Contraception: How to prevent unwanted pregnancy

Contraception: A woman taking contraceptive pills
EJ
Emeh Joy

Many countries of the world such as India, Pakistan and Nigeria are battling with overpopulation as the economy is low and seemly has little in stock for its many citizens.

One reason for this is the fact that many are not informed on contraceptive methods while some simply do not understand the need to give birth to just the number they can cater for.

There is a need to educate the masses on healthy and effective ways of preventing pregnancy as well as debunking some pregnancy myths to avoid population explosion.

If people are informed about how to avoid unwanted pregnancy in the first place; perhaps, there might not be the need to opt for abortion which is not only illegal in some areas but can also be life-threatening.

What is contraception?

Contraception is the means of preventing pregnancy through the use of contraceptives. Note that once a sperm gets to an ova (egg) and fuses with it, conception (pregnancy) is bound to happen and after fertilization comes implantation of the fertilized egg to the uterine wall.

Contraception can be achieved in several ways, such as:

  • Stopping the production of the ovum in the ovaries
  • Keeping the sperm cell from reaching the oval
  • Stopping the fertilized egg from attaching to the uterine lining

In some countries like the U.K., contraception methods, like the use of condoms, are free. Also, there are different contraception methods one can opt for.

Methods of contraception

Pregnancy can be prevented via hormonal methods, barrier methods, intrauterine devices and implants as well as the use of other methods such as emergency contraception., sterilization and natural family planning.

Different contraceptive methods

Hormonal methods

The hormonal method prevents contraception by disrupting ovulation, i.e. the release of an egg from the female's ovaries. However, these methods are not protective against sexually transmitted diseases.

They are mostly available as prescription contraceptives. They include:

Contraceptive injection

A certified medical professional should give contraceptive shots. It is 90 per cent effective if done appropriately according to the CDC.

For people who use injection, fertility might not return to normal immediately they stop getting the shot. It might take up to 10 months or longer for the person to be able to conceive.

Contraceptive pills

People in the U.S. commonly use this form of contraception, and it comes in various brands. According to the UK NHS, they are 99 per cent effective if taken as prescribed; however, they are said to be typically 95 per cent effective in reality.

Contraceptive pill for preventing pregnancy

Pills come in two forms- combined pill (contains progestin and estrogen) and mini pill (contains progestin only). With the combined pills, one has to take one daily as instructed, and it also presents with the monthly menstruation, but in the case of the mini-pill, there might not be scheduled menstruation.

Patches

This contraceptive method, according to NHS, should be 99 per cent effective but with typical use, it is about 90 per cent effective. Contraceptive patches can be placed on the buttocks, stomach, upper arm, back etc.

Its user has to wear a patch for 21 days (three weeks) and then remove it for seven days (one week) to enable menstruation to take place.

Use of vaginal rings

This is also known as NuvaRing and is a little less than 95 per cent effective with typical use. It involves placing a small, plastic ring in the vagina for three weeks which would release into the body hormones that prevent pregnancy.

Just as it is with the patches, the ring has to be removed for one week to enable the period flow before inserting another.

Barrier methods

Barrier methods simply prevent the sperm from getting to the egg and can come in different forms.

Male condoms

They are the most commonly used barrier method and also protect against sexually transmitted infections. According to the CDC, when used correctly, they offer more than 80 per cent protection against pregnancy.

To use the male condom in the right way, you have to go for the right size, place it on the head of the erect penis, pinch the tip to remove air and scroll down carefully to avoid tearing it.

Do not reuse a condom that has been used before. Condoms are found over-the-counter and do not have to be prescribed.

Female condoms

Just like the male condoms, they protect against STI and are also alternatives to the male condom. CDC reported that they are about 79 per cent effective for preventing pregnancy. They are not as popular as male condoms. Couples can check for them in the local stores or online.

Cervical cap

This consists of a soft silicone cup placed deep within the female's pelvic cavity just in between the vagina and the uterus. It is placed at a point called the cervix to obstruct the passage of the sperm and prevent it from getting to the egg.

When it comes to its contraception effectiveness, it varies according to different sources. According to Planned Parenthood, it is about 70 to 85 per cent effective.

Diaphragm

Diaphragm is another barrier method that involves inserting a diaphragm a few hours before intercourse inside the vagina. Spermicide should be applied on the diaphragm before use, and it should be left in place six hours after sex and then removed after 24 hours.

