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

Birth control is a method by which unwanted pregnancy is prevented. Partners can plan their childbearing in a better way using the increased levels of awareness about birth control.
 
Methods of birth control
1. Intrauterine devices (IDUs): These are most effective methods of birth control. The intrauterine device (IUD) is a long-acting and reversible form of contraception for women. It is of two types: Copper IUD (contains copper) and Hormone-releasing IUDs (progestin hormone is released into the womb slowly). It is a small device that is fitted inside the womb and it provides contraception by preventing fertilization of the egg.

2. Sterilization: This is a process of birth control that renders a woman incapable of conception or a man incapable of sperm delivery. The process is conducted with the consent of the individual and can be done using either surgical or non-surgical methods. In both the cases, tubes carrying sperms (in males) and fallopian tubes (females) are either cut or blocked.

3. Condoms: These are the most commonly used measures for birth control. Male and female condoms act as barriers and prevent the sperm from reaching the uterus.

4. Oral contraceptive pills: These pills are the most popular measures of birth control used by women across the world. This is the most convenient way of postponing pregnancy. However, it is very important that the side effects of the contraceptive pills be noted. The side effects cause changes in the body, such as irregular bleeding, increase in the breast's size increased levels of blood pressure as well as eventual infertility.

5. Contraceptive Injections: In this method, one hormone injection is administered, the effects of which last inside the body for a time period of 8 to 12 weeks i.e. 2-3 months. The contraceptive injection has the similar effects as that of contraceptive pills on birth control. Evidently, the shot is irreversible, which makes the woman infertile for a period of three months. However, similar to the pill, protection from STDs is not offered by contraceptive injections. But these injections can guarantee 99% safety and surety on being used.

6. Natural Family Planning: Even though it is not any external pill or device, Natural Family Planning is also a method of birth control. It relies on the knowledge of timings of the menstrual cycle (periods) so that the couple can avoid sex during the time period when the woman is fertile.

6 Sure Shot Ways of Birth Control

Using contraceptive methods is the easiest method for a couple to avoid pregnancy and enjoy a tension free physical relationship. People have used birth control methods for thousands of years. Today, we have many safe and effective birth control methods available to us.

All of us who need birth control want to find the method that is best for us. If you're trying to choose, learning about each method may help you make your decision. Only you can decide what is best for you. Some contraceptives, such as condoms, will also protect a person from sexually transmitted diseases (STDs).

The methods can be categorised into temporary and permanent methods.

Temporary methods:
1. Withdrawal method: This involves removing the penis from the vagina before ejaculating. Ejaculation should be away from the introitus. However it requires extreme self-control on the part of your man.

2. Barrier methods: These methods prevent sperm from entering the uterus. Barrier methods are removable. Types of barrier methods include:

a. Condom: This is the oldest barrier method. A condom is a thin tube that the man puts over his penis. This keeps the sperm from getting to the egg. Condoms are also called rubbers.
b. Female condom: This is like a condom, but it goes in the woman's vagina.
c. Diaphragm and cervical cap: These are put in the woman's vagina to cover the cervix
d. Contraceptive sponge: This is a sponge that is filled with spermicide and is put in the woman's vagina over the cervix.
Barrier methods can be easy to use and have few side effects.

3. Hormonal methods: These can only be used by women. Hormonal methods cause changes in the woman's reproductive cycle and include Birth Control Pills, Birth Control Patches, Emergency contraception pill, Implants and so on. Unlike barrier methods, hormonal methods do not interfere with sex.

4. Intrauterine methods: In this method an object called an intrauterine device or IUD is put in the woman's uterus. There are two types of IUD: the copper IUD or an IUD with hormones implanted on it. The hormonal IUD has better protection against pregnancy but costs more. You need not do anything once it is inserted. Also it is effective for up to 10 years.

Permanent methods

Of course, the permanent methods are more effective for preventing pregnancy than the temporary methods. The decision to proceed with a permanent method should only be made if a person is absolutely sure that no more children are desired. The biggest problems after a permanent procedure is regret that it was done.

