CONTRACEPTION

INTRODUCTION: On average, more than 50% of all pregnancies in many communities are unplanned. Despite the fact that every year new contraceptive options are introduced with various improvements, there are still many myths and misconceptions when it comes to child spacing. Although no family planning method is effective if it is not used correctly, many methods are very reliable. In our discussion here, we will take a look at the various contraceptive options from the most reliable to the least and compare their risks, benefits, and reliability.

DYNAMICS OF FAMILY PLANNING: Although there are many kinds of contraceptives, all work either by inhibiting the development or release of ova or blocking the meeting of ova and sperm. This goal is accomplished by two general mechanisms, each with many variations:

(1) Inhibiting the development and release of the egg, a basis for oral contraceptive pills [OCPs], long-acting progesterone injection such as Sayana press and depo provera, or contraceptive patch and ring.

(2) Imposing a mechanical, chemical, or temporal barrier between the sperm and egg, which is the basis for the condom, diaphragm, spermicide, intrauterine contraception, and fertility awareness.

FAMILY PLANNING USING INTRAUTERINE DEVICES (IUD): As a secondary mechanism, intrauterine devices (IUDs) placed as emergency contraception (EC) alter the ability of the fertilized egg to implant and grow. It is important to understand that the mechanism of action of the IUD not placed for EC is via changes in the amount and viscosity of cervical mucus, endometrial suppression, inhibition of sperm migration and viability, changes in transport speed of the ovum, and damage to or destruction of the ovum.

MAKING A CHOICE FOR FAMILY PLANNING: Before helping any woman or couple choose among the many contraceptive options, the physician must consider two things. First, the physician must understand and be able to explain, in language the woman and partner can understand, the physiologic or pharmacologic mechanism of action of all of the available contraceptive methods, along with their effectiveness rates, indications, contraindications, complications, advantages, and disadvantages.

Second, the physician must know the woman and her partner well enough to recognize personal, physical, religious, or cultural values affecting the use of each contraceptive method under consideration and be able to help them deal with those issues using empathic evidence-based discussions, regardless of any personal bias. When done correctly, these discussions allow the couple to understand the contraceptive options and the physician to freely provide evidence-based recommendations.  In this manner, an appropriate individualized contraceptive method can be chosen whose correct, regular use is highly likely.

RELATED;

1.  ECTOPIC PREGNANCY

2.  DRUG USE IN RELATION TO PREGNANCY

3.  PRETERM LABOR AND CHILD BIRTH

4.  OVULATION AND THE MENSTRUAL CYCLE

REFERENCES