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Vasectomy: Vasectomy is a surgical procedure for permanent birth control in the male. In this procedure the tube transporting the sperms (vas) is blocked such that sperms do not enter the ejaculate. This prevents the fertilization of the woman's eggs. This procedure is also relatively pain free and has the advantage of daycare surgery.
Permanent methods
Tubal ligation: Tubal ligation is a permanent form of birth control. After this procedure, the egg and sperm do not meet and hence pregnancy is prevented. The common surgical techniques are the Pomeroy's and the Parkland's techniques. One method that is increasingly popular nowadays is the laparoscopic tubal ligation. There are several advantages of this method like less pain, day care surgery and less scarring. Tubal ligation is ideal for women who have completed their family and do not want any more children.
Natural Contraception This is also called the rhythm method of contraception. This is the only method accepted by some religious and cultural norms. This method is based on the identification of the fertile period of a cycle and to abstain from sexual intercourse during that period. In a woman with a regular menstrual cycle of 28 days duration, the period between day 10 to day 20 of menstrual cycle is considered the 'unsafe period.’ Other natural methods similar to this include coitus interruptus and prolonged lactation.
Oral Contraceptive Pills These are small pills which are commonly called birth control pills. They work by preventing ovulation (egg release) in women. These pills are best started after consultation with a gynecologist as patient selection is important for maximum benefits of pills. The oral contraceptive pills are usually started in the early part of the menstrual cycle. They decrease the chances of heavy flow. Common side effects may include bloated feeling, breast pain, headache etc. These side effects are greatly reduced or absent in the modern oral contraceptives which are called low dose pills. The potential benefits of modern pills are greater when compared to the risks, in a well selected individual. Most women take these pills up to fifty years, under the supervision of gynecologist. On stopping these pills, fertility is immediately restored. Other similar medications include the 'mini-pill' and the injectable contraceptives which are widely used in the lactational period for birth spacing.
Intra-uterine Devices (IUDs) commonly called the copper-T, IUDs are copper containing devices places inside the cavity of the uterus. These are widely used around the world. During the past few years there have been many changes and the modern copper-T has been made more safe and effective than before. Copper-T has the advantage that once inserted, it can be worn for many years. This gives the woman the insert and forget capability. Copper-T requires the doctor's help for insertion and it is a relatively pain free procedure. Copper-T is generally inserted in the early part of the menstrual cycle after the menses has stopped. It can also be inserted after delivery or abortion. The modern copper-T is called the Cu-T 380 A and is very safe and effective. Once inserted, it can be safely worn up to ten years. Few disadvantages may include mild cramping and increased flow during menses. This problem is largely reduced by the modern copper-T design. Other modern copper-Ts include hormone releasing copper-T which can be used to cure various menstrual disorders.
Barrier method or condoms are the most widely used contraceptives in the world. They are made of polyurethane or latex. They are made available by the government under the brand name of 'Nirodh' at various government centres. The advantages are that condoms are cheap, easy to carry, simple to use and disposable. They do not have any side effect or contraindication except the fact that few people may have allergy to latex. They have the added advantage of protection against sexually transmitted diseases. They are most useful in couples in whom the coital act is infrequent. Some of the few disadvantages may include slippage, breakage and discomfort. The failure rate is higher compared to other methods of contraception. The failure rate can be further decreased by the use of spermicide incorporated in some condoms.
Family planning: Taking charge of your fertility.
Rapid growth of the population is an important issue in most developing countries. A successful family planning programme helps to make many womens' lives easier by preventing unwanted pregnancies. When a country's population grows slowly, it helps in conserving resources, improving health and living standards. The term contraception includes all measures, temporary or permanent designed to prevent pregnancy due to the coital act.
In developing countries about half of sexually active women of reproductive age, or over 800 million women, want to avoid pregnancy for at least two years or want to stop child bearing altogether. About 17 percent of those women, or 140 million, are not using any method of family planning, while several others are using less effective, traditional methods. Together these women are said to have an unmet need for modern contraception. More than 80 percent of unintended pregnancies occur in women who want to avoid pregnancy but are not using an effective contraceptive method. Most of these pregnancies end up in abortions. In many developing countries, including India, these abortions are done by unsafe methods and result in women dying or suffering serious injuries.
The unmet need for contraception is often portrayed as a problem of access, leaving the perception that women do not use contraceptives because they cannot find them or afford them or they have to travel too far to get them. But while access is an issue, women have many other reasons for not using family planning, including personal, religious or cultural objections, fear of side effects, health concerns or lack of knowledge. Thus, just making contraceptives available does not ensure that women will use them. There has to be awareness about contraception. This is the aim of this article.