When family planning is looked at from a broader perspective; The rapid increase in human population in this century threatens human existence. At today's rate, the world population will double in 47 years.
From adolescence to perimenopause, women are faced with having or avoiding having children. After all, it is every woman's natural right to have as many children as she wants, whenever she wants.
The permanent prevention of pregnancy that may occur is called "Sterilization" in medical language, and the methods used for this purpose are called "Sterilization". , temporary prevention is called “Contraception”, and the methods used for this purpose are called “Contraceptive” methods.
The primary target in family planning is the mother and To protect the health of newborn babies. In pregnancies that occur at frequent intervals, the mother's body health is at risk, and at the same time, events such as low birth weight, abnormal babies, and infant death are encountered more frequently in unborn babies.
Contraception Methods
Natural contraception methods
These are the methods that people have been using for centuries. Although it is widely used by the public, its reliability is low and the risk rate is at a significant level of 30%.
Natural contraception methods for women
Vaginal washing: Relationship Washing the vagina (chamber) after washing is not only completely ineffective in terms of protection, but also disrupts the vaginal Ph, resulting in an increased risk of vaginal infection.
Calendar method: It is a method based on fertility and ovulation symptoms. By monitoring the symptoms, it is determined which days are most likely to become pregnant. If a child is desired, unprotected intercourse can be had on these days. If children are not desired, care is taken to protect them these days. In a woman who has a regular menstrual cycle, ovulation occurs 14 days after the start of menstruation. Increase in body temperature, tension and tenderness in the breasts, groin pain, and white discharge with the consistency of egg white are the symptoms of ovulation that can be noticed by the woman. After ovulation The quality of the flow changes. It becomes thicker and stickier. In the calendar method, the 11th-18th days of the menstrual period are the days with the highest probability of getting pregnant. In cases of menstrual irregularity and inability to notice the symptoms, the validity of this method decreases and the risk rate increases.
Lactation Amenorrhea: It is popularly known as milk preservation. Menstrual cycles in breastfeeding mothers may occur in several ways. Even though she is breastfeeding, she can have normal menstrual cycles every month. As long as she is breastfeeding, she may not have a menstrual period at all, or she may have intermittent and irregular menstruation. It should not be forgotten that a breastfeeding mother has no protection against pregnancy, regardless of her menstrual cycle. Especially after the 6th month of breastfeeding, couples should choose one of the effective contraceptive methods that do not prevent breastfeeding.
Natural contraception methods for men
Coitus Interruptus: This method, colloquially known as withdrawal or ejaculation, carries a high risk of pregnancy. In addition, it can cause psychological distress in couples who are protected by this method for a long time.
Medical contraception methods
They are modern and effective contraception methods and their reliability can reach up to 99% .
Modern and medical contraception methods for women
- Vaginal barriers: Diaphragm, suppository, spermicide creams;
- Diaphragm: It is attached to the cervix. It prevents the sperm in the vagina from entering the uterus.
- Spermicide creams: It destroys the fertilization ability of sperm.
- Vaginal suppositories: They are inserted into the vagina 10-15 minutes before intercourse, and the vagina is not washed in any way until 6 hours after intercourse. A new suppository is used before each intercourse. These methods can also be combined and used together, thus increasing their effectiveness. These methods can be recommended for breastfeeding women as they do not have any side effects on breastfeeding.
Intrauterine Device (IUD): Known as Spiral.
Protection mechanism during pregnancy: It prevents the egg from reaching the uterus and the sperm from reaching the egg. However, even if the egg is fertilized, the spiral disrupts the intrauterine environment and prevents the fertilized egg from nesting. It prevents Spiral usage period is maximum 5 years. After 5 years, IUD+pregnancy, spiral thread breakage, and spiral+ectopic pregnancy possibilities increase, so it must be replaced. Spirals are available in copper and hormonal materials. Hormonal spirals can only be inserted in special cases for the patient and when the gynecologist deems it appropriate. Before inserting the spiral, the patient should be examined in detail by the gynecologist and it should be determined that there is no obstacle to the insertion of the spiral. If there is a vaginal infection, cervix erosion (wound on the cervix), the spiral is placed after the patient is treated.
Situations in which the spiral is not recommended:
<When should the spiral be inserted?
