What is contraception?
Birth control pills regulate hormones to prevent pregnancy, but behavioral methods rely on timing and changes to sexual behavior.
Contraception, commonly known as birth control, is the adoption of preventive measures to avoid pregnancy. Contraception techniques prevent the sperm from fertilizing the egg (ovum) and forming a fetus in the uterus.
So-called “natural” methods rely on behavioral and scheduling changes in your sex life, predicated on exceptional self-control skills. For these reasons, behavioral methods of birth control are the least effective available, according to the U.S. Centers for Disease Control.
What is the importance of contraception?
Voluntary birth control has become globally significant with the rapid increase in population. Contraception helps prevent the risk of unsafe abortions due to unwanted pregnancies. Effective control over reproduction may also contribute to a woman’s physical and mental well-being, and her ability to pursue her personal goals.
What are the different types of contraception?
For centuries, people have tried various methods to avoid pregnancy after vaginal intercourse. For example, Egyptologists translated a vaginal pessary contraception recipe from 1850 BCE including crocodile dung and fermented dough. Contraception has evolved to be less dangerous and more effective since then, falling into five primary categories:
- Natural methods: These involve behavioral adaptations and periodic abstinence.
- Mechanical barriers: The use of physical barriers such as condoms to prevent the sperm from reaching the ovum.
- Hormonal methods: This technique involves the use of hormones by the woman to:
- Prevent the release of egg from the ovary.
- Thicken the mucus around the cervix to prevent sperm entry.
- Thin the uterus lining (endometrium) preventing the fertilized egg’s attachment to it.
- Intrauterine devices: Intrauterine devices are implanted inside the uterus and work by releasing small amounts of hormones or by triggering the immune system to make the environment hostile to the sperm and the fertilized egg.
- Permanent contraception: This method involves a minor surgical procedure to
- Sever the fallopian tubes in women to prevent the mature eggs from reaching the uterus.
- Sever the vas deferens in men to prevent the sperm from getting into the semen.
What are the natural contraception methods?
Natural contraception methods are perhaps the safest way of avoiding pregnancy, but involve periodic abstinence. It requires consistent self-control and some of the methods have a high failure rate. Advantages of natural contraception are:
- No need of any devices
- No costs
- No hormonal or surgical interference with the body
There are three types of natural contraception:
Coitus interruptus
Coitus interruptus is the technique of withdrawing the penis from the vagina before ejaculation.
- Efficacy: Efficacy depends on the man’s capability to withdraw in time. Failure rates are approximately 4% in the first year with perfect use and 22% in typical use.
- Advantages:
- Can be practiced any time.
- Theoretical reduction of the risk of transmission of sexually transmitted diseases (STDs)
- Disadvantages: It requires perfect awareness and enormous self-control.
Lactational amenorrhea
Vaginal intercourse may not result in pregnancy for about six months after the birth of a child, while the mother breastfeeds the baby and is yet to start periods. This method of contraception requires:
Breastfeeding the baby in four-hour cycles during the day and six-hour cycles during the night.
Avoidance of other supplemental food and formula milk for the baby.
During lactation, the body naturally suppresses ovulation by reducing the levels of luteinizing hormone, which helps in egg maturation and release. The period of ovulation absence depends on the frequency and duration of breastfeeding, and the length of time after childbirth.
Efficacy: Failure rate is 0.5% with perfect use and 2% with typical use in the first 6 months after childbirth.
Advantages:
- Uterus involution (return to normal size) is rapid.
- Suppresses menstruation.
- Helps with postpartum weight loss.
Disadvantages:
- Time of fertility return is uncertain.
- Frequent breastfeeding without other supplements may be difficult.
- This method cannot be used if the mother has human immunodeficiency virus (HIV) infection.
Natural family planning
Natural family planning requires periodic abstinence from sexual intercourse during the woman’s fertile period, when ovulation occurs. The fertile period is calculated by three methods:
- Calendar method: Ovulation usually occurs 12 to 16 days before the next period. The abstinence period is 18 to 11 days before the forthcoming period, based on the assumption that the ovum and sperm are viable for 24 and 48 hours, respectively.
- Cervical mucus method: This method is an attempt to quantify the cervical mucus discharge, which increases during ovulation.
- Symptothermal method: The woman’s basal temperature is relatively lower before the egg matures and rises 0.2-0.5 C after ovulation. Temperature rise after ovulation indicates the end of fertility period.
A combination of the above three methods may be required to predict the fertility period, after first recording about six menstrual cycles to calculate the approximate ovulation time.
Efficacy: The failure rate in typical use is about 25%.
Advantages: For certain couples, this may be the only method available for cultural or religious reasons.
Disadvantages:
- Suitable only for women with regular and predictable cycles.
- Requires complete abstinence during ovulation.