Birth control methods

Birth control is the spacing or preventing of pregnancies.

1. Birth control methods

2. Introuction Population growth is steadily increasing in a geometric proportion. The population can be controlled either by decreasing the number of births or increasing the number of deaths. Developing medical sciences and human law do not permit the increased death-rate. Only way to control the growth of population is reduced the number of births. Best way to reduce birth is preventing fusion of sperms and eggs(fertilization) that refers the prevention of pregnancies or birth control.

3. Definition Birth control is the spacing or preventing of pregnancies.

4. Necessity for birth control To maintain an economic standard To maintain healthy family To avoid lack of accommodation For better care and education of children. To avoid lack of food In some cases pregnancy may be a thread to the health of the mother Temporary postponement may be advisable after an operation or debilitating illness.

5. Types of birth control Intra Uterine Contraceptive Devices(IUCD) Hormonal control Surgical method Physical barriers

6. Types of birth control

7. Intra Uterine Contraceptive Devices(IUCD) Inserted inside the uterus that prevent fertilization and conception Recommended by national Family Welfare programme (NFWP) in India. 1. Copper-T 2.Lippes loop

8. Copper-T It is T-shaped. It has a horizontal arm and a vertical stem. It is made of polyethylene plastic material. A copper wire is wrapped around the stem of the device.

9. Before insertion, the women are subjected to carefully, thorough, general and pelvic medical examination. Inserted into the uterus through the vagina with the help of syringe. Since copper can dissolve slowly, the copper-T device may be replaced every 3 to 5 years.

10. Advantages of Copper-T: Smaller in size and therefore easier for insertion Low expulsion rate Less pain and bleeding Greater effectiveness Prevents fertilization and implantation

11. Lippes Loop Simply called as a “loop”. It is a double S-shaped, plastic device, made of polyethylene. It has attached threads or tails made of nylon. The loop contains a small amount of barium. It is inserted into the uterus through the vagina with the help of a syringe It is of different sizes.

12. Time of insertion of IUCD Best time-3 and 7 days of the menstrual cycle. Side effects: Backache Lower abdominal pain Inter- rmenstrual bleeding Spotting

13. Advantages Low failure rate Inexpensive Suitable for women who are breast-feeding One time method, and it requires on attention after insertion Reversible It is esthetic No hospitalization is required Reliable method for spacing child births.

14. Disadvantages: May be painful when inserted or removed Most IUCD are associated either with inter- menstrual bleeding or spotting in the first 3 months.

15. Hormonal method of birth control

16. Hormonal method of birth control Pregnancy can be prevented by suppressing ovulation. Contains concentrations of progesterone and low concentrations of oestrogen . They prevent ovulation.

17. The hormones may be taken by the following routes: Oral taken by mouth Injected under the skin Implanted into the body tissue Absorbed from a patch on the skin Placed in the vagina

18. Hormonal methods of birth control: Pills Injections Implants Patch Vaginal ring

19. Contraceptive pills Taken by orally. Two types: Combination pills Mini pills

20. Combination pills Contains the hormones oestrogen and progestin. Eg : Mala D Tablet Containing 50 microgram of ethinyl estradiol (synthetic estrogen) and levonrgestrel (progestin). Each packet has 21 pills. Mode of action: preventing the release of egg (ovulation) and affecting sperm movement in the womb to prevent its union with the egg. It also changes the lining of the womb and renders it unsuitable for pregnancy. 98% effective

21. Mini pills Mini pills contain progestin only(progestin-only oral contraceptives (POPs). Not contain estrogen. Packets of 28 pills. A pill is taken every day to prevent pregnancy Not reduce the milk production Can be taken from 6 th week after child birth.

22. Contraceptive injections Two types of contraceptive injections or hormones. Depo-provera Lunelle

23. Depo-provera Depo-provera is a trade name for Depot Medroxy Progesterone Acetate(DMPA). It is a contraceptive injection. It is similar to minipills in containing only progesterone. It is injected in the upper arm of women once in three months to prevent pregnancy. DMPA does not disturb the previous conception but prevent fertilization. It can be taken at any age of the women. The injection prevents ovulation and thickens cervical mucus. 99% effective

24. Lunelle Lunelle is a contraceptive injection. It is a combination of oestrogen and progesterone. It is administered monthly. It prevent ovulation and thickens cervical mucus. 99% effective

25. Contraceptive implants Norplant is a long hard capsule containing norethindrone enanthate which is a synthetic progestin. Six capsule in the set. They are silicone rubber rods about the size of matchsticks. Surgically implanted just below the skin in the upper arm of women. Effective up to 5 years. 99.5% effective NOLONGER AVAILABLE NOW.

