women can become pregnant from the time they are in their early
teens until they are in their late 40s. About half of all pregnancies
are unplanned. . Birth control (or contraception) allows a woman
to plan her family--both the number and spacing of children.
This information leaflet will tell
you more about:
birth control works
types of birth control are available
to choose the best method for you
| How Birth
understand how birth control works, you should know what happens
during reproduction. A woman has two ovaries, one on each side of
the uterus. Each month, one of the ovaries releases an egg into
a fallopian tube. This is called ovulation. In most women, it occurs
about 12-14 days before the start of the menstrual period. Counting
Day 1 as the first day of bleeding, in someone who has cycles every
28 days this will be around day 14 / 15.
A woman can get pregnant if she has
sex around the time of ovulation. During sex, the man ejaculates
sperm into the vagina. The sperm travel up through the cervix, through
the uterus, and into the tubes. If a sperm meets an egg in the fallopian
tube, fertilization--union of egg and sperm--can occur (see figure).
The fertilized egg then moves down the fallopian tube to the uterus
where it attaches and grows.
Birth control methods work in many
ways. They may:
the sperm from reaching the egg (condom)
the sperm (spermicide)
the eggs from being released (birth control pills, injections)
the lining of the uterus or endometrium (IUCD)
the cervical mucus to prevent sperm from going across the cervix
| Methods of
are many methods of birth control. Each method has good points as
well as side effects. All of these methods are safe when used appropriately.
Some methods of birth control have other non contraceptive benefits.
Some also help protect against sexually transmitted
diseases (STDs), including acquired immunodeficiency
syndrome (AIDS). Today there are many choices of birth
control for women and men. More than one method may be used at the
same time. For instance, a barrier method may be used with any other
method. Using a barrier method with another method increases the
effectiveness. It also may help protect against STDs. Some methods
such as patch, vaginal rings, diaphragm and cervical caps are not
available in India.
methods are effective when used the correct way every time you have
sex. Even one act of sex without birth control can result in pregnancy.
Barrier methods include spermicides, and condoms (male and female):
are chemicals that kill sperm. They are placed in the vagina close
to the cervix. They include tablets, foam, cream, jelly, and film
(thin sheets that contain spermicide).
is a thin sheath made of latex (rubber), polyurethane
(plastic), or animal membrane. The man wears it over his erect penis.
is a thin plastic pouch that lines the vagina.
It is held in place by a closed inner ring at the cervix and an
outer ring at the opening of the vagina. The female condom is not
freely available in India.
Another type of barrier method is
the sponge. The sponge is a doughnut-shaped device. It is made of
soft foam that is coated with spermicide. It is pushed up in the
vagina to cover the cervix. It acts as a physical and chemical barrier
between the sperm and the cervix.
Spermicides are chemical barriers.
The other methods are physical barriers. They keep the sperm from
getting to the egg. Combining spermicides with physical barrier
methods provides more protection. Some people may be allergic to
latex. These people might consider using condoms made from plastic
or animal membrane. Keep in mind, however, that condoms made from
animal skin do not provide the same protection against STDs.
|How to use a condom
condom use also helps protect you and your partner against STDs.
A condom should be used any time you have sex. Only water-based
lubricants can be used safely with a condom. It is unsafe to use
oils or lotions, such as petroleum jelly, olive oil, or cold cream.
To use the male condom, place the
rolled-up condom over the tip of the erect penis. Hold the end of
the condom to allow a little extra space at the tip, then unroll
the condom over the penis. Right after ejaculation, grasp the condom
around the base of the penis as it is withdrawn. Throw the condom
away. It should never be reused.
IUD is a small, plastic device that is inserted and left inside
the uterus to prevent pregnancy. Until now only the copper containing
IUCD was available in India. Now a hormonal IUD is also available
for contraceptive use.
Both types of IUDs are T-shaped, but
they work in different ways. The hormonal IUD releases a small amount
of progestin into the uterus. This thickens
the cervical mucus, which blocks the sperm from entering the cervix.
It also thins the endometrium. This keeps a fertilized egg from
attaching and makes menstrual periods light. The hormonal IUCD or
mirena, has also a lower failure rate than the copper IUCD.
