Birth control is essential in influencing family planning and improving reproductive health, particularly in a densely populated nation like India. It enables individuals and couples to make educated choices regarding their reproductive lives, equipping them with the necessary resources to avoid unplanned pregnancies and manage the timing and spacing of their children.
The significance of women's empowerment is widely recognized worldwide as a crucial strategy for reaching development objectives, including poverty alleviation, universal primary education, sustainable development, and ensuring access to healthcare for all. It is closely linked to improved utilisation of reproductive health services, contributing to reduced fertility rates, fewer unintended pregnancies, and longer intervals between births.
Understanding Birth Control and Its Role in Family Planning
Over the years, social scientists have examined the connection between demographic shifts and economic results, establishing that enhanced literacy and improved economic conditions for individuals contribute to lower birth rates. Conversely, reduced fertility rates positively influence economic growth.
Access to reliable contraceptive methods allows families to prepare more effectively for the financial, emotional, and physical aspects of welcoming new children. In India, where reproductive health and population management are critical issues, a comprehensive understanding of birth control is vital. Its implications extend beyond individual health, impacting societal and economic conditions as well.
The societal stigma associated with abortion forces women to seek unsafe procedures from unqualified practitioners. A study conducted in Bihar and Jharkhand in 2007-08 revealed that abortion providers in both public and private sectors preferred to offer abortion and counselling services to married women over unmarried ones. This practice of limiting access to abortion services based on marital status reflects the biases of providers against unmarried women, resulting in a high prevalence of unsafe abortions in the country.
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The challenges related to family planning and sexual and reproductive health stem from deeply ingrained social norms, which cannot be changed quickly.
Common types of Birth Control
Birth spacing significantly impacts health outcomes, such as decreasing malnutrition and promoting long-term well-being for both mothers and children. Availability of contraceptives facilitates the postponement, spacing, and limitation of pregnancies, which in turn reduces healthcare expenses. This access also enables more girls to finish their education and participate in the workforce, ultimately contributing to gender equality in professional environments.
The circumstances and requirements of each person can vary, making it unlikely that one approach will be appropriate for everyone. Taking into account personal preferences and medical requirements, the individual selects a method that best suits their needs. They can be classified as follows:
Permanent and Limiting Methods:
1. Male Sterilisation (Traditional and Non-Scalpel Vasectomy)
2. Female Sterilisation (Minilaparotomy and Laparoscopic Procedures)
Spacing Methods:
1. Oral Contraceptives – Combined Oral Contraceptive Pills (Mala-N), Centchroman Tablets (Chhaya)
2. Injectable Contraceptives – Medroxyprogesterone Acetate (MPA) (Antara Program)
3. Intrauterine Contraceptive Devices – Copper IUCD 375 and 380 A
4. Condoms (Nirodh)
Emergency Contraceptives:
1. Emergency Contraceptive Pills – Levonorgestrel Tablets (EZY Pill)
Condoms: Most preferred contraceptive
Condoms are a simple yet highly effective form of contraception when utilised properly and consistently. They are unique among contraceptive methods as they offer dual protection against unintended pregnancies and sexually transmitted infections. Additionally, condoms promote male participation in the prevention of unplanned pregnancies. The elevated failure rate associated with condoms is primarily attributed to improper usage, which often stems from insufficient guidance.
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Limitations on Condom Use -
1. Condoms are designed for single use only and must be disposed of after each sexual encounter.
2. It is essential to have an adequate supply of condoms accessible prior to engaging in sexual activity.
3. Some individuals may perceive that condoms diminish their sexual enjoyment.
4. Additionally, latex condoms can trigger itching in individuals with latex allergies.
Family Planning as Birth Control
Family Planning (FP) programs significantly influence women's health by ensuring universal access to sexual and reproductive healthcare services, along with essential counselling information. These programs are acknowledged as one of the most cost-effective strategies for promoting gender equality and equity, as they empower women with the knowledge and autonomy to make informed decisions regarding their bodies and reproductive options through the availability of contraceptive methods.
Advantages of Implementing Family Planning Methods:
1. Avoiding high-risk pregnancies, including unintended ones, contributes to the overall health of both mothers and infants.
2. A smaller family size allows for greater financial resources to be allocated per family member, enhancing spending on health, nutrition, and education, particularly for children.
3. Parents can dedicate more time to their work and family interactions.
4. Adolescents under 18 are in a critical stage of development and are especially susceptible to malnutrition. Pregnancy and breastfeeding can exacerbate this risk, potentially resulting in negative health outcomes for both.
