Unplanned pregnancies - Pt 2

This is the continuation of my article published on October 6 about contraception. In that article, I discussed the oral contraceptive pill, the patch and Depo-Provera injection. Mesigyna is a once monthly contraceptive injection that has similar ingredients to the oral contraceptive pill.

These are all short-term methods of contraception. However, if a woman decides that not to become pregnant for a number of years, an intrauterine device (IUD) may be an option. The two types available here are the copper T 380A IUD and the levonorgestrel releasing IUD (available as the Mirena intrauterine system or IUS).

Intrauterine devices

Both types of IUDs are very effective methods of contraception. The copper-T mainly prevents pregnancy by killing the sperm before it can reach the egg and the hormones in Mirena cause the cervical mucus to thicken, preventing sperm from travelling into the womb and the Fallopian tubes. IUDs are T-shaped devices that can be placed in the uterus by a physician during or after a woman has her menses. The main side effects with the copper-T IUD is increased bleeding with periods, between periods or pain.

Irregular bleeding

However, the Mirena significantly decreases menstrual bleeding in women and can, in fact, be used for treatment in women who have heavy menses. Nevertheless, it can be associated with irregular bleeding and spotting during the first few months of use. Insertion of any IUD is associated with a higher risk of pelvic infection within the first month after insertion. Some women choose to remove the IUD because of the side effects but, if used for five or more years, it has been found to be more cost-effective than other methods of contraception.

Female and male condoms

The male and female condoms are the only two barrier methods available in Jamaica. They are effective in reducing the risk of acquiring a number of sexually transmitted infections but neither offer absolute protection against all types. If the male and female condoms are used in the 'typical' manner, about 15 per cent and 21 per cent, respectively, of unintended pregnancies will occur after one year of use. While it is much less effective than the other methods I have mentioned, ranging from 0.1 per cent for the Mirena IUS to eight per cent for the oral contraceptive pill, it is far more effective than not choosing any method. If left to chance, about 85 per cent of women will be pregnant after one year.

My son is indeed a blessing and he is one of the greatest joys of my life. However, this has been largely influenced by the loving support of my spouse. Please do not cheat yourself or your child by failing to prevent an unwanted pregnancy. It is true for some that it becomes an unexpected, pleasant surprise but for others it is a burden and no child should be seen as a burden. It is easier to prevent an unwanted pregnancy than to deal with the consequences.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.