CONTRACEPTION

Contraception, also known as birth control practice, is prevention of pregnancy by interfering with the whole process of conception and implantation. In the current scenario, numerous methods of contraception are in practice and include barrier or hormonal method, withdrawal, natural family planning, abstinence, and sterilization (surgery). Some of these methods are confined to women and others to men, Some  methods are reversible and some are permanent .

Abstinence

Abstinence means not having sexual intercourse. It is the only birth control method that is 100% effective in preventing pregnancy as well as sexually transmitted diseases.

Natural Planning Method

Natural family planning (NFP) or fertility awareness does not require medication, physical devices, or surgery to prevent pregnancy. This method relies on the woman's body physiology to know the time of ovulation. This method involves monitoring different body changes such as basal body temperature or cervical mucus variations. The woman then abstains from unprotected sex for approximately 7 to 10 days when she may have ovulated.

Barrier Methods

Barrier Methods are a common  methods that form a physical barrier to obstruct the sperm from entering a woman's uterus. Barrier methods include use of

  • male condom

  • female condom

  • spermicides

  • diaphragm

  • cervical cap, and

  • contraceptive sponge.

The male condom is a thin covering made of latex or polyurethane that is rolled over an erect penis before sexual intercourse to prevent the sperm from entering a woman's vagina.

The female condom is a polyurethane (plastic) tube that has a flexible ring at each end and is inserted into the vagina before sexual intercourse.

Spermicides are chemicals that deactivate or kill sperm and are available as foams, suppositories, and jellies.

Diaphragm is a flexible dome that covers the cervix inside the vagina.

Cervical caps are smaller cups made of latex, rubber or plastic. They should be used in conjunction with a spermicidal gel and are placed in the vagina before sexual intercourse.

Sponge is a soft, round barrier device made of polyurethane foam.

Hormonal methods

In this method, synthetic hormonal preparations containing oestrogen and progesterone that can be administered

  • orally (pills),

  • implanted into body tissue (implants),

  • injected under the skin (injections),

  • absorbed from a patch on the skin (skin patches), or

  • placed in the vagina (vaginal rings).  

These methods work by preventing ovaries from releasing eggs for fertilisation.  

They also thicken the mucus around the cervix, making it difficult for sperm to penetrate. They also thin the lining of the womb decreasing its ability to accept a fertilised egg.

Intrauterine device (IUD)

The intrauterine device (IUD) is a small device made of copper that is inserted into the uterus. It works by thickening the mucus around the cervix and by thinning the womb's lining, making it difficult to accept a fertilised egg.

Withdrawal method

Withdrawal method involves the complete removal of the penis  from the woman's vagina before ejaculation.

Sterilisation

Sterilisation is a permanent solution and is meant for men and women who do not intend to have children in the future. Male sterilisation involves vasectomy, a surgical blocking of the vas deferens, the tubes through which sperm pass into the semen. Female sterilisation involves a tubal ligation, a surgical procedure that blocks the fallopian tubes which carry the eggs from the ovaries to the uterus.

Your Choice

The choice of a particular method of contraception also depends on an individual's age, health, frequency of sexual activity, number of sexual partners, future pregnancy, plans to have children in the future, and certain medical conditions.

Therefore, always discuss with Dr Alexander about the choice of birth control method.

It is necessary to know that most birth control methods prevent pregnancy. However, no method of birth control offers protection against sexually transmitted diseases.

LAPAROSCOPIC STERILIZATION

Sterilization is a permanent method of contraception for women planning not to be pregnant in the future.

Laparoscopic technique is a minimally-invasive procedure and in recent years laparoscopic sterilization has gained popularity owing to its advantages over the traditional approach.

Laparoscopic sterilization is a technique of tubal ligation to block or close the fallopian tubes, the pathway for sperms to reach eggs for fertilization.

Fallopian tubes, located on either side of the uterus, pick up eggs released from the ovaries and transfer them to the uterus. So, if these tubes are closed,  sperms fail to reach the eggs and thus fertilization will not occur.

About the Sterilization Procedure

During the surgical procedure, you will have general anaesthesia administered so that your muscles remain relaxed and no pain is felt. A device that helps move the uterus is slowly inserted into the vagina.   Then, a small incision is made near the belly button through which a laparoscope is passed. The abdomen is inflated so that the surgeon gets an improved view of the internal organs.

A second incision is made at the pubic hairline through which a special device is inserted which is used to grasp the fallopian tubes. Next, the fallopian tubes are sealed off either with an electric current that coagulates the tube (electrocoagulation) or by placing a band or clip over the tubes. In some circumstances, the tubes may also be cut. Once the tubes are sealed, both the laparoscope and grasping device are withdrawn and a small surgical dressing is placed over the incisions on the skin.

Recovery After the Procedure

You may return home after the observation period, once you have recovered. A follow-up visit will be scheduled within the next 2 to 8 weeks. Small amount of vaginal bleeding which may continue for few days after the surgery is considered normal.

Laparoscopic sterilization is considered to cause permanent loss of fertility. Hence, a well-informed, careful decision should be taken bearing in mind the other alternatives, before you decide to undergo laparoscopic sterilization. It offers a very safe and convenient form of contraception that requires no additional measures to prevent pregnancy. It also does not affect the menstrual cycle.

Laparoscopic procedure is more advantageous than the traditional procedure. The smaller incisions require a shorter recovery period and the risk of complications are minimal.