Population Stabilisation and Birth Control

Population Stabilisation and Birth Control

 

Population growth:

 

  • Population growth rate is the percentage change in the population size over a specific period, considering births, deaths, and net migration.
  • All-round development in various fields in the last century improved people's quality of life but also led to explosive population growth due to increased health facilities and better living conditions.
  • Reasons for population growth include a rapid decline in death rate, maternal mortality rate (MMR), and infant mortality rate (IMR), along with an increase in the number of people in the reproducible age group.
  • Maternal mortality rate (MMR) indicates the risk of maternal death during childbirth, reflecting the health and healthcare conditions for expectant mothers.
  • Infant mortality rate (IMR) reflects the health and healthcare conditions for newborns, indicating the number of infant deaths per 1000 live births.
  • A census is an official count or survey of a country's population, conducted at regular intervals to collect demographic data.

 

Population stabilisation: 

  •            Population stabilisation refers to achieving a balance between birth rates and death rates in a population, resulting in a stable population size over time. 
  • It is a state where the number of births equals the number of deaths, leading to zero population growth. 
  • Population stabilisation is a crucial goal in managing population growth and addressing various social, economic, and environmental challenges associated with rapid population increase. 
  • By achieving population stabilisation, a society can ensure sustainable development, resource utilisation, and improved living conditions for its inhabitants. 
  • This may involve implementing effective family planning programs, promoting reproductive health, and raising awareness about the benefits of smaller family sizes.
  • Reproductive health encompasses not only physical well-being but also emotional, behavioural, and social aspects related to reproduction, making it a comprehensive concept.
  • India initiated national-level action plans for reproductive health in 1951, known as 'family planning' programs. 
  • Family planning programs initiated in India aimed to control population growth and foster Planned Parenthood.
  • Reproductive and Child Health Care (RCH) programs have expanded the scope of family planning, covering a broader range of reproductive health areas.
  • Sex education is crucial to provide accurate information to young individuals, dispelling myths and misconceptions about sex-related matters.
  • Topics covered in sex education: reproductive organs, adolescence changes, safe sexual practices, STDs, AIDS, etc.
  • Raising awareness about issues like uncontrolled population growth, sex abuse, and sex-related crimes to build a socially responsible society.
  • Successful implementation requires strong infrastructure, professional expertise, and material support in medical assistance for reproduction-related problems.
  • Amniocentesis is a prenatal test used to assess the health of a developing foetus by analysing the amniotic fluid for genetic abnormalities.
  • Female foeticide refers to the illegal practice of aborting female foetuses, perpetuating gender imbalances in society.
  • Saheli, developed by scientists at CDRI, is a notable contribution to oral contraceptives, offering more options for family planning and reproductive health.

Birth control:

 

  • Motivating smaller families is a crucial step to address population growth.
  • Various contraceptive methods are utilised to prevent unwanted pregnancies.
  • Advertisements and posters promote the concept of "Hum Do Hamare Do" (we two, our two) to encourage smaller families.
  • Some young, urban, working couples adopt the "one child norm" voluntarily.
  • Statutory measures include raising the female marriageable age to 18 and the male age to 21.
  • Incentives are given to couples with small families to promote population control.

 

 Contraceptive methods for birth control: 

An ideal contraceptive should be user-friendly, easily available, effective, reversible, and have minimal or no side-effects.

 It should not interfere with the user's sexual drive, desire, or sexual act.

1. Natural/Traditional Methods:

- Periodic abstinence: Couples avoid coitus from day 10 to 17 of the menstrual cycle when ovulation is expected to prevent conception. 

- Withdrawal method: The male partner withdraws before ejaculation to avoid insemination. 

- Lactational amenorrhea method: Breastfeeding mothers experience temporary infertility postpartum. 

2. Barrier Methods:

- Condoms: Thin rubber/latex sheaths covering the penis or vagina prevent sperm entry. 

- Diaphragms, cervical caps, and vaults: Rubber barriers inserted into the female reproductive tract block the cervix during coitus.

 3. Intrauterine Devices (IUDs):

- Non-medicated IUDs: E.g., Lippes loop. 

- Copper-releasing IUDs: E.g., CuT, Cu7, Multiload 375. 

- Hormone-releasing IUDs: E.g., Progestasert, LNG-20. 

