Family planning in India is based on efforts sponsored by the Government of India. From 1965 to 2009, contraceptive use more than tripled and fertility rates more than halved, but national fertility rates remain high in absolute numbers, making long-term population growth a concern. India adds 1,000,000 people to its population every 20 days. Comprehensive family planning has become a priority in an effort to curb the potential population of two billion by the end of the 21st century.

In 2016, India's total fertility rate was 2.30 births per woman and 15.6 million abortions took place, with a 47.0 abortion rate per 1000 women aged 15 to 49 years.

Women in India are not being fully educated about the use of contraception and what they are putting into their bodies. From 2005 to 2006, only 15.6% of women using contraception in India were informed of all their options. The use of contraception is gradually increasing in India. In 1970, 13% of married women used modern contraceptive methods, rising to 35% by 1997 and 47% in 2009.

The Ministry of Health and Family Welfare is the government unit responsible for preparing and formulating family planning in India. In 2017, The Ministry of Health and Family Welfare launched Mission Parivar Vikas, a central family planning initiative. The key strategic focus of this initiative is to improve access to contraceptives by providing assured services, ensuring commodity security, and accelerating access to high-quality family planning services.

Dr.KumarKamble is not only a professional sexologist but also a de-addiction specialist. Dr.Kamble has special expertise and experience in working with the King Edward Memorial Hospital in the Deaddiction center for 4 years.

Dr. Sandhya Saharan is an Obstetrician and Gynaecologist Specialist. She is also the President of Thane OB-GYN Society. She has a special interest in Endoscopy, PCOS, Infertility, and Yoga. He was given the Young Scientist Award in the year 1994. He also won Bharat Jyoti and India's best citizens award in 2007.

Factors to be considered for contraception method 

Dr. Sandhya Saharan informs, “We prescribe contraception so that every episode is a protective episode. After the age of 18, contraception can be considered. The best method of contraception is the barrier method. Hormonal contraception like low dose pills and combination pills are also available. When you have one child already, we advocate the use of copper Ts which is very safe and it is valid for 5 years. Copper T is also available with 10 years validity. There is a lot of contraception available for those who have just delivered low-dose pills and injections. Each one of them has efficacy and limitations. So, the methods of contraception are- 

Barriers  Hormonal contraception  Injectables  Implants Ring  Jellies

We always advise the patient according to their case and then choose the contraception. 

Comfort level during choosing contraception method 

Dr. Kumar Kamble says, “There are various factors to be taken into consideration while choosing contraception method- 

Easy to use  Suited the age group  Doctor’s observation or supervision  Easy availability of contraceptive  Doctor’s advice and availability  Emergency or long term contraception use 

These are various aspects to know which contraception methods can be easy and comfortable. Depending on these factors we can decide the comfort level. Understand the use of contraception and the need for contraception is a must. Consult your healthcare provider in regards to this for a better comfort level of contraception.” 

All you need to know about birth control pills 

Dr. Sandhya informs, “Everyone thinks that taking birth control pills means you cannot conceive for 1 -2 years after stopping it. Birth control pills are reversible and for the specific cycle. You can conceive the very next month after stopping it. Only injectables are a little longer to reverse. Pills take only a month to reverse.”

Hormonal V/s Non-hormonal contraceptive 

Dr. Sandhya states,” All birth control pills are hormonal. The main mechanism of action is to avoid ovulation. It makes the whole uterus hostile to implant it. It doesn’t allow pregnancy and causes many alterations in the body. 

While the non-hormonal contraceptive pills are barrier methods. It is best to choose a non-hormonal contraceptive which is not interfering with body mechanism and metabolism. There are no side effects for non-hormonal pills.”

How soon do birth control pills act for contraception? 

Dr. Sandhya states, “It is better to use barrier methods along with birth control pills for contraception during the 1 st month and the second month you are completely safe with birth control pills. 1 month is considered a waiting period for the body to get used to contraception. If you forget the pill, then there are chances of pregnancy for that particular cycle and you may need to use the barrier contraceptive methods as well to avoid pregnancy. People are misusing the emergency contraceptive pills also called as I- pill which must be avoided. Emergency pills must be used in case of emergency or once a fill. There are many side effects of this emergency contraceptive pill because of its high hormonal content. Everything has limitations and must be taken under supervision. The couples should consult doctors for healthy contraception counseling.”

Are hormonal patches safe?

Dr. Sandhya states, “ Hormonal patches are safe and there is much research and trials conducted for it. Hormonal patches may irritate the user in case of perspiration. Many people are not happy because of skin irritation. This is one of the biggest factors. There should be a specific location so that it does not cause irritation.”

Advice from experts for contraception and family planning 

Dr. Sandhya says, “Any irresponsible act can lead to consuming emergency contraception pill and abortion which is not a good sign for the female counterpart. We have to sensitize the young population and advise them to be responsible and respect the body. Too many abortions can cause infertility problems. So, it is important to educate the girls and the boys too about family planning and contraception.”

Dr. Kumar Kamble says, “The partners should communicate with each other in regards to their relationship. We are entering a modern society and must communicate well. So, males should communicate and have consent with their partners and discuss the same. Consult doctors to choose and know the best contraception. We should be responsible for the reproductive cycle in future life. Education should start from school age. They should be well informed during the sexually active age.”

It is important to be safe 

Dr. Sandhya states, “Young people indulge in many wrong things like drinking and being irresponsible thinking it one episode. One single episode is enough to make you pregnant. Also, STDs must be taken into account. STDs are high in many patients. It is very important to be safe.”

(Edited by Dr.Rati Parwani)

 Contributed by Dr. Kumar Kamble, Sexologist & Dr. Sandhya Saharan, Obstetrician-Gynaecologist Specialist