The most appropriate time to insert the spiral is the days when the patient is on her menstrual period. There is no possibility of the woman being pregnant these days. Since the cervix is open, the procedure is easier and painless. You may experience cramp-like groin pain for a few days after the coil is inserted. Sexual intercourse should be avoided for two weeks, and the spiral should be checked every 6 months, at the latest in 1 year. When the spiral expires, the spiral can be removed and a new one can be inserted immediately. Pregnancy may not occur for 6 months after the spiral is removed. Or in other words, if women who want to have a child after removing the IUD do not become pregnant within 6 months, there is no need to have any tests. There is a 2-3% rate of spiral+ pregnancy in women using spirals. For this reason, women who are protected by the IUD should still follow their menstrual periods. If pregnancy occurs with a spiral, the spiral must be removed. If the spiral is not removed when pregnant, there may be an infection that will be dangerous for the mother's life. If the water sac ruptures early, premature birth becomes inevitable. When the spiral is removed while pregnant, pregnancy is normal by 50%. It can continue somehow. It may be 50% lower. If the spiral does not have a thread, the spiral must be removed by operation and the pregnancy must be terminated with an abortion.
Hormonal contraception (Birth control pills, needles)
Mechanism of action:
strong> It is based on stopping ovulation and suppressing the ovaries. It also thickens the cervical plug and prevents sperm from passing into the uterus. It thins the uterine lining. The content of birth control pills is Estrogen + Progesterone. These hormones are female hormones that normally exist in women. As for injections, monthly injections contain both hormones in depot form. 3-monthly injections contain only Progesterone. Birth control tablets and monthly injections do not cause menstrual irregularities and hormonal disorders. On the contrary, it has a menstrual regulating effect. Since 3-monthly injections contain only Progesterone, they may cause menstrual irregularities. However, it is recommended in special cases, for example, for breastfeeding mothers. Birth control pills and injections have almost 100% protection when used regularly.
How to use birth control tablets: The first box is started on the 1st day of menstruation. After the box is finished, there is a one-week break. A new box is started after a week. (Without counting the menstrual day)One tablet is taken every evening before going to bed. If forgotten one evening, double tablets should be taken the next evening. If a box is forgotten more than twice like this, the box loses its protective feature. If it is forgotten two evenings in a row, bleeding begins. As can be seen, the most important condition when using birth control tablets is to use them regularly.
Advantages of birth control tablets: It has very high protection. It ensures that menstruation is regular and painless. It prevents anemia by reducing the amount of menstruation. It has protective properties against uterine and ovarian cancers.
Points to consider: It should not be used for longer than 5 years. It is not recommended for breastfeeding mothers as it reduces the amount of milk and impairs its quality. It does not protect against sexually transmitted diseases. When the tablets are stopped, pregnancy may not occur for up to 9 months. One should not smoke while using the tablets. Monthly and 3-monthly injections are given intramuscularly. Its effects and side effects are similar to tablets.
Situations where hormonal protection is not recommended: It is not recommended for women aged 35 and over, if there is a family history of breast cancer, for undiagnosed vaginal bleeding, for women with Myoma, for those with Migraine, Depression, Varicose Veins, Liver disease and Thyroid disease.
Modern and medical contraception methods for men
Condom use: In other words, condom use is more reliable than ejaculation and has the advantage of protecting against sexually transmitted diseases. If there is no quality material and it is not used correctly (only used during ejaculation), its reliability decreases. It has the disadvantage of causing allergies in women.
Hormonal contraception: It is not recommended because the preparations used for this purpose are not available in our country and can cause sexual reluctance and sexual dysfunction in men.
Sterilization Method
Female sterilization method
Tubal Ligation: It is the surgical ligation of the uterine canals. With the Laparoscopic (Closed)or Laparotomic (Open) method, the uterine canals are tied, thus preventing the egg and sperm from meeting. This irreversible method is recommended when couples are absolutely determined. It has no significant side effects.
Medical sterilization method in men
Vasectomy: It is the ligation of the man's sperm ducts through surgical intervention. The risk of surgery is very low. There is no change in male sexual functions. The only disadvantage is that this process is not reversible. Before this operation is performed, couples must make a firm decision that they will never want children again.
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