1. Sterilization: Sterilization is a permanent form of birth control that prevents a woman from getting pregnant. These procedures usually are not reversible.

a. A sterilization implant is a non surgical method for permanently blocking the fallopian tubes. The doctor places a coil in each Fallopian tube through the vagina and uterus block each tube completely. It may take up to 3 months to completely block the tubesb. 

b.Tubal ligation is a surgical procedure in which a doctor cuts the fallopian tubes. This procedure blocks the path between the ovaries and the uterus. The sperm cannot reach the egg to fertilize it and the egg cannot reach the uterus.

c. Vasectomy is a surgical procedure that consists in cutting the tubes that carry sperm. This procedure blocks the path between the testes and the urethra due to which the sperm cannot leave the testes and hence cannot reach the egg. It can take as long as 3 months for the procedure to be fully effective.

Temporary & Permanent Contraceptive Methods For Male & Females

Contraceptive methods of birth control are usually quite successful. By these methods, you can enjoy your life without the worry of pregnancy. Modern technology has led to the formulation of avid techniques of contraception; some are temporary and the others permanent. However, no matter how well these methods work, almost all of them have got a variety of side effects on your body and health.

Here is a list of different modes of contraception and the side effects they may cause:

 Hormonal implants
This long term method of birth control is an effective one. The side effects are:
- a surgery is required where rods are inserted under your skin. This might be risky surgery
- if you want to remove it, again another surgery has to be carried out
- an infection may develop in the area where the thin rods are inserted

Intra uterine device
A device is fitted into the uterus, which does not cause pregnancy. An effective method with the following side effects:
- there is a risk of the device falling off
- this causes puncture in the uterus
- the device made of copper may lead to menstrual cramps and spotting

Depo provera hormonal injection
This mode of contraception involves taking an injection, which restricts pregnancy for a period of three months. The side effects are:
- gaining of extra weight, fatigue
- decrease of bone density
- menstrual bleeding along with spotting takes place

Birth control pills
Birth control pills are one of the most common and most effective ways of birth control or contraception. However, several side effects may be observed.
- causes nausea, headaches and also blood clots in rare cases
- in case you use other prescribed medicines along with birth control pills, severe damage may be inflicted

Vaginal ring
This mode of contraception is very effective. It also helps in making menstrual periods of women much lighter and in continuity. The side effects are:
- may cause nausea and headache
- there is a vast increase in appetite
- there is a risk of blood clot formation.

Diaphragm
A very successful mode of contraception where a diaphragm is inserted and fitted into the vagina. The negatives of this mode are:
- it may get out of place during sex and is likely to cause damage
- the process can be a mess
- causes urinary infections

All modes of contraception irrespective of their effectiveness have got some side effects on your health. Hence, you must choose them wisely.

Comparison of Side Effects of Different Contraceptive Methods

Female condoms are generally pouches made of latex and polyurethane, which are used by women during sex in order to prevent pregnancy and thereby reduce the chances of infection by sexually transmitted diseases. Each end of these pouches are made of rings that are flexible. They should be inserted deep inside the vagina before sex is initiated and held in the position by utilizing the rings available at the closed end while the rings which are at the open end remain outside the vagina during sex.

Even though it can be safely used by most people, some women would find female condoms to be an inappropriate form of contraception and would not feel comfortable with their genital areas being touched. Thus, it is very important that the appropriate form of contraception be considered for you and your partner. Condoms should be used correctly. In case of need for extra protection, other options of contraception should be considered.

Pros of female condoms
1. Since the exchange of bodily fluids, such as semen and vaginal fluid is prevented, female condoms aid in offering protection against many sexually transmitted diseases such as HIV.

2. Condoms can prove to be reliable pregnancy averting methods if they are properly and consistently used.

3. Female condoms are only needed during the time of sex. Any form of advance preparation is not required, hence making them suitable for unplanned sex.

4. Prescriptions are not needed

5. The condoms are usually small in size, disposable as well as easy to carry

6. Usually, using condoms does not show any medical side effects.

7. Insertion of female condoms can be done up to a duration of eight hours before sex. The responsibility for utilizing condoms properly should be shared by the woman as well as the partner.

Cons of female condoms
1. Even though condoms are generally very strong, they are prone to splitting or tearing in case of improper use.

2. Availability of female condoms pales in comparison to the male counterparts and they are usually more expensive.

3. The outer ring might produce a cumbersome feeling.

Pros and Cons of Female Condoms

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!

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