BIRTH CONTROL

Studying the progress of Feminism down the ages, one fact has emerged indisputably clear. In a world where power is inevitably tied with sexuality, a woman cannot come close to true female emancipation without holding an equal weightage of the reigns of sexual control in her hands.


This is what makes the case for female contraceptive options such a strong one. The decision to have a child is as much a woman's to make as it is a man's - if not more. Having a child today is a no longer an accidental occurrence, or at least it ought not to be, considering its possible consequences on the macro and micro levels of the world and family.


In India, female contraceptives have long earned a black mark in the minds of their potential users due to the popular misconceptions that are held about them. Exaggerated ideas of the possible side effects of these options have resulted in an almost complete dependence on the male to assume the responsibility of avoiding conception by pulling on a condom. And possible negligence on the part of the male is a burden to both, the struggling poor families that are usually the victims of such ignorance and the country that must support them, despite it's more than fair share of poverty and overpopulation problems.


Internationally, the market for female contraceptives is a rapidly expanding one. Newer and better ways of assuring prevention are hitting the pharmacy shelves weekly. A whole series of parentral contraceptives have been made available, the deep intravasculour kind that consist of implants and injections.


These are placed under skin or inserted into muscle (usually in the arm area that most patients are comfortable with) and both kinds release levels of progesterone that prevent the release of eggs from the ovary - thus avoiding conception.


Newer varieties of the female Pill too have been made available, the advantages being increased user-friendliness. While the Pill of the old left women susceptible to varying levels of nausea, weight gain, hormonal imbalances and mood swings, the latest in the series are third generation contraceptives - mainly low dosage combined and tri-phasic pills. Both are a combination of estrogen and progesterone and both promise a noticeable reduction in the minimal amount of side effects that taking the Pill can cause in some women.


Other options include external prevention devices like the diaphragm and female condom, both of which don't require a gynaecologist for their insertion. While the diaphragm is frequently rejected for being uncomfortable, the female condom is like an answer to women's prayers. In use, the FC fits into the vaginal canal like an inverted male condom - and has no side effects, is 99 per cent effective and forms an effective barrier to STDs.


IUCDs are intrauterine contraceptive devices of two kinds. An IUD (intrauterine device) usually contains small amounts of copper which, when the T-shaped gadget is placed in the endometrial cavity, stimulates an inflammatory reaction that results in all the sperm being destroyed before it reaches the tube to fertilize the egg.


An IUS (intrauterine system) however, has slow releasing progesterone in either of its T-arms, which impair the implantation of the egg in the womb. The side effects of the hormonal IUS makes it definitely riskier. There have been cases of extrauterine pregnancies where the foetus grows outside the womb, usually within the Fallopian tubes, which is very dangerous for the woman. But - the IUS is 99 per cent effective and reduces the bleeding and shedding of tissue during menstruation (a plus for women who have heavy periods).


In India however, all these discoveries are still a long way off from being utilized. The female condom is not even available in the country and neither are the Norplant range of implants. And while Copper-T, IUCD, and the entire range of the Pill (including the tri-phasic and low-dosage combined ones) are available, these are rarely used (despite physician prescriptions) because of the widely held misconceptions about them.

Instead, a heavy reliance on the man's using a condom and even depending on the rhythm method (the 'safe period' between periods, so to speak) has all led to a rather haphazard approach to female control over contraception.


The consequences are grim and noted yearly. Exploding population levels threaten to make us the most populated country in the world, overtaking even China given time and the current rate of population growth. Information on the use and effectiveness of birth control options for women is a topic that really needs airing all over the country. And an increase in the various options available today - like the female condom - would greatly help matters along.


But who will do the job? And how soon? Who can say. For now, it is only offbeat columns like these that even approach the topic. And how much of this will even filter down to the levels where this information is most needed is anyone's guess.