Family Planning Counselling
In delivering family planning services, direct interaction between the individual and the counsellor is essential for addressing needs and serves as the foundation for high-quality care. Given the sensitive aspects of reproductive health and family planning, it is crucial to uphold the rights of users, ensuring privacy, confidentiality, respect, and dignity at all times. The choice to adopt a contraceptive method should be both voluntary and informed, with the user making the decision independently. It is the responsibility of the user to be fully informed and to freely choose and consent to the use of any contraceptive method.
The GATHER framework in counselling consists of the following steps:
G – Greet - Begin by greeting the individual with respect.
A – Ask - Inquire about their contraceptive requirements.
T – Tell - Provide information on various contraceptive options and methods available.
H – Help - Assist them in making informed decisions regarding their method choices.
E – Explain - Clarify and demonstrate the proper usage of the selected methods.
R – Return/ Refer - Ensure continuity by scheduling a follow-up visit and referring as necessary.
Counselling on healthy timing and spacing of pregnancy
Healthy Timing and Spacing of Pregnancy supports women and families in postponing and spacing pregnancies to ensure optimal health outcomes for women, newborns, infants, and children. Healthy timing is defined as having the first pregnancy between the ages of 18 and 35. Pregnancies occurring in teenagers or women over 35 years old are associated with increased risks of maternal and neonatal mortality and morbidity. Spacing pertains to the recommended interval a woman should observe after a live birth, abortion, or miscarriage before pursuing another pregnancy.
Role of Men in Family Planning
Family planning programs predominantly target women as the main users of contraceptives, while men are often relegated to the role of supportive partners. However, there is substantial evidence indicating that men are interested in engaging with existing programs. It is essential to enhance male involvement across all aspects of sexual and reproductive health and family planning, from using contraceptives themselves to supporting their partners in significant decisions, such as those related to abortion.
The responsibility for contraceptive decision-making should be shared equally between men and women, and programs must also address the needs of men. Family planning initiatives should tackle the beliefs, myths, and misconceptions that hinder male participation, as well as other obstacles that may prevent their active involvement. To achieve this, family planning programs should revise their communication strategies to include men as both facilitators and beneficiaries, thereby fostering a sense of shared responsibility.
Change in communication
The challenges related to family planning and sexual and reproductive health are rooted in entrenched social norms. Insufficient communication between partners is a significant concern. It is crucial to tackle sociocultural issues such as sex selection, early marriage, unintended pregnancies, domestic violence, and gender inequality. Enhancing interpersonal and spousal communication can greatly enhance the utilisation and sustainability of family planning methods.
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Use of Media to create Awareness
Media plays a crucial role in fostering impartial reporting and preventing unnecessary alarm regarding the introduction of new methods. It is essential to educate both users and service providers on all facets related to newly implemented methods to enhance their capabilities. Improved service provider training will directly benefit contraceptive users, as they will gain better and more precise access to information about different contraceptive options, empowering them to make well-informed decisions.
Community Health Work
Enhancing the skills of community health workers is crucial for effectively reaching underserved populations. Training for these frontline workers should encompass not only technical knowledge but also a strong focus on community mobilisation and counselling related to contraceptive technologies. It is essential to address the myths and misconceptions that exist within communities about modern contraceptive methods.
Conclusion
The effectiveness of India's family planning is the collaborative efforts of researchers, policymakers, service providers, and users, all of whom must contribute to ensuring equitable access to high-quality family planning services. Achieving this goal is a unified vision among essential stakeholders, including government entities, civil society organisations, and private sector providers. These groups must prioritise addressing the sexual and reproductive health needs of the youth and adolescents in the nation.
By familiarising the population with the various contraceptive options and taking proactive measures to enhance reproductive health, individuals can pave the way for healthier and more thoughtfully planned futures. Whether through counselling, selecting appropriate birth control methods, or utilising online therapy, individuals can take charge of their reproductive health, which is a powerful step towards empowerment.
Rocket Health India is dedicated to offering the necessary support, ranging from therapy to educational materials, enabling the individuals and couples to make well-informed choices regarding their reproductive health. Reach out to Rocket Health India for tailored online therapy and expert advice on family planning and contraceptive options.
References
Dhak B, Saggurti N, Ram F. (2020). Contraceptive use and its effect on Indian women's empowerment: evidence from the National Family Health Survey-4. J Biosoc Sci.;52(4):523-533. doi: 10.1017/S0021932019000609. Epub. PMID: 31599219. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31599219/
Muttreja P, & Singh S. (2018). Family planning in India: The way forward. Indian J Med Res.;148(Suppl):S1-S9. doi: 10.4103/ijmr.IJMR_2067_17. PMID: 30964076; PMCID: PMC6469373. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469373/
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