Know various methods used to prevent pregnancy

One of the common methods used for pregnancy prevention is oral contraceptives, hormone contraceptive patch and vaginal ring.Today, many scientists recommend the oral contraceptive method because the method is initiated sooner after sexual intercourse, which may reduce subsequent pregnancy risk.Sometimes women might have missed pills or dislodgement of the vaginal contraceptive patch or vaginal ring; in this case she may resume using the pill patch or ring that she was previously using. However, people should be reminded that the patch or ring will not be effective past the original date on which it was scheduled to be removed. Women starting hormonal methods immediately after using emergency contraceptive pills should use a barrier method if they have intercourse in the next seven days after starting or restarting the method. In certain circumstances women may wait until the beginning of her next menstrual cycle and then start the method according to the standard instructions for that method.Other methods commonly used to prevent or stop pregnancy include use of injectables, implants, intra-uterine device use, and natural family planning. InjectablesInitiate progestin-only injectables and combined monthly injectables within seven days after the beginning of the next menstrual cycle. Women should use a barrier contraceptive or abstain from intercourse until she receives the injection. ImplantsInsert within seven days after the beginning of the next menstrual cycle. Use a backup method or abstain from intercourse until the implants are inserted. IUD (Intra-uterine device)Insert after the start of the next normal menstrual period. Women should use a barrier contraceptive or abstain from intercourse until the intra-uterine device is inserted. However if a woman intends to use the device as a long-term method and meets intra-uterine device screening criteria, emergency insertion of a copper-bearing IUD may be a good alternative to an emergency contraceptive pill use.Natural family planning; natural family planning may be initiated after the first normal menstrual period following an emergency contraceptive pill use. If intercourse occurs in the interim, an alternate contraceptive method such as condoms or abstinence should be used.Female or male sterilisation; here the doctor will perform the operation only after informed consent can be ensured. It is not recommended that women make this decision under the stressful conditions that often surround emergency contraceptive pill use. Always defer female sterilisation until after a woman’s first menstrual period, to ensure that she is not pregnant. Use a backup method or abstain from intercourse until the sterilisation procedure is performed.Reaching women who have been forced to have intercourse also poses special challenges. Emergency contraceptive pill providers should be attentive to the possibility that these women may be; unaware that something can be done to prevent pregnancy after sexual assault.Some women are not willing to report the assault and, therefore, unwilling to seek services whereas some are concerned they will be blamed for the assault by the medical provider. There is always need for diagnosis and treatment for sexually transmitted infections in some cases. Local authorities should always ensure that police stations, emergency health care centres, and other facilities where women may seek help after an assault can provide victims with emergency contraceptive pills, if appropriate, or at least with information about where to obtain them and other needed treatments as promptly as possible.Another major issue today is that reaching adolescents with emergency contraceptive information and services poses special challenges to programmes.Young women may find it difficult to access relevant information concerning services for emergency contraceptive pills due to lack of confidence or embarrassed to visit a family planning clinic. Some of the young women may hesitate because they do not know the existence of the clinic, find the clinic hours inconvenient, fear a pelvic examination and are anxious about judgmental attitudes of the health care provider.Health authorities should work to ensure that clinics serving adolescents are youth friendly, for example, by ensuring privacy and confidentiality, accessible facilities, reasonably priced services, and flexible hours, particularly during evenings and weekends. The writer is a doctor at the Rwanda Military Hospital Kanombe.