World Contraception Day: Are You Making an Informed Choice?

India Map Showing Maternal Mortality Ratio (MMR)
Map of India depicting Maternal Mortality Ratio (2014-2016)
India Map Showing Maternal Mortality Ratio (MMR)
Map of India depicting Maternal Mortality Ratio (2014-2016)

Amongst so many others, contraception is one of the most hush-hush affairs in our country. Hence, the information regarding it is either limited or altogether wrong. And this combination of wrong and limited information leads to unexpectedly higher maternal mortality rate. As per a 2017 World Health Organisation (WHO) report, approximately 130 women died per 100,000 live births (Maternal Mortality Rate or MMR) in 2016. And a lot of these pregnancies were unintended but occurred due to the lack of awareness.

To reduce unwanted pregnancy, family planning is of utmost importance. And contraception helps couples decide when they want to begin having children, age gap between the children and when to stop procreating. But contraception goes much beyond just family planning and babies. It is a basic human right which entails sexual health, access to contraception, right to abortion, and preventing sexual violence against women, and so on and so forth. Contraception is somewhat also attached to male-ego. Hence, pills (especially emergency pills such as i-pill) are more popular amongst urban adolescents, and in average Indian households (sexual health in rural areas is a different discussion altogether). But is that the only contraceptive method available? Or the awareness is limited to just those small round mass of solid medicines?

The answer is lack of awareness. There are actually various other ways to prevent unintended pregnancies such as Diaphragm, Intrauterine Devices (IUDs) such as T-shaped device, and sterilization which is a non-reversible form of birth control. Besides, fertility awareness which requires keeping track of monthly cycle to know the ovulation time and indulge in sex accordingly also helps. All these methods are broad categories, which have several sub-categories of birth control methods. But among so many of these, pills are the most preferred.

Talking about pills, let’s throw some light on the growing culture of emergency contraceptives. They are called emergency contraceptive pills because such pills have a high amount of levonorgestrel-a kind of hormone which either prevents or delays ovulation or interferes with fertilization of eggs. One example of such pills is ‘i-pill’ which consists of ‘50 times higher Levonorgestrel’ which means popping a single i-pill is equal to popping 50 pills at one go.

Indian culture, which is full of taboos and stigmas, looks down upon any kind of sexual relationship prior to marriage. Hence, young girls who are involved in sexual relationships often go for such emergency contraceptive pills without knowing the concept too well. Which causes a lot of damage to their health. Due to the stigma, seeking guidance from parents or a professional becomes infeasible. A report of WHO also says that “young adolescents (10-14) face a higher risk of complications and death as a result of pregnancy than other women”.

Hence, September 26 is observed every year as World Contraception Day to improve awareness of contraception and empower people to make informed choices on their sexual and reproductive health. Apart from that, India needs to facilitate more public health campaigns in the coming years to achieve Sustainable Development Goal (SDG) target of an MMR below 70 by 2030.