Birth Control & Contraception

Contraception, also known as birth control practice, is prevention of pregnancy by interfering with the whole process of conception and implantation.

Numerous methods of contraception are in practice and include barrier or hormonal methods, withdrawal, natural family planning, abstinence, and sterilisation (surgery).

Natural family planning (NFP) or fertility awareness does not require medication or physical devices,

Some of these methods are confined to women and others to men. Some methods are reversible, and some are permanent.

Methods of Contraception

Abstinence

Abstinence means not having sexual intercourse. It is the only birth control method that is 100% effective in preventing pregnancy and sexually transmitted diseases.

 Natural Planning Method to Prevent Pregnancy.

 This method relies on the woman's body physiology to know the time of ovulation.

This method involves monitoring body changes such as basal body temperature or cervical mucus variations. The woman then abstains from unprotected sex for approximately 7 to 10 days when she may have ovulated.

Barrier Methods

Barrier Methods are a common method that forms a physical barrier to obstruct the sperm from entering a woman's uterus. Barrier methods include the use of

• male condom
• female condom
• spermicides
• diaphragm
• a cervical cap, and
• contraceptive sponge.

The male condom is a thin covering made of latex or polyurethane rolled over an erect penis before sexual intercourse to prevent the sperm from entering a woman's vagina.

The female condom is a polyurethane (plastic) tube with a flexible ring at each end and is inserted into the vagina before sexual intercourse.

Spermicides are chemicals that deactivate or kill sperm and are available as foams, suppositories, and jellies.

The diaphragm is a flexible dome that covers the cervix inside the vagina.

Cervical caps are smaller cups made of latex, rubber or plastic. They should be used in conjunction with a spermicidal gel and placed in the vagina before sexual intercourse.

The sponge is a soft, round barrier device made of polyurethane foam.

Hormonal Methods

In this method, synthetic hormonal preparations containing oestrogen and progesterone can be administered

• orally (pills),
• implanted into body tissue (implants),
• injected under the skin (injections),
• absorbed from a patch on the skin (skin patches), or
• placed in the vagina (vaginal rings).

These methods work by preventing ovaries from releasing eggs for fertilisation.

They also thicken the mucus around the cervix, making it difficult for sperm to penetrate. They also thin the womb lining, decreasing its ability to accept a fertilised egg.

Intrauterine Device (IUD)

The intrauterine device (IUD) is a small copper device inserted into the uterus. It works by thickening the mucus around the cervix and thinning the womb's lining, making it difficult to accept a fertilised egg.

Withdrawal Method

The withdrawal method completely removes the penis from the woman's vagina before ejaculation.

Sterilisation

Sterilisation is a permanent solution for men and women who do not intend to have children in the future.

• Male sterilisation involves vasectomy, a surgical blocking of the vas deferens, the tubes through which sperm pass into the semen.
• Female sterilisation involves tubal ligation, a surgical procedure that blocks the fallopian tubes which carry the eggs from the ovaries to the uterus.

Your Choice

The choice of a particular method of contraception also depends on an individual's age, health, frequency of sexual activity, number of sexual partners, future pregnancy, plans to have children and certain medical conditions.

Therefore, always discuss with your doctor the choice of birth control method.

It is necessary to know that most birth control methods prevent pregnancy. However, no method of birth control offers full protection against sexually transmitted diseases.

Sterilisation Surgery

Laparoscopic Sterilisation is a permanent method of contraception for women planning not to be pregnant in the future.

The laparoscopic technique is a minimally-invasive procedure. In recent years, laparoscopic sterilisation has gained popularity owing to its advantages over the traditional approach.

Fallopian tubes on either side of the uterus pick up eggs released from the ovaries and transfer them to the uterus. So, if these tubes are closed, sperms fail to reach the eggs, and thus, fertilisation will not occur.

Laparoscopic sterilisation is a technique of tubal ligation to block or close the fallopian tubes, the pathway for sperm to reach eggs for fertilisation. Removing the distal portion of the fallopian tubes reduces subsequent ovarian cancer formation by 40%, which is often recommended in a sterilisation procedure.

About The Sterilisation Procedure

During the surgical procedure, general anaesthesia will be administered to keep your muscles relaxed, and no pain is felt. A device that helps move the uterus is slowly inserted into the vagina.  Then, a small incision is made near the belly button through which a laparoscope is passed. The abdomen is inflated, so the surgeon gets an improved view of the internal organs.

A second incision is made at the pubic hairline, through which a special device is inserted to grasp the fallopian tubes. Often a third incision is made to the left side of the abdomen.

Traditionally the fallopian tubes were sealed off with an electric current that coagulates the tube (electrocoagulation) or by placing a band or clip over the tubes. In some circumstances, the tubes may also be cut.

Recent data suggest that by excising the Fallopian tube, the risk of ovarian cancer can be reduced by 40%. Therefore bilateral salpingectomy [removing both tubes] is now favoured and called opportunistic risk-reducing salpingectomy.

Once the procedure is completed, both the laparoscope and grasping device are withdrawn, and a small surgical dressing is placed over the incisions on the skin.

Recovery After Sterilisation Surgery

You may return home after the observation period once you have recovered. A follow-up visit will be scheduled within seven to ten days. A small amount of vaginal bleeding, which may continue for a few days after the surgery, is considered normal.

Laparoscopic sterilisation is considered to cause permanent loss of fertility. Hence, a well-informed, careful decision should be taken considering the other alternatives before you decide to undergo laparoscopic sterilisation. It offers a safe and convenient form of contraception that requires no additional measures to prevent pregnancy. It also does not affect the menstrual cycle.

The laparoscopic procedure is more advantageous than the traditional procedure. The smaller incisions require a shorter recovery period, and the risk of complications is minimal.