Spacing - The key to better health for you and your family

Today's urban woman is increasingly taking charge of her own destiny. She is competent in her workplace and runs her home with efficiency. The week goes by in a whirl of activity encompassing work- both inside and outside the home- entertainment, kids and the hundred and one things necessary to keep everything running smoothly. Homemakers, too have hectic schedules, balancing the needs of her husband, children, her own needs, as well as those of other household members such as elderly parents-in-law. Joint families create further demands on women's lives and schedules.

Despite this whirlwind of activity, one area that often gets neglected in all this frantic activity is a visit to a trusted gynecologist. A woman has to begin taking decisions with regard to her reproductive health right from the start of her marital life. She and her partner need to carefully consider their desired family size. If several children are desired then adequate attention should be given to spacing methods that best fit her health needs and lifestyle. Once the family is complete, she and her husband should then consider adopting a method of contraception that is safe, effective and hassle free for years to come. Thus, it is important to have the right information on the myriad of contraceptive choices.

Increasingly various contraceptive options are available to couples during their reproductive years. Unfortunately, however, few couples are aware of their options and lack resources to gain such information. This is where the role of your gynecologist becomes crucial. He/she is the best person to consult for advice on the various methods, whether they would suit your body and your lifestyle and the pros and cons of each method, in order to make a well-informed decision.
There are many facts regarding contraception that you need to keep in mind before making a choice:

* First, it is important to separate fact from myth! Your physician is a wealth of information concerning the most up-to-date developments in family planning.

* Delaying first pregnancy and adequate spacing (ideally 3-5 years) is essential for the physical and mental health, development and wellbeing of you and your child.

* Every person is different! Accordingly, every woman responds differently to every method of contraception.


* Ease of use, discretion and convenience all differ for each method; hence, it is essential to find a method most suitable to your body and your way of life. For example, not all methods are appropriate for breastfeeding, and all are effective for different lengths of time.

Health professionals are great resources for accurate, unbiased information. Nonetheless, couples should take charge of contraceptive decisions and therefore consult several sources of information, including the Internet. Finally, it is important for both partners to reach a consensus about this crucial decision that affects the health and wellbeing of the entire family.

Reproductive Health Articles

Are you breastfeeding your baby? Tips for Lactating Mothers

By, Diepiriye S. Kuku-Siemons

You've just had a child- joy, excitement, worries, are all part of the process of welcoming the newborn into the family. The entire family participates in the initial chores required to make the baby comfortable and happy. The mother however, is the most preoccupied with her new offspring and the time required to take care of the infant. But, in order to ensure that your baby gets your undivided attention and grows up healthy, you need to be aware that ideally you should wait 3-5 years before your next child. But why? Many believe that lactation offers protection. This is a myth that most women believe and therefore they can get caught unawares with another pregnancy when they least expect it!

* During the period of lactation when the mother is breast-feeding her baby, she needs to know some facts about contraception so that she can protect herself from another immediate pregnancy:

* If the woman has not had her first menstrual period since childbirth and if she is fully breastfeeding her baby, she is unlikely to become pregnant during this period. This natural form of birth spacing is known as the LAM (Lactational Amenorrhea Method) of contraception.

* Women who are breastfeeding can start progestin-only methods of contraception as early as six weeks after childbirth. An important fact to remember is that the contraceptive should be estrogen free. Hence, progestin based injectables; condoms, Progestin Only Pills (also called "the mini pill") and IUD's are the best options. If she is not fully breastfeeding, she can use the Combined Oral Contraceptive, (also called "the pill") as well.

* The tri-monthly injectable DMPA can be started as early as six weeks after childbirth. The biggest advantage of this method is that DMPA does not affect the quality and quantity of breast milk or have any adverse effect on the health of the baby. DMPA is long acting and does not require daily action, nor is it coital dependent. Hence, mothers are freer to dedicate time and attention to her health and that of her newborn.

I'm actually feeling better!

Urban chaos is what sums up a modern woman's life in metropolitan cities. Early morning household chores, children and elders in the family to attend to, preparing for the day ahead, breakfast, tiffin to be packed, getting ready for office, the daily commute, dashing to shops to pickup some necessary provisions, dinner and homework, housework and entertaining - its an endless whirl of activity!

