Population
explosion and birth control
Increased health
facilities and better living conditions have enhanced longevity. According to a
recent report from the UN, India’s population has already reached 1.26 billion
and is expected to become the largest country in population size, surpassing
China around 2022. To overcome the problem of population explosion, birth
control is the only available solution. People should be motivated to have
smaller families by using various contraceptive devices. Advertisements by the
Government in the media as well as posters/bills, etc., with a slogan Naam
iruvar namakku iruvar (we two, ours two) and Naam iruvar namakku oruvar
(we two, ours one) have also motivated to control population growth in
Tamilnadu. Statutory rising of marriageable age of the female to 18 years and
that of males to 21 years and incentives given to couples with small families
are the other measures taken to control population growth in our country.
The voluntary use of
contraceptive procedures to prevent fertilization or prevent implantation of a
fertilized egg in the uterus is termed as birth control. An ideal contraceptive
should be user friendly, easily available, with least side effects
and should not interfere with sexual drive. The contraceptive methods are of
two types – temporary and permanent. Natural, chemical,
mechanical and hormonal barrier methods are the temporary birth control
methods.
Natural method is used to prevent
meeting
of sperm with ovum.
i.e., Rhythm method (safe period), coitus interruptus, continuous abstinence
and lactational amenorrhoea.
a. Periodic
abstinence/rhythm method
Ovulation occurs at
about the 14th day of the menstrual cycle. Ovum survives for about two days and
sperm remains alive for about 72 hours in the female reproductive tract. Coitus
is to be avoided during this time.
b. Continuous abstinence
is the simplest and
most reliable way to avoid pregnancy is not to have coitus for a defined period
that facilitates conception.
c. Coitus interruptus is the oldest family planning
method. The male partner withdraws his penis before ejaculation, thereby
preventing deposition of semen into the vagina.
d. Lactational
amenorrhoea Menstrual cycles resume as early as 6 to 8 weeks from
parturition. However, the reappearance of normal ovarian cycles may be delayed
for six months during breast-feeding. This delay in ovarian cycles is called lactational
amenorrhoea. It serves as a natural, but an unreliable form of birth
control. Suckling by the baby during breast-feeding stimulates the pituitary to
secrete increased prolactin hormone in order to increase milk production. This
high prolactin concentration in the mother’s blood may prevent menstrual cycle
by suppressing the release of GnRH (Gonadotropin Releasing Hormone) from
hypothalamus and gonadotropin secretion from the pituitary.
In these methods, the ovum and sperm are prevented from meeting so
that fertilization does not occur.
a. Chemical barrier Foaming tablets, melting
suppositories, jellies and creams are used as chemical agents that inactivate
the sperms in the vagina.
b. Mechanical barrier Condoms are a thin
sheath used to cover the penis in male whereas in female it is used to cover
vagina and cervix just before coitus so as to prevent the entry of ejaculated
semen into the female reproductive tract. This can prevent conception. Condoms
should be discarded after a single use. Condom also safeguards the user from
AIDS and STDs. Condoms are made of polyurethane, latex and lambskin.
Diaphragms, cervical
caps and vaults are made of rubber and are inserted into the female reproductive
tract to cover the cervix before coitus in order to prevent the sperms from
entering the uterus.
It prevents the ovaries
from releasing the ova and thickens the cervical fluid which keeps the sperm
away from ovum.
Oral contraceptives — Pills are used to
prevent ovulation by inhibiting the secretion of FSH and LH hormones. A
combined pill is the most commonly used birth control pill. It contains
synthetic progesterone and estrogen hormones. Saheli, contraceptive pill
by Central Drug Research Institute (CDRI) in Lucknow, India contains a
non-steroidal preparation called centchroman.
Intrauterine devices are
inserted by medical experts in the uterus through the vagina. These devices are
available as copper releasing IUDs, hormone releasing IUDs and non-medicated
IUDs. IUDs increase phagocytosis of sperm within the uterus. IUDs are the ideal
contraceptives for females who want to delay pregnancy. It is one of the
popular methods of contraception in India and has a success rate of 95 to 99%.
Copper releasing IUDs differ from each other
by the amount of copper. Copper IUDs such as Cu T-380 A, Nova T, Cu 7, Cu T
380 Ag, Multiload 375, etc. release free copper and copper
salts into the uterus and suppress sperm motility. They can remain in the
uterus for five to ten years.
Hormone-releasing IUDs such as Progestasert
and LNG – 20 are often called as intrauterine systems (IUS). They
increase the viscosity of the cervical mucus and thereby prevent sperms from
entering the cervix.
Non-medicated IUDs are made of plastic or
stainless steel. Lippes loop is a double S-shaped plastic device.
Permanent birth
control methods are adopted by the individuals who do not want to
have any more children.
Surgical sterilisation
methods are
the permanent contraception methods advised for male and female partners
to prevent any more pregnancies. It blocks the transport of the gametes and
prevents conception. Tubectomy is the surgical sterilisation in women.
In this procedure, a small portion of both fallopian tubes are cut and tied up
through a small incision in the abdomen or through vagina. This prevents
fertilization as well as the entr1y of the egg into the uterus. Vasectomy
is the surgical procedure for male sterilisation. In this procedure, both vas
deferens are cut and tied through a small incision on the scrotum to prevent
the entry of sperm into the urethra. Vasectomy prevents sperm from heading off
to penis as the discharge has no sperms in it.
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