Contraception gets a really bad rep – particularly the hormonal ones and, in some instances, rightfully so. Today though I’d like to share a more neutral and hopefully empowering attitude around contraception.
Firstly, any type of contraception is a CHOICE and it’s important that as women we are as informed as possible so we can make choices that are suitable for our individual needs. It’s not for everyone and at different stages of your reproductive life you may or may not need contraception. Also, everyone’s contraceptive needs vary; it may be used primarily for the prevention of an unintended pregnancy, but that’s not the only benefit of contraceptives – I’ll touch of a few below.
Remember that you are not married to any contraceptive. If it doesn’t work for you, change it! Discuss your needs with your clinician for a smooth and safe transition from one mode of contraception to another.
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The common methods of contraceptive available in South Africa
Female sterilisation or Choice Tubal Ligation
How effective is it? Less than 1/100 women are likely to fall pregnant making it more than 99% effective.
What’s involved? The fallopian tubes are cut or blocked permanently. It’s a difficult procedure if it needs to be reversed, and there are no guarantees of success after a reversal.
Who is it suitable for? Suitable for someone who has completed their family
Also good to know: The male version of sterilisation is known as vasectomy, where the tubes carrying sperm are blocked/cut so that ejaculate/semen does not contain sperm.
IUD Intra-uterine devices
How effective are they? 1/100 women are likely to fall pregnant in the first year on insertion of either hormonal or non-hormonal IUDs.
There are two types of IUD: non-hormonal, and hormonal.
Non-Hormonal : copper IUD
What’s involved? It’s a long-acting (lasts up to 10 years), reversible contraceptive. A T-shaped device is fitted inside the uterus – the procedure is generally done in the doctor’s rooms. A non-hormonal copper IUD works by causing unfavourable environment in the uterus for implantation by thickening cervical mucous, making it difficult for sperm to meet the egg.
Possible side effects: It may increase the number and volume of menstrual bleeding.
Pros: Available free in public healthcare.
What’s involved? It’s a long-acting (lasts up to 5 years), reversible contraceptive. A T-shaped device is fitted inside the uterus and the procedure – and removal – is generally done in a doctor’s rooms. The device releases a small amount of progestin that supresses the growth of the lining of the womb, making it unfavourable for implantation.
Pros: Can be very helpful in treating women with heavy periods.
How effective is it? 1/100 women are likely to fall pregnant after the contraceptive implant.
What’s involved? It’s long-acting (lasts 3 to 5 years) and reversible. A flexible rod is inserted just under the skin of the upper arm in the doctor’s rooms.
Pros: It’s available for free in public healthcare.
Possible side effects: Speak to your clinician if you experience break-through bleeding.
How effective is it? 3/100 women are likely to fall pregnant on this form of contraception.
What’s involved? Is a long-acting (there are injections you get every 8 weeks or every 12 weeks), reversible contraceptive that needs to be administered by a health clinician.
Possible side effects: May cause prolonged breakthrough bleeding initially, and later the absence of a period due to the diminishing lining. But don’t worry, that doesn’t mean the blood is accumulating internally. It may take 6 to 12 months after stopping to return to an ovulatory cycle.
Combined hormonal contraceptives (these have both progestin and oestrogen)
Combined Hormonal Contraceptives come in the following forms:
- The pill: 9/100 women are likely to fall pregnant
- The Patch-weekly replacement.
- The ring – monthly replacement.
Barrier Method: condoms
How effective are they? 15/100 women are likely to fall pregnant using condoms only.
What’s involved: Both male and female condoms are available and they are dual purpose in that they prevent pregnancy and sexually transmitted infections. They do, however, require the cooperation of a partner and must be used every time for most efficacy.
How effective is it? 2/100 women are likely to fall pregnant (if all criteria are met)
What’s involved? This method is based on EXCLUSIVE BREASTFEEDING, does require for the mom to not yet have had a period and for the baby to be under 6 months of age.
Fertility awareness method
How effective is it? About 25/100 will fall pregnant this way.
What’s involved? A woman will either use a calendar, track or ovulation symptoms or a combination of the two to calculate her most fertile period. It requires the cooperation and commitment of your partner.
Coitus interruptus: the “pull out” method
How effective is it? This is one of the least effective methods of birth control, resulting in around 27/100 pregnancies.
What’s involved? It requires the participation of the male partner and careful timing.