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Just how safe are birth control pills?
Kanchana Banerjee
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September 17, 2007

You'd be surprised at the age band of women who come to me for advice regarding birth control pills," says Dr Anita Soni, a gynaecologist with L H Hiranandani hospital in Mumbai. "The age band is lowering; more and more young unmarried women come to me to ask about birth control pills, which one they should take and other specifics. And no they are not embarrassed at asking sex-related questions."


It may be hard to accept but it is a reality in India nevertheless. More and more unmarried women are going on the pill. Ask any gynaecologist and she/he will vouch for the fact that number of young unmarried people, visiting them to seek clarifications about contraceptive options, is on the rise.


A safe option?

In recent years one has seen the easy availability of birth control pills in the market. Dr Soni says, "The pills of yesteryear had many side-effects. They disturbed a woman's hormonal balance and women often sprouted facial hair while others put on weight. But today the pills are much improved. Women can be on them for a prolonged period."

However, when asked, many women still feel unsure about taking a pill everyday. Kavita*, a senior marketing person with a five-star hotel in Mumbai, says, "A pill makes me feel as though I'm taking a medicine. And I feel uncomfortable popping a pill everyday. Doctors reassure you that they are safe and wouldn't interfere with the hormones but somehow I don't and can't believe them. There's bound to be an after effect of taking something everyday." Kavita has opted for the loop as she feels totally safe and sure.


The choice of Today

Irrespective of what the doc prescribes, it's really each to her own in the case of birth control options. While Dr Soni says that spermicidal gels like Today are unreliable and should be used along with a condom, there are women like Mridula (28), a freelance writer based in Delhi, who swears by it.


"I tried the pills but couldn't remember to have them everyday. My husband tried the condom and we both felt very uncomfortable. I have been using Today since my son was born four years ago and there hasn't been any mishap and both my husband and I feel wonderful," she says.


There are many others who have the same to say about spermicidal gels. However, Today is the only brand available in India, so if you're looking for a choice you'll need to look abroad.


For now, a vast majority of women vouch for the pill and condom, which are still most widely used. The condom is considered the safest as it prevents unwanted pregnancy and also serves as protection from STDs (sexually transmitted diseases).


Sunita*, a radio jockey in Mumbai, says, "I find the pill very convenient. Pop a pill everyday and I have my peace of mind." Her boyfriend, a DJ at a nightclub however prefers the condom. "I think it's the safest protection. A woman could have missed taking the pill so I always believe in having a condom. A bundle of joy can give a lot of joy when it is planned and not unexpected."


Better safe than sorry

Most men and women seem to be very sure that they don't want to end up with an unexpected pregnancy, whether married or not. Sunita says, "A child is welcome when carefully planned and thought out. An unexpected pregnancy is not a bundle of joy."


Kaveri*, a marketing executive with a Mumbai-based PR firm says, "I have a steady boyfriend and we hope to marry soon. We do share physical intimacy and take precautions. An unplanned pregnancy is most traumatic and not happy news at all. I'd much rather be careful and have protected sex than conceive and then think of medical termination. An MTP (medical termination of pregnancy) is never a happy and easy option to choose. And why go through all that guilt when all one has to do is be a little careful."


Ashok* (29) works with a five-star hotel in Delhi. "My girlfriend conceived because of carelessness on our part. I suggested an MTP but she didn't want it. I loved her and didn't want to hurt her so we got married, though both of us weren't ready for marriage." Problems crept into their marriage and today Ashok is separated from his wife.


"The only reason for marriage should be love and the desire to be together and nothing else. We decided to marry as she got pregnant and I felt that it was the honourable thing to do. I wasn't prepared for matrimony, leave alone parenthood and neither was she."


This sentiment runs among married women too, especially those who have been married for more than 10 years. These are couples that have gone through child bearing and rearing. They are in their late thirties or early forties and look ahead to a life of fun with their respective partners. "It would be disastrous if I got pregnant. I am 38 years old and have two kids -- 9 and 5," says Anita, a homemaker in Kolkata.


Neelima* (42), is a mother to a 13-year-old boy and 10-year-old daughter. She says, "There is a time for everything and this phase of life isn't for having kids. I wanted two kids and I have that. I can't even imagine what a pregnancy would do to my life. Not only will it embarrass my kids, my husband and I would be devastated. But unexpected pregnancy isn't unheard of at my age. Accidents happen. It has happened to some of my friends."


Her worries are shared by many of her age. These are women years away from menopause but a pregnancy though not impossible is unwanted. "For such women who already have the family they desired, the loop is the best option as it minimises the risk of an unplanned pregnancy," says Dr Soni.


The i-pill

For such unexpected mishaps, there's a new pill in the market -- the i-pill. An emergency contraceptive pill, it needs to be taken within 72 hours or earlier of unprotected intimacy to prevent pregnancy. Although many have only noticed this product after its recent mass media advertising campaign, it has been available for some time now but wasn't actively advertised and also couldn't be bought without a doctor's prescription.


Dr Soni explains, "This isn't a contraceptive and shouldn't be used as one. It's a pill that is to be used in case of unprotected sex to prevent an unwanted pregnancy." Though with a high rate of success, this again isn't absolutely fool proof.

The i-pill is, however, also been looked at with welcome relief by the younger lot. "It is nice to know that there is something to reach out for in case one indulges in unprotected sex," says Sulekha*, a 24-year-old BPO executive in Hyderabad.


The conservatives and the moral police are looking at the product as an easy escape that would be used by the reckless, but all arguments aside, India today is witnessing a rise in premarital sex and such safety options are the need of the hour.


As Dr Soni says, "This isn't about being reckless or footloose. Our society is changing and so are we. We have to accept the changes rather than resist them. It is important for every young person to be aware of the different contraceptive options and STDs. With freedom comes responsibility and one must use it carefully."


While many women, who are on the pill, have given it the thumbs up, before you decide on your preferred method of birth control, seek your doctor's advice.


*Names changed to protect privacy.

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