Contraceptives and Birth Control

Contraceptives are the medicines or devices which prevent conception or pregnancy without effecting reproductive health of the individual. There are several methods of contraception like natural, barriers, IUDs, oral, injectable, implants and surgical method but the ideal is one which is user friendly i.e. comfortable and easy to use, reversible, completely effective against pregnancy and has no side effect. The detail about the contraceptive methods are given below:

1. Natural Methods: These are the methods which do not require any devices or medicines. These are of three types:

a. Safe Period: Avoiding sex during 14-17th day of menstrual cycle usually prevents pregnancy but it is better to avoid sex from 10-17th day for safety.

b. Withdrawal Method: This is method based on the withdrawal of penis before ejaculation however it has high failure rate due to pre-ejaculatory ejection of sperms or failure to withdraw penis before ejaculation. So, this method became more risky.

c. Lactation Amoenorrhoea: After parturition or baby birth, there is a phase of amonorrheoa or absence of menstruation. In this period, sex is fully safe as there is no chance of pregnancy but this period maximum lasts for six months.

2. Barrier Method: In this method, mechanical devices are used to prevent the deposition of sperms into vagina or their passage into uterus. These can be used by the user in complete privacy. These are as follows:

a. Condom: It can be rolled over the male copulatory organ i.e. penis. This also provide protection against sexually transmitted diseases (STD's) like AIDS.

b. Fem Shield (Female Condom): The device is polyurethane pouch with a rings at either end. This covers the external genitalia as well as lines of vagina. This also provide protection from STD's.

c. Diaphragm: This is a tubular rubber sheath with a flexible metal or spring ring at the margin which is fitted inside the vagina.

d. Cervical Cap: It is a rubber nipple which is fitted over the cervix and prevents entry of sperms into uterus.

3. Chemical Methods: These are the chemicals which has spermicidal function. These are available in the form of creams (Delfen), jelly (Perceptin, Volpar paste), foam tablets (Aerosol foam, Chlorimin T or Contab). They commonly contain lactic acid, boric acid, citric acid, zinc sulphate and potassium.

4. Intrauterine Devices (IUDs) or Intrauterine Contraceptive Devices (IUCDs): These are devices made up of plastic or metals or a combination of two. These are inserted in uterus to prevent pregnancy e.g. Copper T, Lippes loop, Progestasert, LNG-20. Most of these lasts for a period ranging from 3 years to 10 years. So, they provide a long term but temporary relief from pregnancy.

5. Oral Pills: These are the pills to be taken orally for 21 days in a menstrual cycle starting from 5th day and ending on 25th day. e.g. Mala D, Mala L, Triquilar, Saheli etc.

6. Injectable Contraceptives: These are injected in the body. These are Depot-medroxy progesterone acetate (DMPA) 150mg every three months or 300mg every six months and norethisterone enanthate (NET EN) 200mg every two months..

7. Implants: These are hormone containing devices inserted subdermally and provide long term contraception. e.g. Norplant is a device which remains active for 5 years and Omplanon is a device which remains active for a 3 years.

8. Emergency Contraception: It is a treatment for unprotected sex, sexual assault, missed pills or some other reason which have risk of pregnancy. e.g. Ovral tablet, Mifepristone pills and insertion of IUDs within 5 days of unprotected sex.

9. Surgical Methods: These are also called terminal methods of family planning. These are permanent solutions to pregnancy. They are vasectomy in males and tubectomy in females.

We can use any of the above methods to prevent unwanted pregnancy but none of these are 100% safe. It is better to use contraceptives rather to take burden of an extra child. Small family is happy family. Except natural methods and barrier methods, all other methods have more or less side effects but the natural methods have highest failure rate. So, the barrier method is more preferable to use. If any emergency situation occur due to leakage of condoms then abortion is another solution and it should be done as soon as possible but not after 12 weeks of pregnancy.