimed Orator & Researcher, B. J. Medical 1990-1992, Topper University Of Pune 1992
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