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Everything in the 21st century seems to begin with an  the iPod, iPhone, iTunes or iWay. If it is not, it is  you  or myself. Everyone is encouraged to look out for himself or herself. No wonder then that the social fabric is breaking down and divorce is on the rise.

We  should be the dominant pronoun when two adults fall in love. Sex is a natural expression of love between two consenting, responsible adults. But they should be aware that the act may culminate in pregnancy. If having a child is not the immediate aim, sex should be preceded by a discussion about contraception.

Most of the time, however, this is not the case. Even couples who use contraception may miss  a few times. Husbands may not use condoms regularly. The consequences of unprotected sex are remembered only the  morning after. Tense, anxious and ignorant about how to proceed, the couple then waits to see if the next period will make its appearance on schedule.

Emergency contraceptive pills are a way to avoid getting pregnant after unprotected sex. Although they should be dispensed only by prescription, they are often available over the counter (OTC). It is 80 per cent effective if the first pill is taken within 72 hours. The second pill has to be taken 12 hours later.

Emergency contraception works because pregnancy does not actually occur at the time of intercourse. The sperm has to travel through the cervix, uterus and fallopian tubes. The ovum has to be released from the ovary and meet the sperm. The process may take a few days. If the emergency contraceptive pills are taken during this window period, pregnancy is prevented.

These morning-after pills contain either progesterone or a combination of oestrogen and progesterone in doses higher than in the 21- or 28-day packs of oral contraceptives. Such pills prevent ovulation, fertilisation and implantation of the fertilised ovum. They block pregnancy at all the three stages. They are different from abortion pills. Chemically, the abortion pill consists of two medications   mifepristone and misoprost. Administered in the correct dose and sequence, it terminates a pregnancy which has already attached itself to the uterine wall and started to develop. It works up to the 49th day after the last period.

Abortion pills should be taken only under medical supervision. They should not be purchased OTC. Scans need to be done before and after the termination.

Both the measures are safe but shouldn’t be used regularly. A woman can control her chances of getting pregnant with almost 99 per cent efficacy. She needs to choose the method that suits her best.

An intrauterine device can be inserted. It lasts for 3, 5 or 10 years, depending on the type and manufacturer’s recommendations.

Have an injection of the long-acting depo progesterone. This protects for 12 weeks. Irregular cycles, breakthrough bleeding or spotting can occur.

Oral contraceptive pills. The active ingredient is given for 21 days. Then there is a pill free interval of 7 days. These regularise the cycle and prevent pregnancy. There are many fears about their safety, which have, however, been proven to be unfounded. The pills do not increase the risk of cancer.

Condoms are efficient if they are used consistently from the beginning till the end of intercourse. They have the additional advantage of preventing sexually transmitted diseases.

Sterilisation of either partner tackles the problem permanently.

Contraception is a sensitive topic. It is rarely discussed openly even with medical professionals. Many religions have their own views. Others feel morally obliged to regulate and enforce standards and norms for social behavior. Neither legislation nor coercion has worked successfully for contraception.

Source:The Telegraph (Kolkata, India)

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