How effective is the IUD?

Dear Doctor,

My husband and I have been thinking about birth control after the birth of our second child. However, after the nauseating side effects I suffered the last time I used birth control pills, we are considering other options. I am particularly interested in IUD. I’ve heard it is good. What are its side effects and how is it applied? Mina

Dear Mina,

Birth control after a baby is born is good for the mother as well as the baby. It removes the apprehension of “getting pregnant soon again” from the woman’s mind, thus, she can be stress free. It also gives her adequate time to recuperate her health, as well as take good care of the new born baby.

IUD (intra uterine device) is very good for spacing of pregnancy, i.e. delaying after birth of a child.  IUD is a small piece of t-shaped flexible device that is put in the uterus to prevent pregnancy. It is long term, effective and reversible. There are two types of IUDs in use. One is coated with copper and is known popularly as copper T. Another is coated with the hormone progestin. Purpose of both is to prevent the sperm meeting the released egg that results in pregnancy.

The IUD is usually inserted any time during menstrual cycle or immediately after a miscarriage or full time delivery. This timing ensures that the woman is not already pregnant, during insertion of an IUD. When inserted with due attention to hygiene, it is very safe.  The side effects are very rare and include shock during insertion or pelvic infection and subsequent sterility after insertion. Successfully inserted once, an IUD lasts for several years.  The time duration of its efficacy is usually informed by the medic inserting it or is available with the product information.  After that, somebody wishing to continue its use can simply get the existing one removed and a fresh one inserted. If pregnancy is desired any time, the IUD can simply be removed.

Using a condom is another technique which prevents, unwanted pregnancy and helps in spacing of child birth. Male condoms are cheap, easy to use and effective.  Good quality latex condoms rarely rupture during intercourse. They also protect against sexually transmitted diseases, including HIV infection. Female condoms are cumbersome to use and are expensive. Diaphragms and cervical caps serve as protective barriers in women against entry of sperms, but are again cumbersome to use.

Some couples “practice coitus interruptus” to prevent pregnancy. Here, the male partner withdraws just before ejaculation. However, the timing of withdrawal has to be very precise, otherwise even a few drops of semen entering the vagina can fertilise the ovum and cause pregnancy.

If a couple has completed the desired family size and the last born is five years or older, sterilisation can also be considered as an option.  Here, the tubes are ligated, which prevents movement of the sperm or egg. Male sterilisation (vasectomy) is easy and recovery is also faster, as compared to female sterilisation (tubectomy). The ligated tubes in either partner can be opened and reopened, if the couple changes their decision for any reason. However, after passage of many years, recanalisation may not be very effective.

 Dr. Rachna   Pande is a specialist in internal medicine. 

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