The copper IUD releases a small amount
of copper into the uterus. A copper IUD does not affect ovulation
or the menstrual cycle. It causes a reaction inside the uterus and
fallopian tubes. This can prevent the egg from being fertilized
or attaching to the wall of the uterus. It also reduces the sperm's
ability to fertilize an egg.
IUD is often inserted during or right after your menstrual period.
The doctor puts the IUD in a long, slender, plastic tube. He or
she places it into the vagina and guides it through the cervix into
the uterus. The IUD is then pushed out of the plastic tube into
the uterus. The IUD springs open into place, and the tube is withdrawn.
Insertion of the IUD does not require anesthesia (pain relief),
although you may have some discomfort.
Once the IUD is inserted, the doctor
will show you how to check that it is in place. Each IUD comes with
a string or "tail" made of a thin plastic thread. After
insertion, the tail is trimmed so that 1-2 inches hang out of the
cervix inside your vagina. You will be able to tell the placement
of the IUD by the location of this string. The string will not bother
you or interfere with sexual intercourse.
Menstrual pain and bleeding may be
increased with the copper IUD, but usually settle down after the
first 2 cycles. Both pain and bleeding are decreased with the hormonal
IUD. Some women have some cramping and spotting during the first
few weeks after the IUD is inserted. Vaginal discharge also can
occur. These symptoms are common and should disappear within a month.
symptoms may signal there is a problem with your IUD. Call your
doctor if you have any of the following symptoms:
missed period or other signs of pregnancy
change in length or position of the string
A doctor must insert and remove the
IUD. The hormonal IUD must be replaced every 5 years. The copper
IUD can remain in your body for as long as 3 to 5 years. The IUD
does not protect against STDs. It may make them worse if you do
get an infection.
With hormonal birth control, a woman takes hormones similar to those
her body makes naturally. These hormones prevent ovulation. When
there is no egg to be fertilized, pregnancy cannot occur. The hormones
also cause changes in the cervical mucus and uterus that help prevent
pregnancy. Hormonal pills, injections, (rings and patches - not
available in India) are all very effective.
most women, the risk of serious complications is small. However,
women older than 35 years who smoke should not use most types of
hormonal methods because it increases their risk of heart attack
|Birth Control Pills
of the most popular methods of hormonal birth control is the birth
control pill (oral contraceptive). Most birth control pills are
combination pills. They contain the hormones estrogen and progestin.
There are many different brands of pills with different doses of
hormones. This variety allows a woman to find a pill that is right
for her. Some pills contain only progestin.
Most pills have to be started on Day
5 of the menstrual cycle and continued for 21 days. Somemof the
lower dose pills will have to be strarted on Day 1 of the cycle.
It is I,portant to be regular with the pill since missing more than
2 tablets may increase the chance of failure.
Birth control pills help protect against
certain types of cancer, such as cancer of the ovary and endometrium.
Most experts agree that women who have no other risk factors do
not have an increased risk of getting breast cancer. These women
can take the pill.
The pill also helps to keep your periods
regular, lighter, and shorter. This makes women less likely to have
anemia (low blood iron). The pill also reduces menstrual cramps.
It lowers your risk of ectopic pregnancy.
Some types of birth control pills also can help treat acne.
One type of injection of hormonal birth control, called depot-medroxyprogesterone
acetate (DMPA), provides protection against pregnancy for 3 months.
This means a woman needs only four injections each year. During
the time that the injection is effective, you don't have to do anything
else to prevent pregnancy. Injections may be good for people who
find daily birth control methods inconvenient. Women who take DMPA
injections tend to have no periods but have some spotting or slight
If a woman has sex without any type of birth control or if she thinks
her method has failed (for instance, a condom slipped or broke),
she may want to use emergency contraception. In this method, certain
doses of combination birth control pills are taken within 72 hours
of sex without birth control. Talk to your doctor right away if
you think you might need this protection. If you use emergency contraception
within 72 hours of unprotected sex, your chance of getting pregnant
is greatly reduced. Emergency contraception should not be used instead
of birth control on a routine basis. Regular use of a birth control
method is more effective and has health benefits that emergency
contraception does not have.
|Natural Family Planning
family planning used to be called the rhythm method or "safe
period." It also is called periodic abstinence or, more recently,
fertility awareness. It isn't a single method but a variety of methods.
