This is one topic that comes in way of all couple. Sometimes couple know they don’t want pregnancy and sometime they are a bit late realizing it. In any case, methods to avoid pregnancy have to be used. In fact, it is not a choice but it is must to avoid pregnancy. The logic is very simple, a couple may plan to have some number of child (it depends) but that does not mean they will have sex only for that many number of times in their whole lifetime. Just imagine if that would be the case!

Hence, it is very important to know various methods to avoid pregnancy. One may ask why is it important to know various methods, wouldn’t one method be enough? It is because you never know what kind of situation you maybe in; a single method may not be suitable in all situations. Moreover trying new method maybe fun and if you are not interested in any fun then at least for your knowledge you should know about it. They are first thing that will come in mind when you think about family planning.

Huge medical science success has ensured wide variety of birth control methods in present times. We have enumerable choice for both men and women, for almost all kind of situation. With so many options available people may choose methods as per their liking and disliking. There are methods as per different budget too. Let us explore them all.

Safe Period: Every month a woman is in safe period that means if you mate with your woman in during that time then the chances of her getting pregnant is almost nil. I say the chances is almost nil because one has to be very careful calculating the safe period. Any miss calculation will result in fertilization. So how do we find out the perfect safe period for our women?

First, one should know the duration of the menstrual cycle, i.e. first day of the last menstrual bleeding to the first day of the present menstrual bleeding. This is the duration of the menstrual cycle. This varies from person to person and it is between 26 to 31 days. Ovulation (part of a woman's reproductive cycle in which an egg is released by a mature ovarian) approximately occurs in the middle of the cycle, i.e. duration of the cycle - (minus) 14 days (this also varies).

A week before and a week after the approximate day of ovulation is considered fertile period. The days apart from this are called the safe periods, where the fertilization does not take place.

Let us take a simple example. If a women's menstrual cycle varies from 26 days to 31 days cycle.

The shortest cycle [26days] minus 18days = 8th day.
The longest cycle [31days] minus 10days = 21st day.

Thus, 8th to 21st day of each cycle counting from first day of menstrual period is considered as fertile period. Period other than this fertile period in a menstrual cycle is considered as safe period.

Any intercourse during non-safe periods will surely result in pregnancy. Hence, it is very important to calculate the safe period very accurately. However, keep in mind, intercourse in safe period just ensures that chances of pregnancy is minimum but not zero completely. Why not zero? Read the next section.

Natal lunar fertile phase: In the previous section, I said that even safe period is not completely safe enough. Women around the world have complained about the concept of safe period not working for them even though they calculated their safe period with 100% of accuracy. The culprit here is our old friend, the Moon. Yes the moon! Sometimes phases of moon play an important role in determining the ovulation time (and thereby playing the spoilsport). It sounds as superstitious but it has been observed to hold good in a huge number of cases as a result of which we just cannot overlook it.

Here is the concept; each individual is born under a particular moon or lunar Phase. Each month when the moon returns to this same position (as it was at the time of birth) it can trigger a woman’s body to spontaneously ovulate even if she was in her safe period. No wonder women complained about the safe period even if they calculated it so accurately! However, let me be clear, it is not myth or superstition but at the same time it is not 100% accurate. It does play a part but not in all cases.

Furthermore – this lunar effect is increased by two factors - stress and sexual intercourse. If you are having intercourse during your natal lunar phase, the chance of ovulation increases. Multiple intercourse increases the factor even more.

To calculate phase of moon at your birth time (lunar fertile phase) you can go to the site tycho.usno.navy.mil/vphase.html or you can download a tool for the same www.softlist.net/program/moon_phase_calculator-download.html

Hence, to be on the safe side make sure are in for safe period and also make sure that it is NOT your natal lunar fertile phase. In such a case you may even avoid taking pills but be doubly sure that your calculation is 100% perfect. In fact it is suggested that you spend few months calculating your safe period and natal lunar fertile phase and be confident with before going for unprotected intercourse.

Condoms: This is also called barrier method to birth control as it creates a physical barrier between sperm cells and egg. I regard this as the best method to avoid pregnancy; no side affects like in case of pills, no need to do complex calculation and most important of all it is the best method to avoid all forms of STDs (sexually transmitted disease). We have both male condom and female condom.

Advantage of using condoms (both male and female)

• It is cheap and readily available (for male condom).
• Do not interfere with the bodies natural hormonal system (for both types of condom).
• Dramatically reduce the risk of catching sexually transmitted diseases - STD's (for both types of condoms).
• Easy to carry around (For both types of condom).
• Can be fitted in advance, so it doesn't interrupt sexual expression and interferes less with the sensation (for female condom).
• Does not need to be removed immediately after ejaculation (for female condom).
• Stronger and less likely to tear (for female condom).

