Though pregnancy is one of the most cherished phases in a woman s life, there are times when it is not desired. This can be due to various reasons ranging from premarital sex to the couple not being ready yet. Whatever the reason, emergency contraceptive measures are available, and I-Pill has become synonymous with that.

Since its introduction, it is widely used to prevent unwanted pregnancies. The easy availability (no prescription required) and low cost have added to its popularity. However, not many realize it has some side-effects and the need to be aware of certain facts when using the I-pill.

It is an emergency contraceptive pill, should be used between 24 to 72 hours after unprotected sex
It is effective in 95% of the women when taking during this time frame
It prevents pregnancy by stopping fertilisation or preventing implantation of the fertilising egg
It stops pregnancy; however, if you conceive before the pill it was taken, it will not have any effect. It is therefore not an abortion pill
So, if you miss the period the next month, test for pregnancy
It does not offer protection against sexually transmitted disease including HIV/AIDS
It is not to be used on a regular basis
If you are on long-term medication, please consult with the doctor before taking the I-pill
It has no long-term consequence. However, there could be some minor symptoms including breast tenderness, nausea, vomiting, headache, and lower abdominal pain (pelvic area),
The next menstrual cycle could be delayed by a couple of days
There could also be spotting before the actual period starts
Women who are allergic to levonorgestrel should not take I-pill.
It can cause skin allergies and reduce libido.
When used repeatedly, it can cause delayed and irregular menstruation
It is ideal for use between the age of 25 and 45. Teenagers should not use it regularly. This needs to be made aware through sex education, as the prevalence of teenage sex and pregnancy is on the rise in India
Repeated usage can cause ovarian damage and severe menstrual issues, so occasional use is the only recommended usage
It is safe to take the pill during lactation. There is no effect on the quality of milk or any other adverse effect on the baby
I-Pill was introduced as an emergency contraceptive method, and not for regular contraceptive purpose. Its correct usage and avoiding complications is largely dependent on sex education which needs to start early and talk about other safe sex measures and avoid using it on a regular basis.


Side-effects of i-Pill Tablets - Every Woman Must Know!! 

Unless you re planning to have a baby, it is best to employ some form of birth control to have a satisfying and pleasurable sexual relationship. Having an intercourse right after the menstrual cycle is least likely to result in pregnancy, but there is quite a possibility that an accident may happen. The withdrawal method is highly undependable and should be avoided as far as possible. Birth control is available in a number of forms. Condoms, birth control pills, IUDs and birth control shots are the most common methods of birth control. Here are five things you should know about birth control.

Birth control prices vary: Birth control is available in a number of price ranges to suit varying budgets. Condoms are the most budget friendly while IUDs are amongst the most expensive. However, IUDS are effective over a long spell of time while condoms must be used only once. In some cases, your insurance may help pay for birth control. Hence do your research properly before deciding on the type of birth control you would like to use.
Not all birth control protects against STDs: The only type of birth control that can protect against both pregnancy and STDs are condoms. All the other forms of birth control do not protect against the transference of STDs. Spermicides and diaphragms can lower the risk of catching an STD, but do not give full proof protection..
Not just one person needs to be completely responsible for birth control: If you are in a committed relationship, both people have to take full responsibility of birth control. Birth control devices are available for both men and women and hence this is a responsibility that needs to be shared equally. However, if you are not in a committed relationship and have more than one sexual partner, it is best to take responsibility of birth control in your own hands.
There are side effects to most forms of birth control: Any form of birth control that involves hormones will have side effects. Some of the common side effects triggered by birth control are nausea, weight gain or weight loss, mood swings, sore or swollen breasts and lighter or heavier blood flow during menstruation.
No form of birth control is 100% effective: Lastly, you should know that apart from abstaining from sex, no form of birth control is 100% effective. At the same time, you should also know that missing a period is not always a sign of being pregnant as there are various reasons that affect your menstrual cycle. Therefore, it is best to undergo a pregnancy test in case you missed your periods.

Birth Control - 5 Things You Need To Know!

Emergency is helpful in preventing pregnancies post unprotected sexual activity. It can be used in case of contraceptive failure, in case of sexual assault, incorrect use of contraceptives and unprotected sex.

Emergency contraception can be done by three methods. These are emergency contraceptive pills, combined oral contraceptive pills and copper intrauterine devices.



The copper IUD is considered to be one of the most effective forms of emergency contraception, when it is inserted within 5 days of unprotected sexual activity.

However, the emergency contraceptive pill regimen as per WHO is:

1 dose of levonorgestrel 1.5 mg, or 1 dose of ulipristal 30 mg, taken within 5 days (120 hours) of unprotected intercourse

The Yuzpe regimen which consists of 2 doses of combined oral contraceptive pills

What is Emergency Contraception?

Emergency contraception is usually referred to as the contraception which is used to prevent a pregnancy within the first 5 days after an unprotected sexual activity. It is used post failures of contraception, coerced unprotected sex, rape or misuse of contraception.

Emergency contraception is only effective in the first few days after an intercourse and before the egg has released from the ovary, and before there is fertilization between the egg and the sperm. The emergency contraception can do no harm to an interrupted pregnancy and a developing embryo.

Who needs emergency contraception?

Any girl or woman who is at her reproductive age might need an emergency contraception in case of an unprotected sexual intercourse.

Uses
1 Breakage , slippage or displacement of barrier methods 
2. Three or more missed OCPills for more than 12 hours 
3. Missed Mini pill for more than 3 hours 
4. Missed Desoestrel pills for more than 12 hours 
5. DMPA injections taken more than 2 weeks late 
6. Miscalculated dates of last period and present ovulation side effects 
These are meant only for emergency contraception and NOT AS A REGULAR CONTRACEPTIVE. It involves pumping of a hormone inside your body at levels which are 5 times higher than normal. hence excessive and unnecessary use may cause irregularity in the period cycles and an adverse effect on the menstrual health over a period of time. Ideally it should be taken under guided medical supervision.


