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

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

A birth control pill is commonly referred to as an oral contraceptive pill. A form of hormonal contraception and is a highly effective method of birth control. Only 1% of women experience unintended pregnancy when on the pill.

Birth control pills are of two types i.e combination pills and mini pills. Combination pills contain synthetic forms of the two hormones called oestrogen and progesterone. The mini pill only contains the hormone progesterone and is called progestin.

However, the pill does have some side effects to it. These include the following:

Intermenstrual spotting: Within the first three months of starting the pill, women experience vaginal bleeding between the two period cycles.
Nausea: Although the symptoms subside after some time, some women till experience nausea for a while after taking the pill. If one consumes the pill with food or before going to bed, this can help lower the likelihood of feeling nauseous.
Breast tenderness: The breasts might feel tender and enlarged after taking the pill. However, anyone who finds a lump in the breast or feels continuous pain needs to seek medical help.
Headaches: Migraines and headaches are a very common phenomenon of the birth control pill. Different types and doses of these pills may result in different headache symptoms.
Gaining weight: Experiencing certain fluid retention in the hip or breast area is very common. It also affects the fat cells of the body because of the oestrogen present in the pills.
Mood swings: Those with a history of stress or depression might start to feel the same again. If one has that kind of a history and starts to feel emotional changes, she should consult a doctor immediately.
Missing periods: It is a common side effect that after using the pill, one's period might get skipped. This is influenced by several factors including stress, depression or thyroid dysfunctions.
Decreased libido: The sex drive can be widely affected by the birth control pill. Although many other factors could result in a decreased libido, but if it remains after having the pill and is persistent, one should seek medical help or consult a specialist.
Vaginal discharge: There could be an increase or a decrease in the vaginal lubrication. Some people might experience vaginal discharge since it is very common. Changes in vaginal discharge never turn out to be harmful.
Changes in the vision: Fluid retention due to the birth control pill can result in the swelling of corneas. Because of this, even contact lenses do not fit comfortably. Contact lens wearers should consult an ophthalmologist if their vision or lens tolerance is disturbed.

Although there are certain side effects to taking birth control pills; however, one should not abstain from taking them in the fear that they might cause certain side effects. These pills are a precautionary measure along with other protection methods and should be taken in case someone wants to avoid pregnancy at the time being.

Birth Control Pills - 10 Common Side Effects of Them!

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

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

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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