Disadvantage of using condoms (both male and female)

• It is complained that it reduces the sensation considerably (for male condom).
• Bit more expensive and not readily available (for female condom).

Diaphragms: This is also a barrier method. A diaphragm is made of soft latex rubber and it is shaped like a cup that could be inserted into vagina so that they fit over the cervix. It is almost like female condom with two disadvantages one it is difficult to fit; two, it does not protect against STDs.

Cervical Caps: This is yet another barrier method. Cervical caps are smaller than diaphragms and a different shape. Cervical caps fit over the cervix and prevent sperm from entering the cervix.

Intrauterine Devices (IUDs): The intrauterine device (IUD) is a small T-shaped flexible device inserted into the uterine cavity. There are two kinds of IUD, The copper IUD and The Progestogen (Mirena) IUD.

The copper IUD is a small plastic device with copper wrapped around its stem. It interferes with the ability of sperm to pass through the uterine cavity and with the reproductive process before ova reach the uterine cavity.

The Progestogen (Mirena) IUD is a small T-shape device with a cylinder containing progestogen around its stem and it also thicken the cervical mucus and change the endometrial lining.

IUDs are around 99% effective in birth control. However, before going for it, it is important to know some of the main advantage and disadvantages of this product.

Advantages of using Intrauterine Devices (IUDs)

• They have long life and can last up to 5years.
• Considering the amount of time it lasts, it will appear as a very cheap option of birth control.
• Progestogen (Mirena) IUD has an added advantage of reducing menstrual bleeding.

Disadvantages of using Intrauterine Devices (IUDs)

• It does not provide any protection against any STDs.
• If the device fails and the woman gets pregnant then it should be removed as soon as possible as it may cause miscarriage.
• It may be displaced during the period and the woman may not be aware of the same hence, it should be checked regularly.
• There is a small risk of infection following three week after it is inserted.
• One has to be very careful while inserting it as it may damage the walls of uterus (the chances are very rare).

Birth Controls Pills: Method to avoid pregnancy by taking birth controls pills are also known as Hormonal methods of contraception. There are different types of birth control pills available.

Progestin-Only Pills, also known as mini pills contains the hormone progestin and are taken daily by the woman. It suppress ovulation, thicken the cervical mucus and reduce sperm transport in the upper genital tract but it does not stop the ovulation.

Advantages of using mini pills

• Unlike some pills it is do not cause any heart problem.
• Breastfeeding mothers can safely take it as it does not hamper the milk production.
• It decreases the likelihood of pelvic inflammatory disease.
• It causes less menstrual cramping and pain. Menstrual loss of blood is reduced as well.
• It lessens the chances of anaemia.

Disadvantages of using mini pills

• First of all it does not offer protection against any STDs.
• It is very rare (about 1%) but it is sometimes related to breast cancer.
• It increase the risk of having functional ovarian cysts.
• It may cause mood swings and headaches.
• It may disturb the period and may cause irregularity in the pattern of bleeding. Sometime bleeding may be in access and my cause abdominal pain.
• Sometimes it may also cause spots on skins but then it depends from person to person.
  

The Combined Oral Contraceptive Pill are very much like mini pills but their composition are different. They are made up of two hormones oestrogen and progesterone. They stop ovaries from releasing eggs i.e. they basically stop ovulation unlike mini pills. They also thicken the cervical mucus and reduce sperm transport in the upper genital tract.

Advantages of using Combined Oral Contraceptive Pill

• It is highly effective if it is taken properly i.e. regularly at roughly the same tim
• It may help reduce the pain at the time of period.
• It offers protection to a certain extent against cancer or ovary and womb.
• It is a suitable method for healthy non-smokers up until the menopause.
• Fertility returns to normal as soon as you stop taking the pill.

Disadvantages of using Combined Oral Contraceptive Pill

• When one starts taken it for the first time it may cause some temporary side effects like headaches, breast tenderness, weight changes. This side effect may last up to first two or three packs
• It is not suitable for smoker over 35 years of age.
• May increase the chances of breast cancer, blood clots and cervical cancer but the chances are very rare.

Surgical method to avoid pregnancy: This method is related to the permanent removal of fertility. This could be done on both male and female.

Vasectomy is a surgical procedure that terminates a man's fertility permanently. Vasectomy can be done by the standard method or the no-scalpel technique. It is advised to go for no-scalpel technique. Vasectomy blocks the vas deferens (ejaculatory duct) so that sperm are not present in the ejaculate.

Tubal Occlusion is a surgical procedure for permanently terminating a woman's fertility. Tubal occlusion can be done by minilaparatomy or laparoscopy. Tubal occlusion blocks the fallopian tubes and sperm are prevented from reaching the ova and causing fertilization.

Tubal Occlusion is said to be more complicated method then Vasectomy and hence it is advised that the male partner should go for Vasectomy.