Diaphragms are not protective against STIs, and according to CDC, they are about 90 per cent effective against pregnancy.

Spermicide

Spermicide is typically a chemical that renders sperm cells inactive. They can be bought without a prescription and can be used in combination with other barrier methods such as diaphragm and condoms.

When using only spermicide, it should be inserted close to the cervix about 10 minutes before sexual intercourse and should remain effective for about an hour after insertion. The method is generally about 71 per cent effective.

Intrauterine devices (IUDs) and implants

IUDs and implants are not novel contraception practices. They have been in use for a while. According to NHS, they have little room for error and are thus as much as 99 per cent effective against conception. However, they are not protective against STIs.

Implants

Implants are also hormonal and involve the insertion of a rod about the size of a match stick into the arms to prevent pregnancy.

Contraception method: A woman getting an implant

Implants act by triggering the release of the progestin hormone into the body, thus, preventing ovulation. According to the CDC's estimation, implants are more than 99 per cent effective against conception. They can be replaced at intervals of three years.

Intrauterine devices (IUDs)

This is a small device that is inserted into the uterus and can be of two types- hormonal and copper-based.

Once the hormonal IUD is fitted, it can be effective for as much as five years before replacement. They might not stop ovulation ultimately; however, they act by thickening the cervical mucus, thus, preventing the entrance of sperm cells into the uterus.

The copper-based, on the other hand, is free of hormone but consists of an IUD covered in a copper wire which destroys sperm cells as they try to gain entrance into the uterus. One of these can be effective for as much as ten years.

With IUDs, there might be adverse reactions like irregular periods, spotting in between periods as well as menstrual cramps.

Other methods

Asides the use of hormonal, barrier and IUDs or implants, there are other methods of preventing pregnancy such as:

Emergency contraception

When unprotected sex happens unprepared or there is a case of broken condom or failure of taking contraceptive pills as directed, emergency contraceptives can be used to prevent pregnancy.

Emergency contraception, however, should not be used in place of conventional birth control methods.

Emergency contraception comes mainly in two forms- emergency contraception pills and copper IUD. The emergency pills are more commonly used and usually contains levonorgestrel chemical.

It should be taken not later than three days after intercourse because the sooner it is taken, the higher its effectiveness.

The copper IUD, on the other hand, can be inserted up to 5 days after sex to prevent conception and is reported to be above 99 per cent effective when used within this time-frame.

Warning: Pulling out (withdrawal) offers only minimal protection against conception as pre-ejaculate might contain sperm.

Sterilization

Both genders can undergo procedures that will reduce or eliminate their fertility permanently. These procedures are more than 99 per cent effective against pregnancy. However, they won't protect partners against STIs.

Vasectomy and tubal ligation

For the men, they can undergo vasectomy which involves the total or partial removal of the vas deferens (the tubes that carry the sperms). It can be reversed in some cases; however, fertility may not be fully restored.

Women, on the other hand, can undergo tubal ligation where the fallopian tubes will be sealed or clamped. Effects of this are usually permanent; however, there are sporadic cases where the tubes reconnect, leaving chances for pregnancy.

Asides the conception methods listed above, some couples adopt the natural method whereby the woman tracks her menstrual cycle and avoid sexual intercourse during the "fertile phase".

The fertile phase coincides with ovulation which is the monthly release of an egg from the ovary. It lasts for about 6 to 9 days in each monthly cycle.

Women note different symptom and changes during their ovulation that helps them track their fertile phase. However, it might not always be accurate.

You can learn all about the menstrual cycle and how to track your cycle if you want to try this contraception method.

Warning: Breastfeeding is not quite effective against pregnancy, as some criteria have to be met for it to work to some extent.

Some signals that help the woman track her cycle to know the fertile phase include measuring basal body temperature as well as taking note of the quantity and quality of the cervical mucus.

CDC reports that natural family planning methods are about 76 per cent effective for contraception when followed duly.

Take away

There are many contraceptive methods available to prevent pregnancy. While some come with high adverse effects, some come with minimal or no side effects. NHS U.K. lists out different things to consider when you are choosing a contraception method.

Couples should talk to their doctors to educate them more about the pros and cons of each contraceptive method as well as to help them make the right contraceptive choices.

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