Birth Control

May 26, 2023, 16:45 IST

Birth control or contraception is a practice to avoid unwanted pregnancy and minimize the risk of contracting sexually transmitted diseases. Birth control is necessary to curb the increasing population by preventing undesired childbirths. It also helps to keep viral and bacterial infections at bay during coitus.

Introduction

The devices and methods employed to prevent conceiving are termed as contraceptives. A wide range of contraceptives targeting different aspects of preventing pregnancy are available today. They may be traditional, barrier, hormonal or surgical methods.

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Characteristics of a Good Contraceptive

A good contraceptive should be:

• Economical
• Easy to use
• Safe
• Effective
• Minimum or no side effects
• Reversible
• Shouldn't hinder the sexual drive of the user
• Easily available to masses

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Natural or Traditional Methods

• Periodic abstinence- In this method, a woman refrains from sexual activity during the ovulation period (from 10th to 17th day) of her menstrual cycle when the chances of getting pregnant are high.
• Withdrawal method- Also called coitus interruptus, the withdrawal method prevents insemination as the male withdraws the penis before ejaculation.
• Lactational amenorrhea- The menstrual cycle is temporarily ceased following parturition during which lactation occurs. No ovulation occurs for about six months provided the mother fully breast feeds the child. Sexual intercourse during this time does not lead to pregnancy. However, this method is not fully reliable and effective since no proper devices are used.
• There are no side effects in all the above natural methods.

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Barrier Methods

• Condoms- Mechanical barriers like rubber or latex condoms are popular contraceptive devices. These are worn on the erect penis by male or inserted in the female’s cervix or vagina during coitus. It prevents the entry of sperm inside the female reproductive tract by acting as a blocker. In India, the government decided to provide condoms to the public by the name of ‘Nirodh’. This was done to curb overpopulation in the country under the National Family Planning Campaign. Condoms are disposable, safe, easy to use, non-surgical and have no side effects. It also helps to decrease the risk of sexually transmitted disorders.
• Cervical caps, diaphragms and vaults- These are reusable latex or rubber devices made to be inserted in the female’s genital tract. Spermicidal ointments, jellies, and foams are made to be used with this method to increase its effectiveness.

Oral Contraceptives

Oral contraceptives are given in the form of pills or tablets consisting of hormones estrogen and progesterone.The pills must be taken every day for 21 days, preferably during the initial five days of the menstrual cycle. It must be continued in an identical manner until the female wants to prevent pregnancy, which must happen after a hiatus of seven days (throughout which the menstrual cycle occurs) . They hinder or delay sperm entry by inhibiting ovulation and implantation in addition to changing the cervical mucus quality.

• Pills are highly accepted by females and quite effective with few negative effects.
• Saheli is a non steroidal pill developed by Central Drug Research Institute, Lucknow. It needs to be administered once in seven days and has high effectiveness.
• Females may also use progestogens as subcutaneous injections or implants, either on their own or in conjunction with estrogen. Although their effective times are significantly longer than those of pills, their action mechanism is identical. Within 72 hours following coitus, progestogens, progestogen-estrogen combos, or IUDs have been found to be particularly successful as emergency contraceptives because they can be used to prevent pregnancy that might result from rape or casual unprotected sex.

Intrauterine Devices

IUDs are special contraceptives which are inserted into the uterus of the female and hence are called Intrauterine devices. A proper medical professional is required to carry out the procedure.

• Non-medicated IUDs - It is a plastic or metal IUD that causes an inflammatory response in the body by a minor injury causing phagocytosis of male gametes. Eg. Lippes loop.
• Copper releasing IUDs - They release copper ions which decrease motility and capacity of fertilisation of sperms. Eg. CuT, Cu7, Multiload 375.
• Hormonal IUDs - They release a combination of hormones making the uterus unfit for implantation and create a fatal environment for sperms inside the female genital tract. Eg. LNG-20, Progestasert.

Surgical Methods

Surgical methods of contraception include two procedures:

• Vasectomy- In this procedure, the vas deferens of the male partner are cut and tied, thus preventing the sperms from mixing into the seminal fluid.
• Tubectomy- It is done on the female partner wherein the fallopian tubes are cut and tied to prevent the egg from reaching the tubes for fertilization.

In these techniques, the chances of fertilization are eliminated completely ensuring high effectiveness. However, surgical methods cannot be reversed easily and are extremely expensive.

Birth Control: FAQs

Q1. What do you mean by birth control?

Ans. Birth control is the use of devices and methods to avoid unwanted pregnancy.

Q2. What are the traditional methods of preventing pregnancy?

Ans. Lactational amenorrhea, Coitus interruptus and Periodic abstinence are the traditional methods. They are based on estimation and guess work and are not fully reliable.

Q3. How do IUDs act as contraceptives?

Ans. Non medicated IUDs cause phagocytosis of sperms, Copper releasing IUDs release copper ions to decrease sperm fertility and motility. Hormonal IUDs make the uterus unfit for implantation.

Q4. What are the surgical methods of contraception?

Ans. Vasectomy and tubectomy are the surgical methods of sterilization. The vas deferens are cut and tied in vasectomy and the fallopian tubes are removed in tubectomy. They have high effectiveness but low reversibility.

Q5. What is Saheli?

Ans. Saheli is a non-steroid based pill developed by CDRI Lucknow. It needs to be taken once in every week by the female. This pill has minimum side effects and is very effective in preventing pregnancy.