Population Stabilisation and Birth Control

Birth control measures:

1. The birth control measures which deliberately prevent fertilization are referred to as contraceptives.
2. The contraceptive methods help to prevent unwanted pregnancies. An ideal contraceptive should be easily available, user friendly, effective and with no or least side effects. 
3. Statutory raising of the marriageable age of the female to 18 years and that of males to 21 years.
4. Small-family couples should be offered some incentives. 
5. Aware people about the slogan of “Hum Do Hamare Do”.
6. Many couples, mostly the young, urban, working ones have even adopted a ‘one child norm’.
7. Birth control is an important step toward population control since it encourages smaller families to use contraceptive techniques.

• An ideal contraceptive should be simple to use, easily accessible, effective, and reversible, with no or few negative effects.
• It should also not interfere with the user's sexual drive, desire, or sexual deed.
• There are numerous contraceptive techniques available today, which can be broadly classified as Natural/Traditional, Barrier, IUDs, Oral contraceptives, Injectables, Implants, and Surgical procedures. 

1. Natural/Traditional methods: Natural approaches are based on the premise of minimizing the possibility of ovum and sperm contact. In this method of birth control, the side effects are almost nil and the chances of failure are high.
   a) Period abstinence: Periodic abstinence is one such strategy in which couples avoid or abstain from coitus between days 10 and 17 of the menstrual cycle when ovulation is predicted. The fertile period is so named because the possibilities of fertilization are so great during this time. As a result, by abstaining from coitus during this time, conception could be avoided.
   
   b) Withdrawal or coitus interrupts: Another approach is withdrawal, or coitus interruptus, in which the male partner withdraws his penis from the vagina immediately before ejaculation to avoid fertilization.
   
   c) Lactational amenorrhea: The lactational amenorrhea (absence of menstruation) technique is based on the fact that ovulation and hence the cycle do not occur during the postpartum phase of strong lactation. Fully breastfeeding increases lactation. This method helps to prevent conception. This is effective up to 6 months following parturition. Because no medications or equipment are used in these approaches, negative effects are virtually non-existent. This approach, however, has a significant failure rate.

2. Barrier methods:
   Ovum and sperms are prevented from physically meeting with the help of barriers and it is also available for both males and females.
   a) Condoms: Condoms are mechanical barriers made of thin rubber or latex sheath to cover the penis in males or vaginas and cervix in females which prevent the meeting of sperm and ova. Condoms also provide protection against sexually transmitted diseases. They are disposable and can be self-inserted and thereby giving privacy to the user. 
   

   Condom for male

   Condom for female

   
   b) Diaphragms, cervical caps, and vaults:  Diaphragms, cervical caps, and vaults are also rubber barriers put into the female reproductive tract to shield the cervix during coitus. They hinder pregnancy by preventing sperm entrance via the cervix. They can be reused. Spermicidal lotions, jellies, and foams are commonly used in conjunction with these barriers to improve their contraceptive effectiveness. 
   
   c) Intra Uterine Devices (IUDs): Intra Uterine devices are inserted by doctors or expert nurses in the uterus through the vagina. These Intra Uterine Devices are presently available as the non-medicated IUDs (e.g., Lippes loop), copper releasing IUDs (CuT, Cu7, Multiload 375), and hormone releasing IUDs (Progestasert, LNG-20). IUDs increase phagocytosis of sperms within the uterus and the Cu ions released suppress sperm motility and the fertilizing capacity of sperms. The hormone releasing IUDs, in addition, make the uterus unsuitable for implantation and the cervix hostile to the sperms. IUDs are ideal contraceptives for females who want to delay pregnancy and/or space children. It is one of the most widely accepted methods of contraception in India.
   i) Non-medicated IUDs: Non-medicated IUDs retards sperm mortality. Also, have a spermicidal effect. Example - Lippes's loop
   

   Lippes's loop

   
   ii) Copper releasing IUDs: Copper releasing IUDs suppress mortality and fertilizing capacity of sperms. Examples - CuT, Cu7, Multiload 375.
   

   Copper T (CuT)

   
   iii) Hormone-releasing IUDs: Hormone-releasing IUDs are currently available. They make the uterus unsuitable for implantation and the cervix hostile to the sperms. Examples - Progestasert, LNG-20.
   

   Hormone-releasing IUDs

3. Chemical methods:
   a) Oral contraceptives: Females also employ oral administration of tiny dosages of progestogens or progestogen–estrogen combos as a contraceptive technique. They are commonly referred to as pills since they are administered in the shape of tablets. Pills must be taken daily for 21 days, particularly within the first five days of the menstrual cycle. After a 7-day break (during which menstruation occurs), the process must be repeated until the female chooses to avoid conception. They hinder or delay sperm entry by inhibiting ovulation and implantation and altering the quality of cervical mucus. Pills are quite effective, have few adverse effects, and are well accepted by E.g., Saheli–the new oral contraceptive for females contains a non-steroidal preparation. It is a ‘once a week’ pill with very few side effects and a high contraceptive value.
   

   Oral contraceptive pills

   
   b) Injectables and Implants: Females can utilize progestogens alone or in combination with oestrogen as injections or skin implants. Their mechanism of action is similar to that of pills, but their effective periods are significantly longer. Progestogens, progestogen-estrogen combos, or IUDs administered within 72 hours following coitus have been found to be particularly successful as emergency contraceptives, as they can be used to avoid possible pregnancy due to rape or casual unprotected intercourse. 
   

   Implants

   
   
4. Surgical Methods (Sterilization): Surgical intervention stops gamete transit, preventing conception. Very effective but reversibility is very poor.  
   a) Vasectomy: Sterilization procedure in males. In vasectomy, a small part of the vas
   deferens is removed or tied up through a small incision on the scrotum.
   

   Vasectomy

   b) Tubectomy: Sterilization procedure in females. In this, a small part of the fallopian tube is removed or tied up through a small incision in the abdomen or through the vagina. 
   

   Tubectomy

   It should be emphasised that choosing a proper contraceptive method and using it should always be done in conjunction with trained medical specialists. It is also important to realise that contraception is not a regular requirement for maintaining reproductive health. In fact, they are used to counteract a natural reproductive occurrence, namely conception/pregnancy. Due to personal circumstances, one is forced to adopt these treatments either to prevent pregnancy or to delay or space pregnancy. 
   

   Side effects of anti-natural contraceptives: Nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding, Breast Cancer, etc. Though not very significant, should not be totally ignored.