Pills and preventions
BENGALURU: Terminating a pregnancy is not easy. It’s taxing on one’s body, physically and mentally. So, before you make such a decision, here’s everything you need to know about emergency contraception.
What are methods of termination of pregnancy?
It can be performed with tablets or with a minor procedure or surgery. It must be performed by a doctor trained to perform terminations. Pre and post procedure counselling are very important to ensure that the complications and sequelae associated with the procedure are minimal.
A checklist before the procedure would include: an ultrasound scan to determine the location and the age of the pregnancy. Blood tests to check that the woman is not anaemic and to note the blood group and to check for sexually transmitted infections. Counselling may be required for women to prevent psychological sequelae. Women with Rhesus negative blood group would require an injection called Anti D post the procedure to prevent Rhesus iso immunization in future pregnancies. Antibiotics may need to be administered as also pain killers. Post procedure an ultrasound scan would be required if tablets were used, to confirm that complete abortion has taken place.
What are the different types of contraception available?
Contraception can be divided mainly into two categories.
Methods with no user failure —methods that don’t depend on you remembering to take or use them eg. Intrauterine Device (IUD, commonly known as Cu T or the loop) /Intrauterine System (IUS), Contraceptive Injections, Implants, Sterilization and Methods with user failure - methods that depend on how well you use them e.g. pills, condoms, diaphragm, natural family planning methods etc. They are also divided into reversible and irreversible or permanent methods. The latter include female and male sterilisation. The most commonly used contraceptive methods in India are condoms, IUD, contraceptive pills, injectables and female sterilisation. Other less commonly used methods are natural family planning methods, withdrawal, vaginal ring, contraceptive patch, female condom and diaphragm with spermicide.
You cannot get pregnant when you are breast feeding
Pregnancy prevention when breastfeeding is known as the lactational amenorrhea method (LAM). LAM is a good form of birth control for the initial six months after giving birth if all the following conditions are strictly followed - the baby is exclusively breastfed every four hours during the day and every six hours at night, with no pumping or formula supplementation. Under these ideal circumstances it has a failure rate of 2 per 100 women.
However, with typical use, this method is only 75 per cent effective.
Being on the pill reduces your chances of pregnancy in the future This is a popular misconception. The pill does not affect future fertility.
You must take the pill at the same time everyday
This was true for the older progesterone only pills, but not the common modern pills which your doctor will prescribe. However, it is useful to take the pill at a regular time to help you remember to take the pill everyday and reduce the chances of missing the pill.
I need contraceptive advice should I see a doctor?
Yes, it would be preferable to see your doctor since he/she will need to take a thorough history and do a full examination to help decide which contraceptive method is best for you. Your doctor will also discuss with you the failure rates of the various birth control methods and advise you as to what is to be done in the event of “contraceptive failure”.
(The writer is a director, senior obstetrician and Gynaecologist at Fortis La Femme Hospital)
Contraceptives a 100 per cent effective?
No. Each one of them has a failure rate including the sterilisation operation. However, depending on how well they are used, most of them are very effective. You can discuss failure rates with your doctor.