All you need to know about contraceptives in India

Before we dive into our options for birth control and emergency contraception, let’s first understand the exact conditions required for a pregnancy to occur:

Release of the sperm and egg
Fusion of the sperm and egg, i.e., fertilization
Implantation of the fertilized egg on the inner wall of the uterus
Contraceptive pills or devices, therefore, function by interrupting or preventing any one of these three stages that lead up to pregnancy.

To prevent the release of the sperm or the egg: we have vasectomies, tubectomies, and birth control pills that are typically prescribed over long periods of time.

To prevent fertilization: we have latex barriers like condoms, intrauterine devices like the copper-T, and spermicidal lubricants.

To inhibit implantation: we have emergency contraceptive pills.

Now let’s look at these pills in a little more detail, shall we?

Contraceptive Pills to Prevent Pregnancies

Contraceptive pills can include two forms of medication—the type that prevents ovulation and the type that prevents implantation of the fertilized egg. These can either be prescribed as everyday or periodic medication, or as emergency pills that are taken the “morning after”.

Everyday or periodic medications include Saheli, Bandhan, Yasmin, and Unwanted 21.
Emergency “morning after” medications include I-pill.
Note: It is legal to terminate a pregnancy in India within the first 24 weeks, and the sale of these contraceptive medications at pharmacies is therefore legal too. The catch, however, is that misinformation and stigma fuel the apprehensions of local pharmacies, who refuse to stock the products or feel obligated to ask potentially intrusive questions before making the sale. However, you are legally entitled to a doctor’s counsel and prescription along with access to the right medication within this 24-week period and are well within your right to seek medical counsel and support from other doctors if your current one does not offer it to you. Please avoid self-medicating or experimenting with herbal/chemical concoctions.

Saheli (Chhaya)

Launched in 1991 and developed in the Central Drug Research Institute in Lucknow, Saheli is a non-hormonal birth control pill. Unlike popular contraceptive pills, Saheli does not use hormones to prevent pregnancy but merely blocks estrogen to prevent implantation. Since the drug does not use hormones to prevent pregnancy, it does not have to be taken every day or at the same time. In fact, Saheli is typically prescribed on a bi-weekly basis for the first three months, and a weekly basis from there on.

To add to the list of perks that Saheli offers, it also does not have the side effects that are usually associated with hormonal birth control and has reportedly shown to reduce the risk of breast and ovarian cancer too!

Bandhan

Bandhan works by preventing ovulation and thickening the cervical mucus to inhibit the movement of sperm. Since it does use a class of progestins to prevent pregnancy, it’s best to consult a doctor to discuss your hormone cycle and seek more information to better understand when and how the best way to introduce Bandhan into your routine would be, and to mutually agree upon the right dosage for you.

Side effects can include headaches, nausea, acne, irregular bleeding, depressive episodes, and breast pain. These side effects are commonly associated with most hormonal birth control meds, so it’s best to speak with a trusted doctor if it’s safe for you. If you are already living with PCOS or are under medications for other health conditions, or are a regular smoker or drinker, it’s best to find a doctor that you can freely discuss this with to better understand your options and find strategies that do not cause you additional harm, whether physical or emotional.

I-Pill

Now here’s what you need to know about the I-Pill or any other brand of medication that is meant for emergency use—it is not meant to be taken on an everyday basis. It is only meant to be taken in the event that your condom breaks or you find yourself having sex without barriers, IUDs, or regular birth control.

The I-Pill is supposed to be available to you without prescription. So if a chemist asks you unnecessary questions or makes you uncomfortable, try seeking a different chemist or speak to your trusted circles to access the medication elsewhere.

Taking multiple I-Pills will not increase its efficacy but will more likely aggravate the potential side effects for you. Take one pill within 3 days of the event, and if possible, try and speak with a medical professional who can help you keep an eye on your health and look out for any signs of distress that may require additional medical support. Side effects include nausea, dizziness, headaches, irregular bleeding, and changes in your mood. If you do find yourself requiring an I-Pill more than once a month, it’s best to consult a doctor about that too, to better understand what to anticipate after those doses.

Much like anything else, no contraceptive pill offers a perfect 100% efficiency rate. Factors like where you are in your cycle when you take the medication, chemical interactions between your birth control pills and other meds, or the presence of alcohol and other substances in your system also play their own role in impacting the efficacy of contraceptive pills. Latex barriers are still crucial for the prevention of the transmission of infections and regular STD tests will also help you get a clearer picture of how your body is doing.

Sexual safety isn’t merely about birth control pills or STI tests. It’s about finding systems of care that guarantee us access to a combination of strategies and solutions—like OB-GYNs who understand the difference between “Would you be comfortable with telling me when you were last sexually active?” and “Are you married?”, or chemists who respect the difference between medications that require a prescription and ones that do not, and acknowledge their role as providers of medication and not lessons on morality.

It’s a pity we live in a world that doesn’t always respect that both conception and contraception are shared community responsibilities and should never feel like a burden on one person alone. But here’s hoping that we get there someday.