Spermicides: Spermicides are chemicals that inactivate or kill sperm. They are available as foams, creams, vaginal tablets, suppositories, and dissolvable films. They cause the sperm cell membrane to break, which decreases sperm movement and their ability to fertilize the egg. Sometimes people use spermicides along with the other protection that they might be taking for double protection.

Advantages of using spermicides

• It is easily available without a prescription.
• It is a reversible form of birth control and does not cause any changes to your body.
• It can be used with other birth control methods to lower the chances of pregnancy further.

Disadvantages of using spermicides

• It does not offer any protection against STDs.
• Some people may be allergic to it.
• Frequent use can cause irritation in the vagina, which increases the risk of getting a sexually transmitted infection, including HIV.

Coitus Interruptus: Also knows as withdrawal method or pull-out method, this is the simplest and traditional family planning method in which the man withdraws this penis completely from the vagina before he ejaculates. This method has been widely used for at least 2,000 years and was used by an estimated 38 million couples worldwide in 1991 (wikipedia).

Advantages of using Coitus Interruptus

• This method is very much preferred by women as it do not require consumption kind of pills or medicine which may cause side effects. Hence, it could be said to be good from health point of view.

• It can be practiced in case there is no availability of any other forms of contraception.

Disadvantages of using Coitus Interruptus

• No prize of guessing this, it offers no protection against STDs. There is no grantee that the withdrawal will take place at correct time and even if it is done accurately, there are some fluids that come out before ejaculation.

• The biggest problem is, it requires a lot of will power and proper understanding between partners to withdraw before ejaculation and even if it is done there are some sperm does get discharged well before the ejaculation hence the success rate of this method is very bad.

Lactational Amenorrhea Method: This contraceptive method is applicable to women who just given birth to a new baby. In this method breastfeeding is used to suppress ovulation. The mother has to breastfeed her child for all feeding (all time, day and night) and the child should be less then 6month of age. As long as the nursing mother is exclusively breastfeeding, the baby is younger than 6 months of age, and the mother has not started having periods, she is more than 98% protected against pregnancy. However it should be kept in mind, as the breastfeeding decreases due the child eating supplement feeding, the contraceptive protection decreases, and other methods should be considered.

Women who bottle-feed might get their periods returning very soon after birth and those women still breastfeeding regularly (especially if through the night) may not see their bleed till night feeds cease. It all varies and its important to realise there are no strict rules in this regard.

Advantages of using Lactational Amenorrhea Method

• If breastfeeding is done correctly and sufficiently then the success rate could be 98% or even more in some cases.
• As it is already proved that breastfeeding is beneficial for child and the mother (reduces the risk of breast cancer) hence, this method is good from the health point of view for child and mother.
• No involvement of any pills hence no side effects on health.

Disadvantages of using Lactational Amenorrhea Method

• As always any contraceptive method that does not offer any physical barrier will be ineffective against the infection from STDs. This is the same case.
• Ovulation will usually occur before the return of the menstrual cycle. Therefore you could be ovulating and not know it.
• Some women may find it difficult to feed their baby at specific times, especially during the night.
• Limited to breastfeeding women only.

People had some unique ways to control pregnancy in ancient times, some of them is even used today but in more refined and scientifically developed form. It is interesting to note that lot of ancient method were working good but it is strictly advised not to follow any of them. Ancient techniques I mention here is just for your information and should not be followed as none of them will be as effective as any of the modern method and moreover they maybe very harmful to health.

Spermicide: As per some of the ancient medical manuscripts, women were advised to grind dates, acacia tree bark, and honey together into a paste and apply it with seed wool to the vulva. Modern science has shown that, since acacia ferments into lactic acid, a well-known spermicide, this method may have been effective. Other compounds that were smeared around the vagina included olive oil, pomegranate pulp, ginger, and tobacco juice.

Vaginal suppositories or diaphragms: Throughout history, women have used objects such as sea sponges or soft wool as a sperm barrier, often in combination with lemon juice or vinegar. Half a lemon might be inserted into the vagina. Oriental women used oiled paper to "cap" the cervix, while European women used beeswax.

It has been recorded as early as 2nd-century BC. Substances used include elephant or crocodile dung, leaves, and seaweed. Other methods have included placing an apricot pit in the uterus, or a product consisting of cocoa butter, boric acid, and tannic acid.

Oral Contraceptives: Women in ancient China drank mercury to prevent pregnancy. Later, women in India imbibed carrot seeds, and an aboriginal group in Eastern Canada drank a tea brewed with beaver testicles. In Ancient Greece and Rome, the juice of the silphium plant was a popular and effective form of oral contraceptive, which women took once a month.

In the 2nd century BC, women were advised to drink the water that blacksmiths used to cool hot metals. Urine and animal parts and poisons such as mercury, arsenic, and strychnine were also used as oral contraceptives.

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