why are contraceptive devices necessary for a happy society?
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Protection Against Unwanted Pregnancy:
A growing number of women and men of reproductive age wish to regulate their fertility and have fewer children. Between the ages of 20 and 44, a fertile, sexually-active woman is potentially capable of giving birth about 12 times, even if she breastfeeds each baby for 1 year. To avoid the need for an abortion, she has to successfully practice birth control for 16–20 of her roughly 25 childbearing years [1].
Couples are faced with conflicting goals of achieving satisfying sex life and keeping a small family, failure to do so results in unwanted pregnancy and abortions. When abortion seeking is risky, late or in the hands of unsafe providers or unhygienic conditions, it can lead to both reproductive morbidity and maternal mortality. World over, if contraception is accessible and used consistently and correctly by women wanting to avoid pregnancy, maternal deaths would decline by an estimated 25–35% [2, 3]. In India, the surveys suggest that abortions are responsible for 10–20% of all maternal deaths [4]. There is a need for awareness regarding effective contraceptive methods, their correct and consistent use.
Need for Protection Against Sexually Transmitted Diseases:
The transmissibility of several STIs and HIV/AIDS is greater from infected man to uninfected woman than the reverse [5]. The vagina offers a large mucosal surface exposed to the partner’s sexual secretions and a more conducive environment for microbial growth than the penile surface in men, therefore biologically, women are more vulnerable to STIs than men. Since the infected semen stays in the vagina for a while, a man can infect the woman more effectively. Also semen contains higher concentration of virus than the woman’s sexual secretions. Thus, men are twice more effective as transmitters of STIs than women.
Vulnerability of Adolescents:
Usually younger women, married or unmarried, are less likely to be using contraception than older women, even in countries where contraceptive prevalence rate (CPR) is high [6]. At macro level, laws, regulations and social policies that determine the access to contraception, affect adult and adolescent women alike in terms of the types of contraceptives that are permitted for distribution or prescription. But at the micro level, there are differences between adolescents and adult women, in fertility level, maturity, knowledge, negotiation in sexual relations and experience, coupled with social expectations affecting their behavioral patterns, as they relate to contraceptive acceptance and use. This increases their vulnerability to unprotected sex and its adverse consequences manifold.
Early sexual debut for adolescent girls means that chances of exposure to infections begin even before completing the process of physiological maturation. Though the systems have begun to function, the defense mechanisms are still evolving, particularly of the cervix. The cervical mucus acts as non-specific barrier for various ascending organisms in adult women. Adolescents do not have the benefit of this mucosal defensive mechanism till several years after menarche [7–9]. This increases their susceptibility to infection up to six times compared to their adult counterparts, particularly gonorrhoea, chlamydia and HIV.