WORLD Contraception Day, observed on September 26, is a worldwide campaign aimed at raising awareness of contraception and highlighting the need to reduce the high levels of unplanned pregnancies. This marks the third year of the campaign.

This day is targeting all women and men in the reproductive age group. It is important for young people to make informed choices about parenthood at the time that is right for them. The motto is: “Your life, your choice”.

Approximately 38 per cent of pregnancies worldwide are totally unplanned and 22 per cent of all pregnancies end in an abortion. In developed countries, an estimated 49 per cent of pregnancies are unplanned and 36 per cent of all pregnancies end in abortions. Approximately 85 out of 100 sexually active women in the reproductive age who are not using any contraceptive method will get pregnant within one year. In Europe more than a quarter of women 15 to 24 years old do not use contraception the first time they have sexual intercourse. In Latin America, 52 per cent of the 18 million pregnancies are unplanned and there is an estimated four million abortions in the region each year. The use of contraception in Asia varies considerably from two per cent in Pakistan to 44 per cent in Indonesia with the vast majority of unmarried, sexually active adolescents not using or only using traditional contraceptive methods.

There are various means of contraception available to both men and women. These include the condom (male and female), the contraceptive injection (depo provera and Mesigyna), the intrauterine contraceptive device, the vaginal ring or vaginal sponge, diaphragm and subdermal implants (Norplant), the oral contraceptive pills and sterilisation (tubal ligation and vasectomy). The choice of method depends on the individual age, the presence of medical conditions which would make the use of oestrogen dangerous and the person’s personal reproductive desires. Methods such as the intrauterine contraceptive device (IUD) and the subdermal implants offer long-term protection against pregnancy. The copper T (IUCD) offers protection up to 10 years.

There are some women who should not use oestrogen-containing contraceptive devices. This includes women with:

1. Oestrogen-dependent cancers such as breast cancer

2. History of having had a clot in the legs or lungs

3. Severe hypertension

4. Sickle cell anaemia

5. Severe uncontrolled diabetes mellitus

6. Systemic lupus erythomatosis

7. Lupus anticoagulant antibody positive status

8. History of heart attack or stroke

9. Liver disease

10. Unexplained abnormal vaginal bleeding

Oestrogen-containing contraceptives include the combined oral contraceptive pills, Mesigyna (monthly injection) and the patch. The risk of an unplanned pregnancy and its associated complications far outweigh any risk of developing complications with the oestrogen-containing methods, but caution must be exercised and proper medical consultation should be sought.

Irrespective of the choice of contraception, the condom (male and female) is the only effective means of preventing sexually transmitted infections such as HIV and safer sexual practice should always be the aim. The condom can be used with one of the other methods for effective pregnancy prevention and prevention of infections. Abstinence, especially in teenagers is the best option but if this is not practical then practising safe sexual activity is the way forward.

– Submitted by OBGYN Dr Sharmaine Mitchell