Contraception is a term for various methods to prevent conception and thus regulate fertility.

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The contraceptive method may be:

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• Temporary for spacing: Delaying the first pregnancy or spacing between child births
   

• Permanent(sterilization) for limiting the family after achieving the desired family size
   

• Ensures health promotion of the mother
   

• Enables her to care and breast feed her child
   

• Prevents low birth weight of the next infant
   

• Spacing of children
   

Choosing the right contraception for you:
 

There are many contraceptive methods available in India, from implants and injections, intrauterine devices (IUDs, both copper and hormonal), emergency contraception, birth control pills and vaginal rings, male and female condoms and diaphragms, female and male sterilisation.

When you are choosing the method of contraception, it is important to have accurate information about how well each method works, the possible side effects, how easy it is to use and how much it costs.

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Condom

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It is put on the erect penis just before intercourse. It collects semen and prevents it from entering the vagina. A new condom is to be used for each intercourse.

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Advantages of Condom:

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• It is easily available, easy to carry and cheap
   

• It protects against Sexually transmitted diseases (STDs), HIV infections
   

• No prescription is needed
   

• Help prevent cancer cervix in female partner
   

Disadvantages of Condom:
 

• Interrupts intercourse as condom has to be put on erect penis
   

• Penile sensitivity sometimes decreases
   

• It can tear off or slip off and can fail if not removed properly
   

• Condom may deteriorate in too much heat or light or if stored for more than 3 years
   

Female Condom
 

The female condom is made up of a soft plastic called polyurethane. It lines the vagina up to the cervix and if used correctly, it can be 99% efficient. It protects against STDs but, it carries the high-risk of breakage. The best part is that unlike male condoms, these can be inserted into the vagina 8 hours before having intercourse.
 

A.  Oral contraceptive Pill
 

Advantages of Oral contraceptive Pill:

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• Can be started only after counseling, screening and selection of clients,
   

• It is effective, safe and non-invasive
   

• The pills act by suppressing ovulation
   

Disadvantages of Oral contraceptive Pill:
 

• Needs to be taken daily
   

• Pre-starting counselling and evaluation needs to be done
   

• Cannot be given when lactating
   

Absolute contraindications are pregnancy, H/o thromboembolism, H/o Cerebro vascular accident, and cardiac disease, malignancy of breast, active liver disease, cholestatic jaundice and migraine
 

Side effects of Oral contraceptive Pill:
 

• Nausea/vomiting

• Breast tenderness

• Headache

• Depression

• Spotting

• Mild elevation of BP

• Weight gain
   

Return of menstruation and fertility: incidence of post pill amenorrhea is low and there is no evidence of decreased fertility
 

Pregnancy outcome: is not affected by pill use

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B. Intrauterine Contraceptive Device (IUCD)

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Copper T is a T shaped plastic device made of poly ethylene an impregnated with Barium Sulphate to make it radio opaque. It has 1-3 % of failure.
 

Advantages of IUCD:
 

• Insertion once in five years

• Readily reversible
   

Contraindications:
 

• Excessive or irregular bleeding

• Active genital tract infections e.g., vaginitis, cervicitis, pelvic inflammatory disease, septic abortion, cervical erosion

• Previous history of ectopic pregnancy
   

Injectable contraceptives
 

A contraceptive injection contains the synthetic form of the hormone, progestogen. One injection can last up to 8-12 weeks depending on what type you're going for. Although, it's a reversible contraception, it can take up to a year for the effects of the injection to wear off. Depo-provera is a natural hormone that is usually produced by the ovaries. It prevents pregnancy by stopping ovulation, thickens cervical mucosa to prevent sperms from moving into the uterus and thins the uterine lining to avoid implantation of a fertilized egg. Some changes in the menstrual period may happen: bleeding or spotting between periods, an increase or decrease in bleeding or no period at all.

Side effects of the contraceptive injection:
 

• Weight gain

• Headache

• Abdominal pain

• giddiness

• Fatigue

• Osteoporosis

• Blood clots
   

Sterilisation
 

Sterilisation A permanent method of contraception whereby the person is rendered infertile. It involves blocking of the duct that carries the egg and sperm. Thus, the ovum and the sperm cannot meet and no fertilization takes place. In males it is called vasectomy and in females it is called tubectomy. Female sterilization can be done by open method or by laparoscopy

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Vasectomy is a very simple, day care procedure. It can be done by incision method or by no scalpel (no cut) method. No cut method has a lower infection risk and heals in a short time. Vasectomy does affect orgasm or ejaculation.
 

Tubectomy is a permanent method where both fallopian tubes are blocked or cut, so that the ovum or egg cannot travel from the ovaries to the uterus for fertilization with the sperm. It can be done by open method or by laparoscopy. In open method, the fallopian tubes are cut and tied, while in laparoscopic method the tubes are blocked by a clip, thereby preventing the ovum from reaching the uterus.

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Both tubectomy and vasectomy can be reversed but the results cannot be guaranteed.