MODERN METHODS OF CONTRACEPTION AND FAMILY PLANNING: AN OVERVIEW

CONTENT

-INTRODUCTION

-TYPES OF MODERN METHODS OF CONTRACEPTION

 

INTRODUCTION

This refers to the use of birth control methods or contraceptives, to prevent pregnancy by disrupting the natural process involved in conception. Before pregnancy can occur, sperms are required to be released into the vagina, swim up through the cervix into the womb where they are required to find their way into the fallopian tubes and then swim through it to fertilize the ovum released during ovulation. The ensuing zygote is then moved back from the tube into the womb, which intentionally has been prepared by nature with nutrients to nurture the newly formed embryo. While the natural methods of family planning work by strictly abstaining from intercourse during the fertile period until she enters the safe period within her menstrual cycle, modern methods of contraception interefere with atleast one or more steps required prior to natural conception by the use of artificial products, drugs or devices which are known as contraceptives. Unlike natural methods of family planning, modern methods of contraception or family planning, allow sex during any period of the menstrual cycle thus specifically ideal for women in a regular relationship who practice frequent intercourse. They tend to be more reliable than natural methods of family planning because they do not require the significant amount of time necessary to learn when a woman is safe or fertile nor do they require the self control to abstain from sex for a very long period of time during the fertile period, hence allowing free intercourse as soon as they are procurred.

There is no single birth control method that is ideal for all women. This is because all modern methods of contraception have some specific side effects depending on the type used. As a matter of fact, different women are best suited for different birth control methods based on the individual’s current medical condition and the side effect profile of each particular contraceptive. In fact, the side effect of a contraceptive may be an advantage for another woman. Similarly, because birth control methods are designed to target different but specific steps involved in the process of conception, various types of contraceptives have different efficacy in protecting against pregnancy and thus different failure rate. Hence it is important that every woman should be given ample information necessary to help her choose the best form of contraception that will provide the best possible protection against pregnancy and yet possess the least possible adverse effect.

 

TYPES OF MODERN METHODS OF CONTRACEPTIVES

They can be divided based on the duration of activity of each course of contraceptive agent into:

1. Emergency contraceptives: These are contraceptives that are used after having sex to prevent unwanted pregnancies hence they are also known as post coital contraception. For maximal effect, they are to be used immediately after sex, but they can act within 72 to 96 hours after sex in some instances. They include Copper IUCD, levernogestrel containing pills commonly called postinor 2, high dose combined oral contraceptive pills (COCs pills) and ulipristal acetate.

2. Short acting contraceptives: These refer to contraceptives that act only for a short period of time before they are renewed. They include those that are only used during intercourse and those that are renewed every one to three months. Examples are all barrier contraceptives such as condoms, diaphragms, cervical caps and some hormonal contraceptives such as everyday pills, hormone containing skin patches, hormone containing vaginal rings and progestogen containing injectables.

3. Long acting contraceptives: These are contraceptives that have a very long duration of action often spanning many years till life. They can be divided into long acting reversible contraceptives (LARC) and sterilization procedures.

A) LARC: This from the name includes all long acting contraceptives that are reversible. They are ideal for women who desire a long term choice of contraception while still desirous of future pregnancies. They are basically divided into two main types; the implantable devices which are simply called implants and the intrauterine devices.

1) Implants: These are contraceptives that are inserted under the skin of women where they actively release hormones that prevent conception for about 3 to 5 years depending on the specific type before being removed at the patient’s wish or after it has expired. Examples include implanon, nexplanon and jardelle. 

2) IUDS: IUD or intra-uterine devices are devices inserted into the uterus to prevent pregnancy. Currently, there are two common types and they include Copper IUDs which can last up to 12 years and progestogen containing IUD which can last up to 5 years.

B) Sterilization: These procedures are also referred to as permanent methods of contraception. They are performed with the mind set that the woman has completed her family size and has no future desire to get pregnant. Clients must be well counselled that once done it is expected to be for life and there must be no future intention of reversing it. They can be divided into male and female methods of sterilization. Female methods of sterilization include bilateral tubal ligation and the placement of essure coils into the tubes while the male method of sterilization include vasectomy.

 

Modern methods of contraception can also be divided into various types based on the particular step in the natural process of conception that the contraceptive agent disrupt or the particular mechanism by which the contraceptive agent performs it’s action. They are:

1. Barrier contraceptives: These refer to contraceptives that prevent the sperms from reaching the egg by forming a barrier between the released sperms and the female reproductive tract. Example include condoms, cervical caps, diaphragm and spermicides.

2. Hormone containing contraceptives:These are contraceptives that disrupt the the normal menstrual cycle and affect the normal function of the ovary, the fallopian tube, the lining of the womb and the cervix. They are different types and include those that prevent ovulation and those that prevent the free movement of sperms through the cervix. By disrupting the lining of the womb, they may also make it very unfavorable for an embryo to survive within the womb if ever a sperm makes it to fertilization. Examples are combined oral contraceptive pills and progesterone only pills.

3. Intrauterine contraceptives: These refer to contraceptives that are inserted into the uterus which acts by directly killing the sperms within the womb or to affect the function of the inner lining of the womb such that it cannot sustain a pregnancy. Some IUDs also contain hormones hence serving a dual function of being both a physical hindrance to the survival of the embryo in the womb and also disrupting the normal function of the inner lining of the womb and the cervix in the process preventing the easy movement of sperms through the cervix and the womb. These same hormone containing IUDs can also disrupt the the normal function of the ovary in the process preventing ovulation.

4. Sterilization: This refers to permanent methods of contraception that acts by permanently blocking the fallopian tube, hence preventing the passage of the sperms to the ovum or permanently block the vas deferens and prevent the passage of sperms out of the testicles to the surface of the penis.

 

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