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As most Indian women hesitate to discuss sex and sexual health, misconceptions about contraception abounds in India. Let’s bust some myths!
By Dr. Lakshmi Ananth
Urmila Rao*, 26, is reluctant to use the pill. She knows it is best suited to her birth control needs, but she has seen her sister gain weight with its use and is afraid of the same thing happening to her. Seema K.*, 25, on the other hand, has been using the pill for over a year now but has recently begun to have doubts. She has heard that prolonged use of oral contraceptives can later make it very difficult to get pregnant. Radhika Sriram*, 23, is certain that she will never remember to take her pills regularly, but has a lot of misgivings about alternative methods and is really confused about choosing one.
These are not uncommon situations. At a time when contraception is an accepted part of life, when there are so many options available that we are actually spoilt for choice, the reality is that many people are just confused. With an abundance of myths surrounding the subject, many couples make birth control decisions based on false beliefs and misinformation.
Dr. Shubha Dwarak, senior consultant gynaecologist, agrees. “Ignorance or, in many cases, incomplete knowledge, anecdotal evidence and hearsay are the reasons for the existence of these myths.” A lot of people get their information from peers, friends or the internet. She adds, “Somebody who forgets to take her pill regularly and gets pregnant is likely to tell her friends it doesn’t work.”
So, do oral contraceptives cause one to gain weight? “No,” says Dr. Shubha, “people gain or lose weight according to their lifestyles. Women using the pill are no more likely to gain weight than those who aren’t.”
But it appears that Indian women aren’t nearly so worried about putting on weight as they are about regaining fertility when required. They also worry about contraceptives causing cancers and congenital anomalies in babies. Oral contraceptives actually cause none of these problems. In fact, they are known to be protective against ovarian and endometrial cancers. As for congenital anomalies, they occur due to disorders or defects in the genes of the parents. They may also occur when harmful medications are taken during the first trimester or the first three months of pregnancy when the foetus is in its early formative stage. This is why it is very important to avoid drugs and harmful substances during pregnancy.
…it appears that Indians aren’t nearly so worried about putting on weight as they are about regaining fertility when required.
Other methods of contraception are not without their fair share of false beliefs. Intrauterine devices (the commonest in India is the copper-T) are recommended as a safe and effective option to limit fertility. Shreevani P.*, 32, was advised by her doctor to get one after her son was born. “But I had heard that it causes very heavy menstrual flow,” she says. Some people fear that these objects may migrate to other parts of the body and lodge themselves in the heart or some other organ, while yet others worry that the device may be preventing pregnancy by causing abortion.
Intrauterine devices are small, flexible contraptions placed in the sac-like uterus to render its environment unfavourable for pregnancy. They work by preventing fertilization from occurring, not by causing abortion after fertilization has taken place. Also, the device cannot go anywhere from the uterus. At worst, it may be extruded completely from the body, in which case it has to be replaced. Women using them may experience irregular or heavy periods in the first few months but usually go on to have less bleeding and rarely, even no bleeding.
Injectable contraceptives, hormones taken as injections instead of tablets, are effective and long acting. But they commonly evoke fears of later facing difficulty with regaining fertility. According to Dr. Shubha, women are very wary of birth control methods that cause complete cessation of menstrual bleeding.
Sterilization is often preferred by couples who have ‘completed’ their family. While tubectomy or female sterilization is widely accepted by women who have two or more children, vasectomy is traditionally linked to weakness, fatigue and even impotence. What many people don’t realize is that the surgery only blocks the tubes that deliver sperm to the semen leaving the rest of the reproductive system intact.
Sterilization is often preferred by couples who have ‘completed’ their family.
In the immediate postpartum period, breast feeding is supposed to be an effective means of birth control. In women who nurse their babies, menstrual cycles resume later than in those who don’t. Most nursing mothers are aware that once their cycles have started they have to adopt other contraceptive methods. But the timing of the first ovulation and menstruation after delivery can be unpredictable. Ovulation can occur before the first period, leaving a person unprotected in the time between the two events.
Surveys reveal that misinformation is very prevalent among young people. They believe pregnancy can be prevented by adopting certain positions or by washing, douching or even bathing after intercourse. Also, they are often unaware that avoiding pregnancy is different from protecting themselves from sexually transmitted infections. They need both and condoms probably offer the best solution for casual relationships. This is probably the basis for the belief harboured by some people that condoms are only meant for casual affairs, while the truth is that they are a safe and effective method that anyone can use.
With each contraceptive having its own benefits and limitations, the important things to keep in mind while choosing one are its safety, efficacy and how suitable it is to your lifestyle. What works for one person may not for another. Also remember that your own needs may change over time. So make sure you get your information from reliable sources and don’t give in to myths.
*Names changed to protect privacy
*Photo credit: Carolina Coca (Used under the Creative Commons Attribution License)
Dr. Lakshmi Ananth is a doctor and a writer who wields both scalpel and pen
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