Natural family planning does not require drugs or devices. The success
of these methods depends on you knowing when you ovulate and not
having sex during the fertile period or using another method, such
as condoms, during that time.
of natural family planning include:
body temperature method
-- Taking your temperature
every day to detect the slight increase just after ovulation
-- Noting changes in your cervical mucus
-- Combining the basal body temperature and
ovulation methods, as well as checking for other signs of ovulation
-- Keep a menstrual calendar for 6 months to
figure out your fertile period (also called the rhythm method)
-- Ovulation and menstruation usually are
postponed in breastfeeding women. If a woman does not ovulate, she
cannot become pregnant.
methods often are combined to prevent pregnancy. You need to know
your body well and you and your partner must be willing to follow
the method. This method can only work when you follow it correctly
at all times.
withdrawal method prevents pregnancy by not allowing sperm to be
released in the woman's vagina. This requires the man to take his
penis out of the woman before he ejaculates. For this method to
work, he must withdraw every time the couple has sex. Drawbacks
are that sperm can be present in the fluid produced by the penis
before ejaculation and some men fail to withdraw completely or in
for women and men works by permanently blocking the pathways of
egg and sperm. This can be done by surgery. The sterilization procedure
for women is called tubal sterilization. The procedure for men is
sterilization is done by laparoscopy and
minilaparotomy. The fallopian tubes are
closed by tying, banding, clipping, blocking, or cutting them, or
by sealing them with electric current. The surgery often is performed
under general anesthesia. Sometimes women
have sterilization right after the birth of a child. This is called
involves cutting a man's vas deferens
so that sperm cannot mix with semen. The tubes that carry sperm
to the penis are clamped, cut, or sealed so that the ends do not
join again. The man is given local anesthesia.
Surgery is done in the doctor's office or a clinic.
is meant to be a permanent form of birth control. If there is a
chance you may want to have a baby later, you should not choose
this method. Attempts to reverse it may not work. Reversal procedures
require major surgery and are expensive.
any given time, a couple may find one method of birth control suits
their needs better than others. Most women and couples use many
methods over their lifetime. Here are some things to think about
when choosing a method:
well the method works
likely you are to use it
side effects it has
it costs, month by month and over time
it helps protect against STDs
methods have a chance of failure. When a method is used correctly
each time, the failure rates are lower. Any method of birth control
described here can work well if it is used correctly. Choose a method
you will be able to use on a regular basis. If your method fails,
you may want to consider emergency contraception.
choosing a method of birth control, you should also think about
preventing STDs. Use of condoms is the best way to prevent STDs.
They should be used with other methods if you are at risk of STDs.
matter which method of birth control you choose, be sure that you
know how it works, how to use it, and what side effects may occur.
Even with methods that do not need a prescription, you need to learn
how to use the method. A doctor, nurse, or family planning counselor
can teach you. The more you know about birth control and your own
needs, the easier it will be to choose a method that's right for
|Ectopic Pregnancy: A pregnancy
in which the fertilized egg begins to grow in a place other than inside
the uterus, usually in the fallopian tubes.
A female hormone produced in the ovaries that stimulates the growth
of the lining of the uterus.
Anesthesia: The use of drugs that produce a sleeplike state
to prevent pain during surgery.
A surgical procedure in which a slender, light-transmitting instrument,
the laparoscope, is used to view the pelvic organs or perform surgery.
Local Anesthesia: The use
of drugs that prevent pain in a part of the body.
A small abdominal incision used for a sterilization procedure in which
the fallopian tubes are closed off.
A synthetic form of progesterone (a female hormone that is produced
in the ovaries and makes the lining of the uterus grow) that is similar
to the hormone produced naturally by the body.
Transmitted Disease (STD): A disease that is spread by sexual
contact, including chlamydial infection, gonorrhea, genital warts,
herpes, syphilis, and infection with human immunodeficiency virus
(HIV, the cause of acquired immunodeficiency syndrome [AIDS]).
Vas Deferens: A small tube that
carries sperm from a male testis to the prostate gland.