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

Contraceptives are generally drugs and devices, which are used to prevent pregnancy. A large number of contraceptives are available which allow the couple to enjoy sex without running the risk of unwanted pregnancies. The general categories of contraceptives are explained below:

Barrier Methods:
i. Male Condom: It is one of the most common forms of contraception. They are worn on the penis before sex is initiated. For safety purpose, a new condom should be used every time the person has sex.

ii. Female Condom: Much like male condoms, these are available at over-the-counter pharmacies without prescription. The condoms can be inserted to the vagina anytime within a period of 8 hours prior to sex.

iii. Diaphragm: This should be coated with a spermicide before sex and placed inside a woman's vagina so that the sperms are prevented from entering the uterus.

iv. Cervical Cap: These are used as replacements for diaphragms because some women may develop bladder infections such as cystitis while using it and these caps have lesser contact with the vagina.

Hormonal Methods:
The main implementation of hormonal changes to provide contraception is the pill. This is the most common form of female contraception available. It comes in two forms:
i. Combined contraceptive pill: Contains a combination of hormones such as progestin and oestrogen.
ii. Mini-pill: Contains only progestin: It is available only with the prescription of the doctor and should be used as per the prescription.

Intrauterine Devices
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 facilitating the prevention of fertilization of the egg.

Sterilization
This is a lifelong option that is available for both men and women. In males, the procedure is known as vasectomy which basically ties and cuts off the tubes that carry the sperm.

In women, two forms of sterilization are available; surgical and non-surgical. Surgically, the fallopian tubes are cut and tied using small cuts in the belly so that the ovaries and uterus are not linked. Non-surgically, coils are inserted into the fallopian tubes so the resultant development of scars leads to complete blockage of the tubes.

Other forms of contraceptives include contraceptive patches, vaginal rings, contraceptive injections, spermicides and contraceptive implants.

Different Types of Contraceptives and Its Uses

With an upsurge in the number of women suffering from dysfunctional reproductive system and a myriad of gynecological problems, resulting in irregular periods, infertility and several other complications, it is of paramount importance to keep a record of the dates and duration of your monthly cycles. This is not only useful for future reference when you visit a gynecologist, but it also helps you to understand if there are any delays in your mensuration cycle or you are having excess bleeding in a particular month.

Why tracking your menstrual cycle is important?
Keeping a track of the menstrual cycles is a mandatory exercise for women who are thinking about pregnancy or those trying to avoid it. Based on you period calendar, you can avoid getting pregnant without opting for contraceptive methods, if you have extremely regular period patterns. It is advisable to abstain from intercourse for a few days before and after the period, which is the prime time for ovulation. Keeping a track of your periods will give you a clear indication as to whether you are pregnant, because delay in the menstrual onset can be an indication of pregnancy. The reverse is also true; if you are trying to get pregnant, conception is usually fruitful on these days of maximum ovulation, which you can easily calculate based on your well maintained menstrual record.

How should you go about keeping a track of your menstruation cycle?
While it not possible to note down every possible aspect of the menstruation in a notebook, the easiest way of maintaining a planner is to mark the first day of each period on the calendar. The difference between two consecutive periods will give you your cycle lengths. In addition you can choose to make a note of how heavy the bleeding is or if there are changes in mood and appetite on those days. You will then be well prepared for your next visit to the gynecologist.

How Tracking Your Menstrual Cycles Can Be Beneficial For Your Reproductive Health?

If your teenager finds out that she is pregnant, and will be having a baby soon, it is a very difficult situation to cope with. Teenage pregnancy is associated with intense stress and trauma in both the girl and her parents, and family. It is important for you to realise that teenage pregnancy can be okay, based on good and wise decisions. You should seek all options at hand, and discuss them with people you trust. There are several coping methods for dealing with the stress, trauma, and difficulty of teenage pregnancy. They are as follows:

Keep in mind that it is okay to be overwhelmed

A flood of emotions is likely to flow through your body on finding out that your teenage daughter is pregnant.
Your mind has to be set for facing several challenges which lie ahead. You have to go ahead.
It is okay to feel upset, but avoid showing it in front of your daughter.
Be supportive

You might be upset and angry, but you need to realise that your daughter is scared and alone.
She needs you by her side during this phase more than ever. Your child s health has to remain relaxed both physically and mentally during pregnancy.
Do not make your daughter feel shameful as it will worsen the trauma. You need to make her understand that you are with her to figure out some kind of solution.
Ask your daughter what she wants

It is important for you to ask your pregnant teenage daughter about what she wants, and you should respect her wishes.
Your daughter has to be comfortable with the choices you make regarding the pregnancy.
Give her advice and help her in exploring options

Instead of forcing your opinions and views on your daughter, you need to lead her to beneficial resources and support centres.
It is important for your daughter to make the best decision, without a lot of influence over what has been decided.
Explore the available options with her and point out the various pros and cons.
Teach your daughter the skills required to become independent

While you have to help your teenage daughter emotionally, financially and in many other ways, you should also teach her the ways of becoming an independent self sufficient adult.
If she decides on having the baby, it is very important for her to learn to take care of the baby and deal with all the issues that are likely to be faced.
It is also recommended for you to take your pregnant teenage daughter for therapy and proper counselling. These are also important for her to cope with the trauma and make the best decisions.

Teenage Pregnancy - How To Deal With Stress And Trauma?

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

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