Making the decision on contraceptive options

All Woman

MEN and women rely on birth control to enjoy a tension-free sex life without having to worry about becoming pregnant at an inconvenient time. And while most couples go for temporary contraceptive methods which allow for pregnancy after discontinuance, others who do not want to have children in the future opt for more permanent solutions.

According to obstetrician-gynaecologist at Gynae Associates Dr Daryl Daley, contraceptives encapsulate all forms of birth control, including short-term, long-term and sterilisation, which is a permanent method that surgically removes the body's ability to reproduce.

“Contraceptives are a way of temporarily or permanently preventing pregnancy. There are a variety of contraceptive options that you can choose from, depending on your needs or what you believe is the most suitable option for you. Regardless of the one that you choose, it is important to get adequate medical advice and counselling,” Dr Daley said.

He explained that each option has its own advantages and disadvantages, and more often than not doctors recommend long-term contraceptives, except in special circumstances.

“With sterilisation being 99 per cent permanent, the next best thing is long-acting reversible contraception (LARC). Long-acting means they last more than 3 months, and pregnancy can result when you stop taking them. Examples of these include the Mirena which lasts for five years, the Copper T IUD, which lasts for 10 years, the Jadelle implant which lasts for five years, and the Depo-Provera injection which lasts for three months,” Dr Daley said.

He said that even birth control pills, once taken properly, can be considered long-acting because their effect lasts more than a month.

On the flip side, Dr Daley said that sterilisation, which in the case of women is done by way of tubal occlusion, is done by tying off the tubes and cutting them, through classic open surgery or laparoscopic surgery.

In the past Dr Daley said that this procedure would have been reserved for older women who decided that they did not want any more children; however, other factors also qualify you for sterilisation, such as health conditions that would be affected by pregnancy.

“In all honesty, once the mother has completed childbearing years and is confident that she is ready, then I would give it to her. For example, a 24-year-old having three children and requesting sterilisation, I would oblige certainly, following counselling. On the contrary, if an 18-year-old comes to me with just one child, I would have reservations and I would counsel her, but if she is mentally stable and is certain that she wants to have her tubes tied and signs the consent form, then I would just have to go through with it,” Dr Daley reasoned.

Dr Daley said one crucial step that should never be overlooked with patients who request sterilisation is counselling. This, he argues, could save many women and families future heartbreak, drawing reference to a number of women who have desperately sought his help to have their tubes untied. However, this procedure is irreversible in most cases.

“It is very important, especially in the case of younger women, that they consider all the LARC options available. We see too many women, when they find a husband, running back because their husband wants a child/children. So I usually say to my patients, I know you want to tie your tubes, but here is another option that is just as effective.”

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