Avoid an unplanned pregnancy this festive season
Although most people love surprises, an unplanned pregnancy is the last thing you would want to start the year with. Here is how to protect yourself this festive season.
The rising rate of unplanned pregnancies in South Africa emphasises the need for effective contraceptive use, particularly during the festive season and among the country’s adolescent population.
Approximately 40 per cent of all pregnancies globally are unplanned and in South Africa, many of these pregnancies occur among adolescents, with the number of teen pregnancies increasing dramatically between 2011 and 2013.
Statistics SA’s figures show that close to 100 000 schoolgirls fell pregnant in 2013 compared to 81 000 in 2012 and 68 000 in 2011. According to the World Health Organisation (WHO), about 17 million teens give birth every year. South African has an extremely high teen pregnancy rate compared to Europe.
There are two main methods of contraception – hormonal and non-hormonal methods. Hormonal methods are further divided into long-acting (e.g. implants, injectibles or intrauterine devices [IUDs], female sterilisation or vasectomy) and short-acting methods (e.g. oral contraceptives or ‘the Pill’, barrier methods such as condoms as well as the patch and vaginal ring).
According to Dr Petro, short-acting contraception is suitable for women who wish to conceive within a period of time shorter than two years. The Long Acting Reversible Contraceptive (LARC) is ideal for women who wish to prevent pregnancy for three to ten years. LARC is the most effective form of contraception and also has the fewest contra-indications. These methods can be used for shorter periods as well, explained Petro.
“Women should be advised that an inter-pregnancy interval of less than two years is associated with adverse maternal and new-born outcomes.”
Dr Mala Panday, an obstetrician and gynaecologist in the Family Planning Services Department of the Department of Health in KwaZulu-Natal, notes that each method has indications and contra-indications. One method may be safe for a particular woman, while another might not be as ideal. Therefore, it is important to consult with a healthcare professional who will weigh up the risks and benefits of the different methods before recommending a contraceptive. According to Mala, the benefits of contraceptive use far outweigh the risks. Apart from birth control, she says contraceptives have other benefits as well. Oral contraceptives can help to clear up acne and protect women against ovarian and uterine cancer.
Risks associated with combined hormonal contraception include venous thromboembolism. IUDs are contra-indicated in women with a current genital tract infection, and progesterone-only contraceptives may be contra-indicated in someone who is allergic to a particular ingredient, said Mala. Risks can be minimised by adhering strictly to prescribing guidelines, which are summarised in the WHO’s Medical Eligibility Criteria, published in 2015.
Petro recommends that Krugersdorpers should discuss the following with their healthcare professionals before accepting a contraceptive: the method, what it contains, route of administration, how often it should be taken, how it works, how long it works for, common side effects, how to stop the method, return to fertility on stopping and where to go if problems are encountered.
According to Mala, implants are one of the most effective contraceptive methods because they are long-acting and reversible and do not require any action from the user. Implants have a more than 99 per cent efficacy rate with ‘perfect use’ and an almost similar ‘typical use’ efficacy.
Other benefits associated with an implant include: easily available and accessible, discreet, no need for follow up visits to healthcare providers every few months, low side-effect profile and few contra-indications.
“Implants are especially ideal for adolescents,” noted Mala.
The main benefit of contraception is that it prevents unintended pregnancies. Unintended pregnancies are associated with a high risk of maternal and fetal mortality and morbidity. Careful consideration should be given to the risks and benefits associated with each method, but the benefits far outweigh the risks, he added.
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