In what situations should emergency contraception be used?

Emergency contraception can be used after a sexual intercourse. These include:

In case of no use of contraceptives

If it is a case of rape or coerced sex, where the woman was not protected

When there is a contraceptive failure, like

breakage

incorrect use or slippage

OCPILLS,

mini pills

DMPA

3 or more missed combined oral contraceptives, progestogen-only pill (minipill) taken more than 3 hours late, desogestrel-containing pill 12 hours or more, norethisterone enanthate (NET-EN) progestogen-only injection taken more than 2 weeks late

Delay in placing or dislodgement or early removal of the skin patch or the hormonal ring

Breaking, dislodgement, tearing or early removal of cervical cap or diaphragm

Failure of withdrawal that is ejaculation the external genitalia or vagina

The spermicide tablet failure

Miscalculating the periods, failure from using a barrier on the fertile days

Expulsion of an intrauterine contraceptive device (IUD)

Methods of Emergency Contraception:

There are three emergency contraception methods:

Copper-bearing intrauterine devices (IUDs)

Emergency contraception pills (ECPs)

Combined oral contraceptive pills or the Yuzpe method



Safety of Emergency Contraception

4 Types of Contraception for Birth Control

There are a number of contraceptives available but which method of birth control suits you depends on your sexual life, preferences and your lifestyle as a whole. Professional medical help should be sought in order to understand what method of contraception sis ideal for you.

Here is a list of 4 types of contraceptives for birth control.

1. Barrier methods

Barrier methods are designed to prevent the sperm from entering the uterus. They constitute-

- Diaphragms: It is a shallow and flexible cup that is made of either latex or soft rubber. It is inserted into the vagina before the sexual intercourse where it prevents the sperm from entering the uterus.
- Cervical caps: It is a thin cup of silicone whose function is same as the diaphragm, only it is smaller in size, so less noticeable and more rigid as well.
- Contraceptive sponges: These are soft foam sponges that are filled with spermicide and are disposable. They are also inserted into the vagina before sexual intercourse in order to prevent pregnancy by killing the sperm cells or preventing them from entering the vagina.
- Spermicides: These are chemicals that can kill the sperm and hence assist in birth control.

Other methods include male condoms and female condoms.

2. Hormonal methods

Hormonal methods use hormones in order to either stop or regulate ovulation so as to prevent pregnancy. There are various methods through which hormones can be injected into the body. Some of them are-

- Contraceptive patch: It is a thin patch made of plastic that sticks to the skin and is responsible for releasing hormones into the bloodstream through the skin.
- Vaginal rings: A thin, flexible ring that is inserted into the vagina where it stays for 3 weeks and is removed after that, only to be re-inserted in the 5th week.
- Implantable rods: They are inserted under the skin of the upper arm of women where they release progestin.

Other methods include contraceptive pills and progestin-only pills.

3. Intrauterine methods of contraception

The intrauterine device is a small device, T-shaped that is inserted into the uterus in order to prevent pregnancy. The good thing about intrauterine devices is that they can remain functioning for many years at a stretch. IUDs are two types-

- Hormonal IUD(Intrauterine Device)
- Copper IUD

4. Sterilization

Sterilization is the most reliable contraceptive for birth control as it is permanent. It either prevents the release of sperm or the fertilization of the egg. Sterilization methods can either be surgical or non-surgical. Some of the sterilization techniques are-

- Tubal ligation: It is the surgical technique used in females.
- Vasectomy: It is the surgical technique of male contraception.

Other methods include sterilization implants.



4 Types of Contraception for Birth Control

The contraceptive pill, or simply 'the pill', is a type of hormonal contraception taken by women to prevent pregnancy. Now, even though the birth control pill is extremely effective in preventing unplanned pregnancy, it is not without some side effects. The common side effects of birth control pill include:

1. Intermenstrual spotting: Some women experience intermenstrual spotting or bleeding in the time between their menstrual cycles. This is very common in the first three months of you taking the pill. Most of the times, intermenstrual bleeding resolves itself.

2. Nausea: Some women might experience mild nausea when they take the pill for the first time. The nausea will resolve on its own after some time, but if it gets critical or persists, seek medical help. Taking your pill at bedtime or with food can aid in countering the nausea.

3. Breast tenderness: Breasts can become tender or enlarge as a result of birth control pills. Reducing salt and caffeine intake, and wearing a support bra can be beneficial.

4. Headaches: The development of migraines and headaches are the effects of the sex hormones. Different pills with varied doses and types of hormones may lead to different symptoms of headaches. Studies suggest that pills with low hormone doses are usually linked with headaches.

5. Weight gain: There is no logical link between weight fluctuations and contraceptive pills, but fluid retention (specifically in the hip and breast areas) and enlarged fat cells are common side-effects.

6. Mood changes: Women who may have suffered from depression should consult their doctors when taking the pill. A study discovered that taking pills usually leads to the thickening of the cortexes (outermost layers of the brain involved with analysing incoming stimuli and reward response). However, there is more research pending on this issue.

7. Missed periods: Skipping or missing a period is very common when you are on the pill. Factors such as stress, travel, illness and thyroid or hormonal abnormalities can influence this.

8. Decreased libido: The pills contain hormones that can lower your sex drive or libido.

9. Vaginal discharge: Some women experience differences in their vaginal discharge when they are on the pill. Vaginal lubrication can dip, which causes discomfort during sex.

10. Visual changes: Fluid retention is a side-effect of the pill, which even ends up affecting the cornea; they change shape or swell up.

Birth Control Pills - 10 Common Side Effects!

There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

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