[Hey Ladies!]...Introduction to contraception

Contraception is the use of any of the various methods to prevent pregnancy; while family planning is the use of conception or other measures to limit the number of children and plan the timing and spacing of birth.

The practice of conception is as old as human existence. As far back as 1550 BC, an Egytian manuscript called “Ebers Papyrus” directed women on how to mix dates, acacia and honey into paste, smear it over wool and use as vaginal pessary to prevent conception.

Also, the ancients also used sheep bladder as condom, and half a lemon as a makeshift cervical cap. The also used pessary of crocodile dung and fermented dough. All these vaginal pessaries created a hostile envrionment for sperm cells and hence, prevented conception.

Soranus of Ephesus created a highly acidic concoction of fruits, nuts and wool that were placed at the cervical (entrance of the womb), serving as spermicide.

Continue after the cut....

However, most of these acient contraceptive techniques were ineffective and they were associated with serious complications, especially severe infections of the female reproductive system.

Control of fertility is very essential for national growth and development. Most developing countries currently facing the crisis of rapid population growth have begun to see the threatened human survival. The world population will be double in 40 years, analysts say, while poor nations with poor socio-economic growth will double their population in less than 20 years.

Good child spacing and effective control of reproduction are essential to women’s ability to achieve their individual goals and to achieve a sense of well-being.

The choice of contraception method takes into account factors such as efficacy, safety, benefits, cost and personal consideration. Various methods are available now and they include behavioural methods, barrier methods, spermicides, hormonal methods, permanent methods, emergency conception, etc.

Behavioural methods include abstinence, coitus interruptus and natural methods.

Abstinence is complete refraining from sexual intercourse, with no side effect if followed totally. Its efficacy is 100 per cent, with no risk of sexually transmitted diseases. Women who abstain totally till their 20s or before marriage have less chance of contacting sexually transmitted infection, less cases of infertility, and less chance of cervical cancer. It is a method that costs nothing.

Coitus interruptus is the total withdrawal of the penis from the vagina before the man ejaculates. This will prevent fertilisation because there is no sperm to fertilise the egg. Failure rate in the first year of use is about four per cent. Coitus interruptus has the advantage of no cost, as no device is used; but the man must be disciplined enough to withdraw at the appropriate stage of sexual intercourse.

Natural family planning is one of the most widely used methods and is well accepted by some religious and cultural beliefs. No drugs or devices are needed. It involves periodic abstinence from sexual intercourse. Couples avoid sex during the time the woman has  the highest chance of getting pregnant (ovulation).

Body temperature chart and cervical mucus changes are also used. This is called symptothermal method. The woman’s waking temperature before coming out of bed (basal body temperature) is taken. The method breaks the woman’s monthly cycle into three phases — Phase 1: Pre-ovulation (before the release of egg, beginning with the first day of the cycle. Phase II: This the fertile period, when eggs are released and pregnancy can occur. Phase III comes after the fertile period.

The basal body temperature of a woman is relatively lower in the first half of the menstrual cycle, which is the follicular phase. But this rises in the second half; thus, due to the thermogenic (heat production) effect of the dominant hormones called protesgerone, the temperature can vary between 0.20C to 0.50C. The higher temperature begins one to two days after the release of egg. Sexual intercourse can resume three days after the rise in basal body temperature.

Also, monitoring of cervical mucus can be done when the woman examines her cervical mucus with her fingers. Sexual intercourse is allowed four days after the maximal cervical mucus, coinciding with the rise in basal body temperature until the onset of menses.

The method has no harmful effect, with no side effect of any medication because no medication is used. It is accepted by most religious groups. Also, it is culturally accepted in many countries.

One of the setbacks of this method is that the cycle must be regular. Abstinence during the Phase II fertile period must be total. The method does not protect against sexually transmitted infection, though.

Other methods of periodic abstinence include rhythm or calendar methods. Here, couples decide on when to avoid sexual intercourse based on calendar calculation for the past six menstrual cycles. The method may fail because of variation in menstrual cycle. It’s not as reliable as symptothermal method.

Lactation amenorrhea method can also be adopted. After child delivery, a breast-feeding mother does not see her period and may not get pregnant. For this method to be effective, breast-feeding must be exclusive, there must not be menstruation during the period, and it must not be used for more than six months.

There is elevation of the hormone prolactin. There is also reduction in other hormones from the brain. All these lead to suppression of ovulation. The duration of this suppression of ovulation varies. And as soon as the first menses comes, other methods of conception must be used.

The failure rate within six months is 0.5 per cent. Unfortunately, exclusive breast-feeding may not be convenient for all women and the method cannot be suitable for mothers living with HIV/AIDS.

To be continued.

- Samuel Adebayo(dayspringsk05@yahoo.com)

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