TEMPORARY METHOD OF BIRTH CONTRO

 STD-12      UNIT-6     CHA-4

REPRODUCTIVE HEALTH

TEMPORARY METHOD OF BIRTH CONTROL 

• Temporary methods are commonly used to postpone or to space births . 

Natural Methods . 

• These methods avoid meeting sperm and ovum . 
• Periodic absence or Rhythm Method ( temporary avoidance of sex ).
• It is one such method in which the couples avoid or abstain from coitus ( copulation or intercourse ) from day 10 to 17 of the menstural cycle because ovulation can occur during this period . 
• The chances of fertilisation are very high during this period , therefore , it is called the fertile period.
• This method is based on the following facts.
• ovulation occurs on about the 14th day of menstruation . 
• ovum remains alive for about 1-2 days . 
• sperms survive for about 3 days.
• The effectiveness of this method is limited because only a few women have regular menstrual cycles and the actual time of ovulation can not be produced as the ovulation in humans occurs about 14 days before the onset of the next menstruation.
• Coitus interruptus ( withdrawal method ).
• Male withdraws his penis from the vagina just before ejaculation to avoid insemination so that semen is carried outside the vagina.
• This method is only moderately effective because time of ejaculation is very pleasant specially for male.
• Some sperms may pass into the vagina before ejaculation.
• Lactational Amenorrhea Method - LAM ( absence of menstruation ) 
• There is no menstrual cycle , and therefore , ovulation does not occur during intense lactation following parturition . However , this method is effective only up to maximum period of six months after child birth.

Barrier Methods . 

• In these methods ovum and sperms do not meet due to barriers . Infact they prevent fertilization . 
• These methods are available for the males and the females which are as follows : 
• Condoms . Condoms are made of thin rubber / latex sheath used to cover the penis in the male or vagina and cervix in the female just before coitus ( intercourse ) so that the ejaculated semen is not released in the female reproductive tract.
• This prevents fertilization Nirodh ( Hindi name of Condom ) is popular brand of condom for the male.
• Nirodh also protects the user from STDs and AIDS.
• Both the male and female condoms are disposable Female condoms are known as femidoms.
• Diaphragms , Cervical Caps and Vaults . 
• These are also made of rubber , inserted into the female reproductive tract to cover the cervix before coitus.
• They must be left in place at least 6 hours after intercourse . 
• They prevent fertilization by blocking the entry of sperms through the cervix.
• These barriers are reusable. Spermicidal jellies , creams and foams are generally used along with these barriers to increase their efficiency . 
• Diaphragm . It is soft rubber cup that covers entrance to uterus.
• It prevents a sperm from reaching an egg ; and holds spermicide. There are no dangerous side effects.
• It is reliable if used properly.
• It provides some protection against sexually transmitted discases and cervical cancer .
• Cervical Cap . It is a miniature diaphragm that covers cervix closely.
• It prevents a sperm from reaching an egg and holds spermicide. 
• There is no dangerous side effects.
• It is fairly effective and can remain in place longer than diaphragm.
• Vault Cap . It is hemispheric dome like rubber or plastic cap with a thick rim which is meant for fitting over the vaginal vault over the cervix.

Chemical Methods ( Spermicides ) 

• Foam tablets , creams , jellies and pastes are inserted in the vagina before intercourse to prevent sperms from entering the uterus.
• These contain spermicides ( kill spermatozoa ) such as lactic acid , citric acid , boric acid , zinc sulphate and potassium permanganate.
• Sponge ( ' Today ' ) is a foam suppository or tablets containing nonoxynol as spermicide.
• Delfin is also available in the form of cream.
• They can be used by anyone who is not allergic to these spermicides . These are relatively unreliable.

Intrauterine Devices ( IUDs ) . 

• These devices are effective and popular methods . 
• IUDs are inserted by doctors or expert nurses in the uterus through vagina.
• These devices are presently available as the non - medicated IUDs ( e.g. , Lippes loop ) , copper releasing IUDs ( Cut , Cu7 , Multiload 375 ) and the hormone releasing IUDs ( Progestasert , LNG - 20 ) . 
• IUDs increase phagocytosis of sperms within the uterus and the Cu ions released suppress sperm motility and the fertilising capacity of sperms . 
• The hormone releasing IUDs , make the uterus unsuitable for implantation and the cervix hostile to the sperms.
• IUDs are ideal contraceptive methods used by the females.
• In India , it is one of most widely accepted methods of contraceptive .
• Some drawbacks of IUCDs ( also called IUDs = Intrauterine Devices ) are : 
• Their presence may act as a minor irritant and this makes the egg to move down the oviducts ( Fallopian tube ) and uterus before fertilization or implantation.
• Their spontaneous expulsion , even without the woman's knowledge . 
• They can cause excess menstrual bleeding and pain . 
• Risk of perforation of uterus.
• Tubulal pregnancy in plantation of embryo in the oviduct ( Fallopian tube)
• Risk of infection . This device is not recommended for those who eventually intend to conceive.

Oral Contraceptive Pills ( Oral Pills ) . 

• They are used in the form of tablets , there fore , they are called ' pills ' . Pills have to be taken daily for 21 days starting within the first five days of menstrual cycle . 
• After a gap of 7 days ( during which menstruation occurs ) it has to be repeated . 
• They inhibit ovulation and implantation . Pills are very effective with lesser side effects . 

Hormonal pills act in four ways . 

• Inhibition of ovulation . 
• Inhibition of motility and secretory activity of oviducts ( Fallopian tubes ) 
• Changes in cervical mucus impairing its ability to allow passage and transport of sperms . 
• Alteration in uterine endometrium to make it unsuitable for implantation.
• Types of Oral Contraceptive Pills . 
• They contain either progestin ( = progestogen = progesterone ) alone or a combination of progestogen and oestrogen ( = estrogen ) . 
• Thus oral contraceptive pills are of two types : mini pills and combined pills . 
• Mini Pills . They contain progestin only ( with no oestrogen ) " Saheli " contains a non - steroidal preparation called centchroman which is taken once in a week after an initial intake of twice a week dose for 3 months.
• It has high contraceptive value with very little side effects 
• Saheli contraceptive pill has been developed at Central Drug Research Institue ( CDRI ) , Lucknow . 
• Combined Pills . They are most commonly used oral contraceptive pills. 
• They contain synthetic progesterone and oestrogen to check ovulation.
• Pill Mala D and Mala N are commonly used combined contraceptive pill. 
• They are taken daily without break.
• Oral contraceptive pills increase the risk of intravascular clotting
• Therefore , they are not recommended for women with a history of disorders of blood clotting , cerebral blood vessel damage , hypertension , liver malfunction , heart disease , or cancer of the breast or reproduc  

Horinone Injections ( Depo - Provera ) . 

• These are progesterone derivative injections.
• Injection is given once every 3 months, that releases a hormone slowly and prevents ov lation. 
• They are convenient and highly effective with no serious side effects. There is occasional heavy menstrual bleeding.

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