CONTRACEPTION ( FAMILY PLANNING OPERATIONS )
What is Contraception ?
Contraception can be defined as the use of physical barriers or artificial methods to prevent pregnancy.
There are many contraceptive options ranging from barriers such as condoms to permanent methods such as tubectomy and vasectomy.
Types of Contraception
Family planning operations are classified into the following types:
Type I: Long-Acting Reversible Contraception
This type of contraception is a solution that can be reversed at any point in time. Some of the more common methods of contraception that fall under this type are:
- Contraceptive Implant : called Nexplanon that can last up to 3 years. In this method, a flexible plastic rod is placed in the upper arm under the skin. Progestogen, a hormone that prevents pregnancy, is then released into the bloodstream.
- Intrauterine device (IUD) : is a small, T-shaped copper device that is surgically inserted into the uterus. It lasts up to 10 years.
- Insertion of IUD :
- The position and size of the womb are noted and checked for any infection.
- The cervix and vagina are thoroughly cleaned using an antiseptic.
- A Speculum is used to hold the vagina open.
- A tenaculum is then used to hold the cervix and uterus steady.
- The depth and position of the uterus are then measured.
- Slowly, the IUD is inserted into the uterus using an inserter.
- The string attached to the IUD is cut leaving a 3cm of thread hanging from the cervix.
After the procedure, the patient might have cramps similar to periods and vaginal bleeding, which is normal. However, the patient is advised to see the doctor if she has a high temperature, severe lower abdominal pain or smelly discharge.
- Removal of IUD : The doctor usually removes the IUD for the following cases:
- Patient wants to be pregnant.
- Replacement of device.
- The patient experiences a feeling of discomfort.
- Other side effects.
It is a simple birth control method where the strings attached to the IUD is grasped with the help of forceps. The device slides out when the arms of the IUD collapses.
In some cases, a method called hysteroscopy is performed if the device attaches itself to the uterine wall. This procedure may take longer to complete and the patient may require anesthesia.
Type II: Hormonal Contraception
This type of contraception is performed with the help of hormones to help in contraception. Some of the common methods used are:
- Oral contraceptive pill : It temporarily stops the release of an egg.
- Contraceptive Injection : like Depo-Provera, Sayana Press or Noristerat are injected into the bloodstream releasing progestogen that, in turn, prevents pregnancy.
- Vaginal ring (NuvaRing) : is a soft plastic that is placed inside the vagina. This device releases the hormones progestogen and estrogen into the bloodstream.
Type III: Barrier Methods
This birth control method usually uses barriers to help in the contraception process. Some of the barrier methods used are:
- Condoms : can be used by both male and female.
- Contraceptive diaphragm : This is a thin soft silicone cup, which is inserted into the vagina before sex.
Type VI: Permanent Contraception
This type of contraception, as the name suggests, is a permanent solution where the patient will not be able to conceive, once this method of contraception is performed. Some of the methods are:
- Tubectomy : It is a permanent method of preventing pregnancy. It is a surgical procedure where the eggs are prevented from reaching the sperm by sealing or blocking the fallopian tubes.
- Vasectomy : It is also a permanent surgical procedure performed on male patients to prevent pregnancy by sealing or cutting off the tubes that carry sperms.
Side Effects of Contraception
The patients, using oral contraceptive pills or hormone contraception, might suffer from the following side effects:
- Intermenstrual Spotting that occurs usually within the first 3 months of using the pills.
- Mild Nausea experienced usually when taking the pill for the first time, which subsides after a while.
- Breast Tenderness is a common side effect of pills.
- Headaches and migraines might increase due to the presence of hormones in these pills.
- Weight Gain is a common side effect of the pills.
- Mood Changes with an increased risk of depression.
- Missed Periods is another common side effect.
- Decreased Sex Drive can also occur due to the hormones in the pills.
- Changes in Vaginal Discharge can also occur.
- Eye Changes can occur due to the hormonal changes caused by the pill, leading to thickening of the cornea.