Contraception & Abortion
 
Q. What is the 100% reliable contraception so that I do not become pregnant?  
A. Abstinence is the only 100% reliable contraception. Most of the hormonal contraceptives (oral, injectable, implants) come close to 100% (>99%)
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Q. What are the problems of an unwanted pregnancy? 
A. The problems of an unwanted pregnancy are abortion and its complications or the additional burden of maintaining an unwanted pregnancy. If you are unmarried add to it the social pressures from family and friends. For the unmarried and brave be ready for the ostracism faced by a single mother if your partner ditches you.
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Q. Is it important to use condoms every time we have sex?
A. Condoms are one of the best contraceptives for preventing sexually transmitted diseases though not as effective in preventing a pregnancy. Assuming you or your partner may have other sexual partners it is always prudent to be safe and use condoms during intercourse.
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Q. We have sex infrequently, can ‘i-pill’/‘unwanted 72’ be used for protection?
A. Often it is difficult to describe what infrequent means and realizing that the timing of the act is often unpredictable, contraception or protection should be planned well in advance. i-pill/unwanted 72 are emergency contraceptives and meant for use when pills are forgotten, condoms burst or when  the safe period is calculated incorrectly. It works for a single act of intercourse with a 90% efficacy and is actually a backup method and not an alternative method for regular contraception.
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Q. If I wash off secretions just after sex can I still be pregnant?
A. Douching or washing of the genitalia is no guarantee that all the sperms will be washed out. There are still chances of becoming pregnant, as some sperms would have crossed in before you washed and you can really never be sure that all the sperms have been washed off, as they cannot be seen.
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Q. I have missed my periods. I am scared I may be pregnant. What to do?
A. Of course if you had sex you may be pregnant even if you were using protection, as nothing is 100%. The first thing to do in that case is to get your urine tested for pregnancy. This may be done by picking up a pregnancy test kit at any chemist shop. It is not always essential to take a morning sample, if tested after a week of the missed period. Pregnancy can be detected as early as a couple of days after the missed period date. Instructions of testing are clearly inscribed over the packet.
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Q. Can abortions be done without an operation?
A. Yes. There are medicines, which can be prescribed to induce abortions. This should always be done under the supervision of a doctor and are most effective (>95% completion rate) in the first two months of pregnancy.
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Q. How reliable is a medical abortion? Is it painful?
A. Done in the first seven weeks the efficacy is close to 99%. Till 9 weeks it is still reliable in up to 95% cases. Thereafter the efficacy falls. Yes the process is painful but usually well tolerated with oral analgesics. Hospitalization is often not necessary but hospital backup should be available in an emergency.
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Q. What are the problems of abortions if I get it done in a ‘cheap’ place?
A. By ‘cheap’ place I presume you mean the illegal and untrained care providers. This leaves you at a risk of complications like severe bleeding, uterine perforation, bowel injury and infection in the short term and chronic pain and sub fertility in the long run. You may actually die from the procedure. One Indian mother dies every 40 minutes due to an illegal abortion.
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Q. How can I be sure the abortion is complete?
A. One way is waiting for the next period, which makes it pretty clear and simple. Alternately, an ultrasound examination could reveal an empty womb/uterus, three weeks after the procedure confirming completion. Pregnancy tests can remain positive for several weeks after an abortion and are not good guides.  
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