- IUDs increase phagocytosis of sperms, suppress sperm motility, and alter the uterus and cervix to prevent conception. 

4. Oral Contraceptives (Pills):

- Progestogens or progesterone–oestrogen combinations inhibit ovulation and alter cervical mucus to prevent sperm entry. 

- Contraceptive pills are taken daily for 21 days, preferably within the first five days of the menstrual cycle. After a 7-day gap, during which menstruation occurs, the pattern is repeated until the individual wishes to prevent conception. These pills inhibit ovulation, alter cervical mucus quality, and prevent sperm entry. They are highly effective, have fewer side effects, and are well accepted by females. 

- Saheli is a non-steroidal, once-a-week contraceptive pill with fewer side effects.

 5. Injectable and Implantable Methods:

- Progestogens alone or in combination with oestrogen can be administered as injections or implants under the skin.

 - Emergency contraceptives can be used within 72 hours of coitus to prevent possible pregnancy due to unprotected intercourse.

6. Surgical Methods (Sterilisation):

- Vasectomy: In the male, a part of the vas deferens is removed or tied to prevent gamete transport.

Vasectomy involves removing or tying up a small part of the vas deferens through a scrotal incision. 

- Tubectomy: In the female, a part of the fallopian tube is removed or tied to prevent conception.

Tubectomy removes or ties up a portion of the fallopian tube through an abdominal or vaginal incision.  

Both techniques are highly effective in preventing pregnancy but have poor reversibility.

 

 Importance of Professional Consultation:

 

  • Selection and use of a suitable contraceptive method should be done in consultation with qualified medical professionals.
  • Contraceptives are used to prevent or delay pregnancy and should be practised responsibly to maintain reproductive health.
  • Widespread use of these methods helps control population growth but may have minor side effects that should not be ignored.

 

Medical Termination of Pregnancy (MTP)

 

  • Medical Termination of Pregnancy (MTP) or induced abortion is the voluntary termination of pregnancy before full term.
  • Approximately 45 to 50 million MTPs are performed worldwide annually, accounting for 1/5th of conceived pregnancies each year.
  • MTP plays a significant role in population control unintentionally, as it is mainly meant for getting rid of unwanted pregnancies due to casual unprotected intercourse, contraceptive failure, or rapes.
  • MTPs are essential in certain cases where continuing the pregnancy could be harmful or fatal to the mother or the foetus.
  • The debate surrounding the acceptance and legalisation of MTP in various countries is influenced by emotional, ethical, religious, and social factors.
  • The government of India legalised MTP in 1971 but imposed strict conditions to prevent misuse and curb indiscriminate and illegal female foeticides.
  • MTPs are considered relatively safe during the first trimester (up to 12 weeks of pregnancy) but carry higher risks during the second trimester.
  • A concerning trend is the illegal performance of MTPs by unqualified quacks, leading to unsafe and potentially fatal outcomes.
  • Misuse of amniocentesis to determine the sex of the unborn child followed by selective MTP based on gender is illegal and dangerous for both the mother and foetus.
  • Effective counselling on the importance of protected intercourse and the risks associated with illegal abortions, coupled with improved healthcare facilities, can help address these issues and promote healthier practices.

Sexually Transmitted Diseases (STDs)

 

  • Sexually Transmitted Diseases (STDs) or Venereal Diseases (VD) or Reproductive Tract Infections (RTI) are infections transmitted through sexual intercourse.
  • Common STDs include gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B, and HIV leading to AIDS.
  • Hepatitis-B and HIV can also be transmitted through sharing injection needles, surgical instruments, blood transfusion, or from an infected mother to the foetus.
  • Except for hepatitis-B, genital herpes, and HIV, other STDs are completely curable if detected early and treated properly.
  • Early symptoms of STDs include itching, fluid discharge, slight pain, and swellings in the genital region. Some infected females may remain asymptomatic for an extended period.
  • Delayed detection and lack of proper treatment can lead to complications like pelvic inflammatory diseases, abortions, stillbirths, ectopic pregnancies, infertility, and reproductive tract cancer.
  • Prevention and early detection are crucial to combat STDs, and reproductive health-care programs prioritise these aspects.
  • The age group of 15-24 years is particularly vulnerable to these infections, and prevention can be achieved by avoiding sex with unknown/multiple partners, using condoms during intercourse, and seeking immediate medical attention if there are any doubts or symptoms of an infection.