Population explosion and birth control
Increased health facilities and better living conditions have enhanced longevity. According to a recent report from the UN, India’s population has already reached 1.26 billion and is expected to become the largest country in population size, surpassing China around 2022. To overcome the problem of population explosion, birth control is the only available solution. People should be motivated to have smaller families by using various contraceptive devices. Advertisements by the Government in the media as well as posters/bills, etc., with a slogan -Naam iruvar namakku iruvar- (we two, ours two) and -Naam iruvar namakku oruvar- (we two, ours one) have also motivated to control population growth in Tamilnadu. Statutory rising of marriageable age of the female to 18 years and that of males to 21 years and incentives given to couples with small families are the other measures taken to control population growth in our country.
Birth control methods
The voluntary use of contraceptive procedures to prevent fertilization or prevent implantation of a fertilized egg in the uterus is termed as birth control. An ideal contraceptive should be user friendly, easily available, with least side effects and should not interfere with sexual drive. The contraceptive methods are of two types – temporary and permanent. Natural, chemical, mechanical and hormonal barrier methods are the temporary birth control methods.
1. Natural method is used to prevent meeting of sperm with ovum. i.e., Rhythm method (safe period), coitus interruptus, continuous abstinence and lactational amenorrhoea.
a. Periodic abstinence/rhythm method Ovulation occurs at about the 14th day of the menstrual cycle. Ovum survives for about two days and sperm remains alive for about 72 hours in the female reproductive tract. Coitus is to be avoided during this time.
b. Continuous abstinence is the simplest and most reliable way to avoid pregnancy is not to have coitus for a defined period that facilitates conception.
c. Coitus interruptus is the oldest family planning method. The male partner withdraws his penis before ejaculation, thereby preventing deposition of semen into the vagina.
d. Lactational amenorrhoea Menstrual cycles resume as early as 6 to 8 weeks from parturition. However, the reappearance of normal ovarian cycles may be delayed for six months during breast- feeding. This delay in ovarian cycles is called lactational amenorrhoea. It serves as a natural, but an unreliable form of birth control. Suckling by the baby during breast-feeding stimulates the pituitary to secrete increased prolactin hormone in order to increase milk production. This high prolactin concentration in the mother’s blood may prevent menstrual cycle by suppressing the release of GnRH (Gonadotropin Releasing Hormone) from hypothalamus and gonadotropin secretion from the pituitary.
2. Barrier methods In these methods, the ovum and sperm are prevented from meeting so that fertilization does not occur.
a. Chemical barrier Foaming tablets, melting suppositories, jellies and creams are used as chemical agents that inactivate the sperms in the vagina.
b. Mechanical barrier Condoms are a thin sheath used to cover the penis in male whereas in female it is used to cover vagina and cervix just before coitus so as to prevent the entry of ejaculated semen into the female reproductive tract. This can prevent conception. Condoms should be discarded after a single use. Condom also safeguards the user from AIDS and STDs. Condoms are made of polyurethane, latex and lambskin.
Diaphragms, cervical caps and vaults are made of rubber and are inserted into the female reproductive tract to cover the cervix before coitus in order to prevent the sperms from entering the uterus.
c. Hormonal barrier
It prevents the ovaries from releasing the ova and thickens the cervical fluid which keeps the sperm away from ovum.
Oral contraceptives —
Pills are used to prevent ovulation by inhibiting the secretion of FSH and LH hormones. A combined pill is the most commonly used birth control pill. It contains synthetic progesterone and estrogen hormones. Saheli, contraceptive pill by Central Drug Research Institute (CDRI) in Lucknow, India contains a non-steroidal preparation called Centchroman.
d. Intrauterine Devices
(IUDs) Intrauterine devices are inserted by medical experts in the uterus through the vagina. These devices are available as copper releasing IUDs, hormone releasing IUDs and non-medicated IUDs. IUDs increase phagocytosis of sperm within the uterus. IUDs are the ideal contraceptives for females who want to delay pregnancy. It is one of the popular methods of contraception in India and has a success rate of 95 to 99%. Copper releasing IUDs differ from each other by the amount of copper. Copper IUDs such as Cu T-380 A, Nova T, Cu 7, Cu T 380 Ag, Multiload 375, etc. release free copper and copper salts into the uterus and suppress sperm motility. They can remain in the uterus for five to ten years.
Hormone-releasing IUDs such as Progestasert and LNG – 20 are often called as intrauterine systems (IUS). They increase the viscosity of the cervical mucus and thereby prevent sperms from entering the cervix.
Non-medicated IUDs are made of plastic or stainless steel. Lippes loop is a double S-shaped plastic device.
3. Permanent birth control methods are adopted by the individuals who do not want to have any more children.
Surgical sterilisation methods are the permanent contraception methods advised for male and female partners to prevent any more pregnancies. It blocks the transport of the gametes and prevents conception. Tubectomy is the surgical sterilisation in women. In this procedure, a small portion of both fallopian tubes are cut and tied up through a small incision in the abdomen or through vagina. This prevents fertilization as well as the entry of the egg into the uterus. Vasectomy is the surgical procedure for male sterilisation. In this procedure, both vas deferens are cut and tied through a small incision on the scrotum to prevent the entry of sperm into the urethra. Vasectomy prevents sperm from heading off to penis as the discharge has no sperms in it.