Today's urban woman is becoming increasingly independent and wants to enjoy a hassle-free life. She takes many important decisions in order to make her life smoother and free of unnecessary complications. If she is a working woman, with hectic work schedules, which includes outstation travel, she has to organize her home front in such a manner that things function smoothly even in her absence. This means getting reliable servants and training them extensively to cook, clean and look after the needs of the children. It also means organizing efficient school transport so that the child is taken care of when in school as well as when she returns home.

An important decision the modern urban woman has to take early in her married life is the number of children she and her husband would like to have and the spacing they want between the children. For this, they have to consider many factors such as the maternity leave to which the mother is entitled, the baby's healthy rearing and the mother's health and well-being so that she can continue to look after her home and office duties efficiently after her delivery.

In all this activity, does a woman have time to think about her reproductive needs? Carelessness about contraceptive requirements could result in an unwanted pregnancy just when neither the woman nor the couple is ready to take up the responsibilities of parenting.

Taking a decision about which contraceptive to use and when to use it are unsolved puzzles in the reproductive history of most Indian families, of which women bear the greater responsibility both socially and technological. To whom should women turn for accurate and tailor-made advice for their reproductive needs and responsibilities? The best option is to consult a qualified nearby gynecologist. Once the doctor has listened to the woman's history and the pattern of contraceptive use, if any, he/she can advise on the mode of contraception that best suits the woman's health and well-being at that particular juncture in the couple's married life.

Countless urban women users of safe and convenient methods of contraception have expressed their relief and satisfaction in their choice of contraception by saying, "My doctor suggested various methods. She told me about the Pill, Condom, Injection, Copper T, etc. but I find the Injection more suitable for me because it is hassle free and effective. We are tension free now, that there will be no chances of my getting pregnant. It will not limit the satisfaction and happiness level of being with my husband."

Today's woman has many more contraceptive options available to her than her mother had, and she can select a method or a combination of methods that are suitable for her health and lifestyle.

Combined Oral Contraceptive

* The COC or combined oral contraceptive contain very low doses of hormones which are similar to the natural hormones in a woman's body.

* They are very effective if used regularly and fertility returns soon after stopping the pills.

* The disadvantages include the hassle of remembering to take a pill each and every day, mood swings and depression in some cases and discontinuation during lactation as it effects the quality and quantity of the mother's milk.

The three monthly injectable contraceptive-DMPA

* It is a safe, effective, reversible and private method of contraception, ideal for spacing families.

* DMPA is very effective for lactating mothers as it does not affect the quality and quantity of the mother's milk.

* It is hassle-free as it is administered as a muscular injection once every three months.

* The side effects are reversible, including irregular bleeding, which may lead to temporary stopping of periods or delayed return to fertility.

In addition to these methods of contraception, it is important to know about emergency contraception as well, incase a couple has had unprotected sex or if a woman has forgotten to take her pill or in cases of condom failure. The important thing to remember here is that this is not a regular method of contraception but an emergency measure to stop pregnancy.

The Emergency Contraceptive

* This is to be used only in an emergency when a woman has had unprotected sex and is an effective way to stop an unwanted pregnancy.

* It can also be used after an incidence of sexual violence or rape and be effective in preventing pregnancy.

* These are effective if taken within 72 hours of unprotected sex.

* The Government of India has recently made this available 'over the counter' in a bid to reduce unwanted births. This means that a woman does not need a doctor's prescription to buy the pills from any chemist.


All the above methods can be used by a liberated, urban woman to prevent unwanted pregnancy and some prefer to use a method such as the injectable DMPA as one shot provides protection for three months. Besides, there are many non-contraceptive benefits connected with taking hormonal contraceptives such as protection from some types of cancers, a glowing skin, a carefree attitude and better health for both mother and child.

However, the key to this feeling of well being is to see your doctor today, select the contraceptive method that is best suited to your requirements and start a new life with confidence and security. Imagine the relief you will feel if you are secure in the knowledge that you have control over your own body and can make decisions regarding your reproductive functions as you and your partner see fit. You can actually feel better and enjoy your life more once you are secure in your choice of contraception and don't have the constant uncertainties surrounding pregnancy looming over your head!