Birth Spacing and Contraception
BIRTH SPACING
Birth spacing is the time interval from one child’s birth date till the next child’s birth date. Studies show that 3 to 5 years between births is generally best for the well-being of the mother and her children. Very short birth intervals (less than 15 months) are associated with maternal death as well with various complications of pregnancy. They are also associated with complications in the new born infant as well as associated with foetal deaths. Birth spacing results in a healthier pregnancy and also reduces under-5 mortality.
Advantages:
- A planned pregnancy is good for health of both the mother and baby.
- Short intervals between births can also be bad for mother’s health as there is a greater risk of bleeding in pregnancy, and therefore, increased risk of maternal death.
- PIt gives mother the time to replenish the required nutritional stores for another pregnancy and child feeding.
- It prevents unwanted pregnancies, and thus, prevents rates of induced abortions.
- The infant mortality decreases when births are spaced upto 3 to 5 years apart.
- Birth spacing also lowers the risk of fetal death, pre-term delivery, neonatal death and low birth weight babies.
- Research shows that a child born 3 to 5 years after the birth of its sibling is about 2 ½ times more likely to survive than children born at shorter intervals and is less likely to be malnourished during infancy.
- Optimal birth spacing provides the greatest health, social, and economic benefits for a family.
- Also longer intervals allow parents to devote more time to each child in the early years, easing pressures on the family’s finances and giving parents more time for activities other than child rearing.
What Is Contraception?
Contraception methods are preventive methods to help women avoid unwanted pregnancies, which includes all temporary and permanent measures to prevent pregnancy resulting from coitus (intercourse).
What Are The Types Of Contraceptives Used?
The contraceptives can be classified as spacing methods and terminal methods.
A. Spacing Methods -are temporary methods used to prevent unwanted pregnancy
- Physical methods – Condom, Diaphragm, Vaginal Sponge.
- Chemical methods – Foams, Creams, Jellies, Suppositories
- Combined methods – A combination of physical and chemical method like Condoms lubricated with spermicides
- Tetanus vaccination is given to pregnant women two doses – first dose is given at 16 – 20 weeks and second dose is given at 20-24 weeks of pregnancy.
- Intrauterine devices (IUDs) – Lippes loop, Copper-T, etc.
- Hormonal methods – Oral Contraceptive Pills (OC Pills), Male Pills, Injectables like DMPA, NET-EN, Subdermal Implants and Vaginal Rings.
- Miscellaneous – Abstinence, Coitus Interruptus, Safe Period/Rhythm Method etc.
B. Terminal Methods - are permanent methods to prevent pregnancy
- Male sterilization – Vasectomy.
- Female sterilization - Tubectomy.
Barrier Methods:
Barrier method suitable for both men and women are available. The aim of these methods is to prevent live sperm from meeting the ovum. Male condoms, female condoms, diaphragm, vaginal sponge, cervical cap, etc are barrier methods of contraception. These methods require a high degree of motivation on the part of the user. They are only effective if used consistently and carefully.
Intra-Uterine Devices:
In the intrauterine method of birth control gyanaecologist carefully places a flexible plastic device with a copper wire inside the uterus, with a polyethylene string at the bottom of the IUD. The copper wire alters the uterine wall chemistry, and thus, prevents the sperm from fertilizing the egg. It is an advisable method of contraception in women who have atleast one kid. IUD use is a reliable method with low failure rate. It is even effective as a post-coital (emergency contraception) if inserted within 3-5 days of unprotected sex.
Birth Control Pills/Oral Contraceptive Pills:
Birth control pills prevent ovulation. These pills contain hormones such as oestrogen and progestogen. They can be a combination of estrogen and progestogen or only Progestogen-only pill (POP). Taken daily, these hormones in the pill prevent your ovaries from releasing eggs, and thus, pregnancy will be prevented since there are no eggs to fertilize. These pills also cause changes in the lining of the uterus and the mucus of the cervix which further discourages pregnancy. However, birth control pills have some side effects like head aches, nausea, water retention, breast swelling, depression and water gain. Cramping is reduced due to these pills and so these pills can reduce the bleeding and consequently reduce the menstrual period. As a result prolonged use of these pills can lead to premenstrual syndrome (PMS).
The injectable contraceptives, subdermal implants and vaginal rings are a form of Depot-formulations. These are highly effective, reversible, long-acting and oestrogen free for spacing pregnancies in which a single administration suffices for several months or years cannot be stressed.
Emergency Contraceptive Pills (ECPs):
Emergency contraceptive pills (ECPs) are drugs that act both to prevent ovulation or fertilization or post-fertilization implantation of an embryo, depending on which phase of the ovulation cycle the woman taken it is in. they are also called as “the morning after pill” or “the day after pill.” They are the hormonal method of contraception. They can be only progestin pills or combined oestrogen-progestin pills. ECPs can be effective upto 120 hours of unprotected sex but they are most effective within the first 24 hours. EC may not be recommended for a woman who is breastfeeding or has given birth in the last 6 weeks or has history of epilepsy, cardiovascular or kidney disease, migraine headaches, diabetes, or hypertension.
Abstinence:
The only method of birth control which is completely effective is complete sexual abstinence.
Coitus Interruptus:
This is oldest method of voluntary fertility control. The male withdraws before ejaculation, and thereby, tries to prevent deposition of semen into the vagina. The chief drawback of this method is that the precoital secretion of the male may contain sperm and even a drop of semen is sufficient to cause pregnancy. The slightest mistake in timing the withdrawal may lead to the deposition of a certain amount of semen.
Safe Period/Rhythm Method:
The rhythm method is a method of birth control that uses the menstrual cycle to predict the most fertile time of the month that is when a woman is most likely to become pregnant. Once a woman has identified the most fertile time then she will not have sex or use a barrier method of birth control during that time period. This can be done by either keeping a track of the menstrual cycle for a few months to determine one’s own individual pattern of ovulation (Rhythm Method). Also keeping a track of the body temperature so that you can tell when you are ovulating. (Basal Body Temperature). Keeping a check on how thick your cervical mucus is will also help as it is thickest at the time of ovulation (Cervical Mucus Method).
Sterilization:
Voluntary sterilizaion is a well established contraceptive procedure for couples desiring no more children. For permanent and guaranteed prevention of pregnancies, sterilization is the best option. Tubal ligation i.e. closure of fallopian tubes in women and vasectomy, closure of spam ducts of men are two such methods of sterilization.
NOTE:
- All methods mentioned above are capable of preventing pregnancy. Among all of them only condom is a device that can prevent pregnancy as well as protect one from contracting sexually transmitted diseases like Chlamydia, herpes, genital warts, gonorrhea, syphilis and HIV.
- On using any method of contraception if you are experiencing any health complain then get examined by your gynaecologist.
- Choose your birth control device carefully, depending on your health, the number of sexual partners you have, how frequently you engage in sexual activity and on your desire to have children in future. Your doctor may help you select the best form of birth control.
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