- Family with many members are not easy to handle and will be problematic as compared to small family.
- So, the necessity of planning a family is felt which can be made effective by following various measures.
- Several scientific methods of birth control have been developed in order to have a small family.
- Thus, family planning can be defined as the practice of controlling the number of children one has and the intervals between their births, particularly by means of contraception or voluntary sterilization.
- These may be grouped under two main categories: natural and artificial.
- However, they should be used under the supervision of a qualified medical practitioner.
- When some external objects are used or family planning it is called artificial method.
- The various approved artificial methods of family planning may be classified into two groups. They are:
- The various methods under this group are:
- These methods include a barrier that prevents or blocks sperm cells from reaching the ovum.
- These are available for both men and women.
- For this, condoms and diaphragms are generally used.
- It is a sheath of animal membrane, rubber, or plastic that is placed on the erect penis.
- It is a barrier device since the ejaculate is collected within the condom instead of within the vagina.
- It also protects from transmission of various sexually transmitted diseases.
- They are the most common contraceptive devices employed worldwide as they are inexpensive, easy to use, do not require medical supervision and have few side effects.
- Condoms for both male and female are available.
- It is a shallow rubber cup that fits over the cervix (neck of the uterus) to prevent the sperm reaching the ovum.
- The cup holds a spermicidal (sperm killing) jelly or cream that immobilizes any sperm that may be present around the edges of the diaphragm.
- These are substances that are toxic to sperm cells.
- The most commonly used spermicidal agents are foams, tablets or creams that are inserted into vagina before sexual contact.
- They kill the sperm cells.
- These include KMnO4, ZnSO4, lactic acid, citric acid, etc.
- Most commonly used chemicals are Kamalchakki and Today foaming tablets.
- The administration of female sex hormones to suppress fertility is one of the most effective temporary methods for preventing pregnancy.
- Birth control pills or oral contraceptive pills usually consist of a mixture of the hormones, oestrogens and progesterone.
- Both hormones prevent ovulation, if taken in sufficient amount.
- They are both synthetic steroids in nature.
- They have longer half-life in the circulatory system than the natural steroids, which are rapidly degraded by liver.
- Commonly used oral pills in Nepal are Nilokan white, Sunaulo gulaf, Kanchan, Ovaral, Mala-D, etc.
- These pills are ingested once in each day for about 21 days.
- Then the medication is stopped, or a placebo pill is taken for the next 7 days which is without oestrogen and progesterone.
- The resulting drops in hormones allow menstruation to occur.
- After the stoppage of menstrual flow, the administration of the pills begins again.
iv)Intra-uterine contraceptive devices (IUCDs)
- These are tiny plastic and metal (usually copper) loops or coils.
- These are inserted into the uterus through the cervix.
- These work mainly by preventing fertilization, but may also interfere with the implantation of the fertilized egg into the lining of the uterus.
- Some IUCDs also release small amounts of synthetic progesterone into the uterus to prevent conception.
- It should be inserted by doctor or nurse as it remains in a place for 3 years.
- Its working mechanism is not quite clear but it successfully prevents implantation of the developing embryo with the uterus.
- However, some effects are noticed in some women like uterine cramps and increased menstrual flow.
- Though it is an effective means some complications are noticed during its use.
- Commonly used IUCDs are copper T-200 or loop.
- It is the name for an injection of progesterone.
- It is used at every three months.
- It is injected into the body of a female within seven days after menstruation.
- It prevents the release of an ovum from ovary and prevents pregnancy.
- It is popular by name 3 month injection or Sangini injection in Nepal.
- In this method, two small flexible capsules containing hormones are implanted in the arm of woman by trained health worker.
- These capsules release hormones in the body which make the ovum inactive.
- So the woman does not become pregnant after sexual intercourse.
- A single implant of these capsules acts as contraceptive for five years.
- The implants working for three years are also available nowadays.
- It is a set of six small (3-4 cm long) flexible tubes, which are inserted under the skin of the upper arm through a minor surgery.
- Once introduced, it is effective for five years.
- It is a progestogen that thickens the cervical mucus, which prevents the sperms from meeting the egg.
viii)Emergency contraceptive pills
- These pills are used for emergency purposes.
- It prevents pregnancy after unprotected sexual intercourse.
- A woman takes two tablets within 72 hours of unprotected sexual intercourse and the second dose of remaining two tablets after 12 hours.
- These are available in the name of E-con or i-pills.
- However, these pills should not be used frequently as they have various side effects.
- These include surgical methods, which are suitable for the couples already having two or more children. These are:
- It is a commonly used method that makes a male permanently incapable of fertilization.
- In this method, both the spermatic ducts coming from the testes are cut and tied separately within the scrotal sac.
- This prevents the sperms from coming out during ejaculation.
- Finally the sperm cells are destroyed in the epididymis.
- It is also a common method of permanent birth control in females.
- Both the fallopian tubes are tied and cut or clamped through an incision made through the wall of the abdomen.
- Laparoscopy is commonly used for this purpose so that only a small opening is required to perform the operation.
iii)Interruption of pregnancy
- Surgical procedure called abortion might be used to terminate the unwanted pregnancies.
- This method is normally used only in pregnancies not older than 3 months.
- An instrument is inserted into the uterus through cervix and the inner lining of the uterus along with the implanted embryo is scraped in this method.
- The embryo disintegrates and is suctioned out of the uterus.