26. Implanon system It is replaced by implanon system. Uses a single rod Progestin desogastrel is used as the hormone source. Provides 3 years of contraception.

27. Contraceptive patch A patch is a thin plastic patch like a bandaid that can be placed on the skin of the buttocks, stomach upper outer arm or upper torso. The trade name is ortho evra . The patch is changed each week for a schedule of 3 weeks on and 1 week off.

28. It is slowly releasing a combination of hormones estrogen and progestin through the skin. These hormones prevent ovulation and thicken the cervical mucous and creating a barrier to prevent the sperm from entering the uterus.

29. Surgical methods

30. Surgical methods It is some sort of operation done in the reproductive system of male and female, to prevent fertilizations. It includes Female sterilization( Tubectomy ) Male sterilization (Vasectomy)

31. Tubectomy It is a surgical operation in female genital organs. The fallopian tubes are cut ends are made into knots.

32. Female sterilization Female sterilization involves cutting and tying off the fallopian tube. When sterilization is performed 1-3mdays after delivery, it is known as post-partum sterilization A) Traditional tubectomy B)Mini-lap operation C) Laparoscopy

33. A) Traditional tubectomy An abdominal operation in which a small piece of each fallopian tube is removed and ligated . The operation is done under general or spinal anesthesia. Hospitalization is required for 5 to 7 days.

34. B)Mini-lap operation It is a modification of the traditional tubectomy . It is a simpler procedure. It requires a small supra-pubic incision of 2.5 to 3cm just above the pubic hair. The fallopian tubes are cut and the ends are blocked. Then the incision is closed.

35. C) Laparoscopy This is more sophisticated operation. The abdomen is first inflated with gas(carbon momoxide , nitrogen or air) to push away the intestine from the site of operation. Advantages: The short operation time Shorter stay in the hospital The formation of small scar’s

36. Male Sterilization (Vasectomy) It is a surgical operation done in the male. The vasadeferens is cut on the sides of testis. The cut ends are made into knots . Advantages: Very effective mothod of contraception A very safe procedure No long-term side effects Does not interrupt sexual behavior Does not require hospitalization

37. Physical barriers

38. Condom or sheath Male reproductive organ(penis) is completely covered by a rubber sheath during intercourse. It prevents ejaculation into the vagina. The rubber sheath may be thin(condom) or thick (washable sheath).

39. Occlusive diaphragms These are ready made rubber or plastic diaphragms which can be placed over cervix uteri. The diaphragms are cup-shaped or dome-shaped. Placed in the cervix uteri it prevents the entry of spermatozoa into the cervical canal and thus prevents fertilization.

40. Vaginal ring Vaginal ring is a ring-shaped device containing progestin. Eg : Nuva Ring (trade name) Flexible ring about two inches in diameter. Once a month, the ring is inserted into the upper part of the vagina where it slowly releases the hormone.

41. Mode of action: The hormone inhibits the monthly release of an egg(ovulation) by the ovaries and changes the mucous produced by the cervix, slowing or preventing the movement of sperm. It will remain there for three weeks. 99% effective.

42. Total abstinence Conception is prevented when the couple abstains from inter course.

43. Abstinence during fertile period Ovulation occurs on the 14 th day of the cycle. The spermatozoa deposited in the female genital tract may survive for three days. Ovum after release will be alive for one day. If there is intercourse between the 9 th day and the 17 th day-pregnancy is possible. 9 th to 17 th day of menstrual cycle is called danger period. I st o 8 th and 18 th to 28 th – constitute safe period

44. Spermicidal substances in the vagina Chemical which kill or immobilize spermatozoa. These chemicals immobilize the spermatozoa deposited into the vagina.

45. Douching Douching is the practice of washing or flushing the vagina with water or other fluids. Vaginal douches are available as prepackaged mixes, most commonly involving water mixed with vinegar, baking soda, or iodine.

46. Altering cervical mucous The motility of the sperm in the cervical canal is accelerated by the cervical mucous. The chemical in use is chlormadinone acetate.

47. Abortion Abortion is the expulsion of conception products from the uterus. It is done by a physician. It is a birth control method and should done before 20 th week of gestation. MTP-Medical Termination of pregnancy D and C- Dilation and Surgical curettage.

48. Gamete specific antigen antibody mediated termination of pregnancy Department of Biotechnology(DBT) and Indian Council of Medical Research (ICMR) developed anti-fertility vaccines for men and women. BCG(Beta Chorionic Gonadotrophin )- female anti fertility vaccine(in 2 nd phase of clinical trial in India). OFSH vaccine(Ovine follicle stimulating hormone)- to control sperm development in man.(1 st phase of clinical trial)

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