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Effective contraception: Better safe than sorry

Here is everything that you should know to terminate pregnancy.

Termination of pregnancy 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 squeal 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 to post the procedure to prevent Rhesus iso immunisation in future pregnancies. Antibiotics may need to be administered and also pain killers. Post-procedure an ultrasound scan would be required if tablets were used, to confirm that complete abortion has taken place.

Contraceptive is not a new thing. However, over the years the techniques of terminating a pregnancy have evolved.

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. For example, Intrauterine Device (IUD, commonly known as CuT or the loop) /intrauterine System (IUS), contraceptive injections, implants, sterilisation and

Methods with user failure – methods that depend on how well you use them. For example 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. All the other methods fall into the reversible category.

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, diaphragm with spermicide.

Is contraception 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. failure rates can be discussed with your doctor.

Some common misconceptions

You cannot get pregnant when you are breastfeeding

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 4 hours during the day and every 6 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 every day

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 every day and reduce the chances of missing the pill.

It would be preferable to see the 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”.

With all the contraceptive methods available; be responsible, be safe, use contraception and prevent unintended pregnancies and sexually transmitted diseases.

*Disclaimer: The article has been contributed by Dr Prathima Reddy MBBS, MRCOG (London), FRCOG (London), FACOG (USA) Director, Senior Obstetrician and Gynaecologist - Fortis La Femme Hospital, Richmond Road Bangalore). The opinions expressed in this article are the personal opinions of the author. The facts and views appearing in this article do not reflect the views of Deccan Chronicle and Deccan Chronicle does not assume any responsibility and liability for the same.

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