Monday, March 4, 2024

HEALTH: CONTRACEPTION IS NOT JUST A WOMAN’S BUSINESS

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India’s population stands over 1.43 billion and it is expected to grow further. There are various reasons for the rise in population from lack of knowledge on contraceptive methods to people ignoring family planning means. This week’s Health Talk by The Pioneer’s Shikha Duggal was conceived to put together nuggets of knowledge about contraceptives and attitudes towards them.

Indians are criticised for their explosive population growth, right? And contraceptive usage is also so low! Eligible couples are still resistant to family planning methods. So obviously, stabilising the population still looks distant. This week’s health talk was conceived to assess knowledge about contraceptives and attitudes towards them.

As Dr. R. Suchitra, a gynaecologist at Citizens Speciality Hospital, Hyderabad, shared, “While awareness of contraceptives may be widespread, there are still significant gaps in the adoption and consistent use of contraceptive methods. Knowledge about contraceptives empowers individuals, particularly women, to make informed decisions about their health.

Understanding contraceptive options enables people to choose methods that align with their health needs and preferences. For example, some contraceptives can help manage medical conditions like polycystic ovary syndrome or reduce the risk of certain cancers. Proper family planning, which includes knowledge of contraceptives, can reduce maternal and infant mortality rates. Additionally, certain methods, like long-acting reversible contraceptives (LARCs), are highly effective and suitable for those who want to delay or space pregnancies. Unintended pregnancies can have significant social, economic, and emotional implications for individuals and families.”

The responsibility for contraception should be shared equally between partners. The medical expert added, “Many contraceptive methods, such as condoms and vasectomy for men, directly involve the male partner. Respecting each partner’s autonomy and preferences is a fundamental aspect of a healthy relationship. Both men and women should have the freedom to express their desires and concerns regarding family planning. Traditional gender roles have often placed the burden of contraception solely on women. Challenging these stereotypes in contraception can contribute to more equitable relationships.”

Access to contraception has a significant impact on global demographics. Adequate spacing between pregnancies made possible through family planning, can reduce the risk of maternal mortality and complications during childbirth. It allows women’s bodies to fully recover between pregnancies. The field of family planning continues to innovate. Researchers are exploring new contraceptive methods, such as male hormonal contraceptives, and methods that are less invasive and more user-friendly. While contraception methods offer various benefits, they also have disadvantages that couples should consider when choosing the most suitable method for their needs. “These may include nausea, headaches, mood changes, breast tenderness, and changes in menstrual patterns. Some individuals may experience weight gain as a side effect.”

Case study: A nineteen-year-old unmarried woman found herself in a dire situation due to her lack of awareness about contraception methods. As a result, she underwent a medical termination of pregnancy that tragically led to a severe infection known as sepsis. When she sought medical help at Citizens Speciality Hospital, she was presented with multiorgan failure, necessitating urgent medical intervention. Regrettably, to save her life, it became imperative to perform a hysterectomy — the surgical removal of her uterus.

According to data from the National Family Health Survey-5, Dr. Tripura Sundari, a gynaecologist from KIMS Hospital Health Department, gave us insights like the significant rise in the overall contraceptive prevalence rate, which has increased from 54 percent to 67 percent since the NFHS-4. Today, many people in the country are aware of at least one form of contraception, with over 99 percent of those who are currently married and between the ages of 15 and 49 knowing about at least one. Additionally, more than half of those who are currently married know how to use emergency contraception. As per the latest National Family Health Survey, female sterilisation continues to be the single most dominant method of contraception (67%) versus contraceptive use by men (condoms, sterilisation), which accounts for a mere 17%. These skewed preferences show the disproportionate responsibility women have to bear for birth control. Effective counselling, however, can play a critical role in assisting couples in making the best decision. It’s important to note that some short-term spotting may still happen even with implants or medicated intrauterine contraceptive devices (IUCDs), often for a month or two, and that this can be treated with short-term medications. After the medicine’s effects start, women may experience amenorrhoea and the absence of regular menstrual periods. While this might seem like a positive outcome, many women become anxious about the possibility of pregnancy due to the absence of their periods.

We have another case study literated to us by Dr. Simran Shamanur from Allo Health: “Artka Singh, a sex educator associated with us, once conducted a case study with the 450 women residing in a semi-rural colony. They used to complain about constant back pain and low bone intensity. And the women’s age range was around 20–45. Gradually, she got to know that these women got married in their early 20s, around 13 to 15, and after their first child, they opted to get a hysterectomy done, but they were not told about the side effects like calcium deficiency, severe hormonal issues, mood swings, increased risk for osteoporosis, changes in blood vessels that increase the risk for cardiovascular disease, and many others. India was actually the first country in the world to launch a family planning programme in 1952, just a few years after its independence. We have come a long way from following just a quantitative clinical approach to a much more well-rounded approach that goes beyond childbirth and introduces the concept of child and mother reproductive health and welfare.”

POPULAR CONTRACEPTION METHODS

Fertility awareness methods: These methods involve tracking menstrual cycles and avoiding intercourse on fertile days. They can include methods like the calendar method, the cervical mucus method, and the temperature method.

Birth control pills: Oral contraceptive pills are taken daily and contain hormones to prevent pregnancy. They are highly effective when taken consistently and correctly.
Condoms: Male and female condoms are barrier methods that provide protection against both unintended pregnancies and sexually transmitted infections (STIs). They are widely available and easy to use.

Diaphragm: A diaphragm is a silicone or latex dome-shaped device that covers the cervix and is used with spermicide. It must be inserted before intercourse and left in place for several hours afterward.

Vaginal ring: The vaginal ring is a hormonal contraceptive that is inserted into the vagina and left in place for three weeks. It releases oestrogen and progesterone to prevent pregnancy.

Intrauterine device (IUD): IUDs are small, T-shaped devices inserted into the uterus by a healthcare provider. They offer long-term contraception, with some types providing protection for up to 3–10 years, depending on the type.

Permanent methods: Vasectomy for men and tubal ligation for women are permanent surgical procedures that block or seal the fallopian tubes in women and the vas deferens in men, respectively. These methods are considered irreversible. It’s essential for individuals and couples to consult with the gynaecologist to determine which contraception method best suits their needs, taking into account factors such as health, lifestyle, and future family planning goals.

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