Mina was a 19-year-old girl who was rushed to our health facility in the afternoon being agitated. She had generalized painful muscle contractions. She was very irritable and stiff. When asked about her state, her mother said she was pregnant and went for an abortion the previous week. This was a case of a generalized tetanus which is a serious emergency. In a flash of seconds, all the staff was mobilized to bring Mina back to her feet; yet to no avail.
Mina became unresponsive, this is when her mother knew it was probably the end of her daughter’s life. The cry of Mina’s family and friends was like a siren which announced to the staff another victim of complications of abortion because of an unplanned pregnancy. This raises the need of our populations to know and use contraceptive methods.
According to WHO, contraception, also known as birth control or family planning is defined as the intentional prevention of conception through the use of various devices, sexual practices, chemicals or surgical procedures [1].
Simply said, contraception is a method or device used to prevent pregnancy. About 214 million women in developing countries want to avoid pregnancy but are not using a modern contraceptive method [2].
In Cameroon, 43% of people of reproductive age (11-49 years) are sexually active and want to delay having a child or want no more children. But just 37 % use a modern contraceptive method [5]. The consequences of the non –use of contraceptive methods is an increase in the number of unplanned and mistimed pregnancies. Many women who have such pregnancies are subsequently exposed to the risk of childbirth without appropriate obstetric care or to the perils of unsafe abortion, which threaten the lives, health and economic wellbeing of women and their families. Family planning is therefore the solution to reduce the number of unplanned pregnancies, abortion and infant death.
Different methods of contraception are available in Cameroon, including [6,7]:
Ø Long lasting reversible contraception
Ø Hormonal contraception
Ø Barrier methods
Ø Fertility awareness understanding the monthly fertility pattern can help to avoid getting pregnant. The fertility pattern is the number of days in the month a woman can get pregnant, and the days when pregnancy is unlikely. Contraception is achieved by avoiding having sex on fertile days or using a barrier method of birth control.
Ø Emergency contraception
Ø Permanent contraception
Ø Long lasting reversible contraception: it last for a long time.
These are the most effective types of contraception. They are more than 99% effective at preventing pregnancy. There are two types:
Ø The intrauterine contraceptive device: this is a device inserted into the uterus where it releases a copper component or a small amount of hormones to prevent the sperm from reaching the egg.
Ø The implant this a single, thin rod that is inserted under the skin of a woman’s upper arm. The rod contains a progestin that is released into the body over three years.
Hormonal contraceptive include:
Ø The contraceptive pill containing hormones which are taken at the same time every day
Ø The depo provera injection: women get injections of the hormone progestin in the arm or buttocks every three months to prevent pregnancy
Barrier methods are:
Male condom: this is a thin tube that fits over the penis. It prevents sperm from getting into the vagina. The male condom also protects against sexually transmitted infections. A new condom must be used each time a man has sex.
Female condom: this is a thin plastic pouch that is open on one end. The closed end is placed onside the vagina. The female condom also protects against sexually transmitted infections. A new condom must be used each time a woman has sex.
Diaphragm: this is a rubber or silicone dome with a firm, flexible rim. It fits inside the womans vagina and covers the cervix.
Spermicide: this is a substance that kills sperms. It must be used each time the woman has sex. Spermicide used alone does not work well to prevent pregnancy.
Emergency contraception: this is a pill taken up to five days after an unprotected sex. It is 98% effective. It can be used to prevent pregnancy if you haven’t used protection, if your normal contraception fails e g condom spilt, if you have missed more than one contraceptive pill, if you have missed your injection or if you have been forced to have sex without contraception. NB: emergency contraception should not be a regular method of birth control.
Permanent contraception:It can be done through Vasectomy: the vas deferens which carries the sperm from the testes to the penis are tied so the ejaculate does not contain sperm cells Ø Tubal ligation fallopian tubes are tied so that the sperm and egg cannot meet. Contraceptive methods also have some side effects specific to each method. The choice of a method of contraception is personalized to the needs of each couple as well as their health condition. Contraception allows individuals and couples to anticipate and attain their desired number of children; while helping them to space and limit births. If you need to know more on th e different contraceptive methods as well as which method to choose, seek advice from your doctor.
Dr TENTOUM Claire Aimée
REFERENCES
[1] WHO. Contraception. http://.who.int/health-topics/contraception#tab=tab_1. (2020). Accessed 19 Sept 2021. [2] WHO. Family planning/contraception methods. http://www.who.int/news-room/fact[1]sheets/detail/family-planning-contraception. (2020). Accessed 19 Sept 2021 [3] Agbor NE, Nsagha DS, Ngouakam H. Predictor of contraceptive methods mix inthe Cameroon Development corporation plantation camps. PanAfrican Medical Journal.2021;38(156).10.11604. http://www.panafrican-med[1]journal.com//content/article/38/156/full. [4] Tameh TY, FouelifackYF, Ymele F, Mbong EN, Fomulu N. Modern contraceptive choice among patients seen at the “Cameroo n National Planning Association for Family Welfare” Clinic Yaounde. Clinical Medicine: Reproductive Health. 2017;11:1-6. [5] WHO. Cameroon contraception within the context of adolescents’ sexual and reproductive lives: Country profile. http://www.who.int/health-topics/adolescent-health/ [6] New Zealand Family Planning. Contraception methods. http://www.familyplanning.org.nz/advice/contraception/contraception-methods. accessed 19 Sept 2021. [7] Geneva Foundation for Medical Education and Research. Barrier contraceptive methods. http://www.gfmer.ch/Books/Reproductive _health/Barrier_conraceptive_methods.htm.