The Sunday Mail
Donald Dube
Methods of family planning are classified into three broad categories, namely: short-acting, long-acting and permanent methods. Under the short-acting methods are contraceptive pills, injectable, condoms and fertility awareness-based methods. Long-acting reversible contraceptives include implants and intra-uterine contraceptive device. For permanent methods there is tubal ligation for women and vasectomy for men.
Short-acting methods
- The pill is a short-term hormonal contraceptive taken by women to prevent pregnancy.
It prevents maturing of the egg. One pill must be taken by mouth each day at the same time, to make it work. In Zimbabwe, there are two types of pills in the public sector, namely: combined oral contraceptives (e.g. control) and progestogen only pill (e.g. secure). When taken regularly and correctly, the pill is a very effective method of preventing pregnancy.
- The male condom is a thin sheath of rubber used by a man to prevent his partner or wife from becoming pregnant. The male condom is a dual protection method.
This means that apart from preventing unintended pregnancy if correctly and consistently used, it can also prevent sexually transmitted infections (STIs), including HIV.
The female condom is a thin sheath or pouch worn by a woman during sexual intercourse. It provides continuous lining of the vagina, which inhibits exchange of sexual fluids, hence preventing pregnancy and STIs including HIV.
- Injectables are hormonal contraceptive methods injected to women by a trained healthcare provider once periodically depending on type e.g. (depo provera/petogen). The injectable does not affect the quantity and quality of breast milk in breastfeeding mothers and is effective for most women as long as she does not default.
Sayana press is another hormonal contraceptive injection that is easily administered, reliable, safe and effective, with almost no risk of unintended pregnancy. Sayana press is a three-month, progestin-only, all-in-one pre-filled single-use injectable contraceptive that combines the drug and needle in the uniject injection system.
It is small, light, easy to use, and requires minimal training, making it especially suitable and easy for community health workers and for women to administer themselves through self-injection.
- Fertility awareness based methods
Lactational Amenorrhea Method (LAM) — for breast feeding mothers. This is a natural method of preventing pregnancy for a woman who is exclusively breastfeeding for up to six (6) months after child-birth. A breastfeeding woman uses LAM when:
Her baby gets little or no food or drink, except breast milk and she breast feeds often, both day and night;
Monthly bleeding has not returned after child-birth;
Her baby is less than six (6) months old.
A woman should plan to take up another method before the end of the effective period which lasts up to six months after child-birth.
Long-acting reversible methods
1.Implants
Implants are small contraceptive plastic rods which are inserted under the woman’s skin, usually on the inner part of the upper arm. An Implant is a long-acting reversible contraceptive, highly effective in preventing pregnancy. It can be used by almost any woman who is in good health.
There are three types of implants:
- a) Jadelle (Progestogen-Only-Contraceptive) — Jadelle is a two-rod implant which is long-acting, reversible and highly effective in preventing pregnancy for up to five years.
- b) Levoplant — Levoplant is also a two-rod implant which is long-acting, reversible and highly effective in preventing pregnancy for up to three years.
- c) Implanon (Progestogen-Only-Contraceptive) — Implanon is a one-rod implant which is long-acting, reversible and highly effective in preventing pregnancy for up to three years.
Implants do not reduce the quantity of breast milk and therefore appropriate for breastfeeding women.
Implant can be removed anytime the woman wishes to stop using it.
The woman can fall pregnant immediately upon removal of the implant.
The Implant should be inserted and removed by a trained medical person.
Implant does not protect against STIs including HIV.
- Intrauterine Contraceptive Device (LOOP)
The intrauterine contraceptive device (IUCD) or loop is a small plastic device which is placed inside a woman’s womb to prevent pregnancy. For as long as it remains in the womb, a baby will not develop. It takes a few minutes to insert the IUCD into the womb. It offers protection for up to 12 years but is reversible at any given time one wants to get pregnant.
The IUCD does not interfere with milk of the breastfeeding woman. The IUCD can easily be inserted or removed at a Health Centre by a trained nurse or doctor. IUCDs are effective for most women. The IUCD does not protect against STIs including HIV.
Permanent methods:
- Male Surgical Contraception (Vasectomy)
Male surgical contraception known as vasectomy is a method that is permanent and recommended for a man who does not want any more children.
The man’s tubes are blocked so that when he has sex his semen has no sperm to fertilize the woman’s egg. It is a small and minor operation done at a hospital or clinic. It can be done while the man is awake after being given an injection on the area to prevent pain.
The man will continue to enjoy sex as before without getting a woman pregnant. Vasectomy is not reversible and does not protect against STIs including HIV.
- Female Surgical Contraception (Tubal Ligation)
Tubal ligation is a method that is permanent and recommended for a woman who does not want any more children.
The woman’s tubes are blocked so that her eggs cannot travel to meet the man’s sperms during sex. In many cases, the woman is awake during the operation. She may also be able to go home on the same day.
Tubal ligation is an effective method of contraception. A woman whose tubes have been blocked will still have her normal monthly menstrual periods.
Tubal ligation is not reversible and does not protect against STIs including HIV.
Mr Donald Dube is the marketing and communications manager for the Zimbabwe National Family Planning Council (ZNFPC).
