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  • Family Planning Advice :

     

    It’s very unfortunate that educated female becomes pregnant just because they are not aware or not using Family Planning methods properly.

    The result is unwanted pregnancy and any termination of pregnancy is illegal as also damaging to her reproductive health in future.

    Dr. Parulben Shah’s Clinic offers a useful, cafeteria approach to the patients for avoiding unwanted pregnancies. Patients may choose non-permanent measures like Oral Contraceptive pills, barrier methods, I.U.C.D., injectable contraceptives (Depo-Provera) or permanent methods, that is, voluntary sterilization.
     
     Non-permanent methods:

    • Oral contraceptive pills: Should be started one month before the date of marriage. Also helps in pre-marriage counseling and adjusting the date of menstrual period and date of marriage. Recommended till you plan for first pregnancy for 2-4 years.
    • Barrier contraceptive: Condoms: High failure rate, so proper technique of using is very important to safe guard against high failure rate. Also give protection against AIDS and STDs.
    • Injectable Contraceptives: Used for few months after Delivery during lactation. Can also be used for long time after proper counseling.
    • I.U.C.D.: Recommended commonly after first pregnancy and effective for 3-5 years.

    Permanent methods:
    Voluntary surgical procedure for permanently terminating fertility in women

    Methods

    • Abdominal Tubal ligation (interval or postpartum)
    • Laparoscopy (45 days after delivery or immediately after menstrual period)

    Mechanism of Action

    • By blocking the fallopian tubes (tying and cutting, rings, clips or electro-cautery), sperm are prevented from reaching ova and causing fertilization.

    When to Perform

    • Anytime during the menstrual cycle you can be reasonably sure the client is not pregnant.
    • Days 6–10 of the menstrual cycle (proliferate phase preferred)
    •  Postpartum: within 2 days or after 6 weeks
    • Along with Medical Termination of Pregnancy (MTP)

    Appropriate for

    • After one or two children of more than 5 years of age.
    • Women of any reproductive age (usually < 45) or parity who want highly effective, permanent protection against pregnancy
    • Women for whom pregnancy would pose a serious health risk
    • Postpartum women
    • Along with Abortion
    • Women/couples who are certain they have achieved their desired family size
    • Women who understand and voluntarily consent to the procedure

    Method Characteristics: Benefits

    • Same day Discharge (Within two hours)
    • Highly effective (0.2–4 pregnancies per 100 women during the first year of use)
    • Effective immediately
    • Permanent
    • Does not affect breastfeeding
    • Does not interfere with intercourse
    • Good for client if pregnancy would pose a serious health risk
    • Simple surgery which usually is done under local anesthesia
    • No long-term side effects
    • No change in sexual function (no effect on hormone production by ovaries)

    Non contraceptive Benefits

    • Decreases risk of ovarian cancer

    Method Characteristics: Limitations

    • Must be considered permanent (not reversible)
    • Client may regret later
    • Small risk of complications (increased if general anesthesia used)
    • Short-term discomfort/pain following procedure
    • Requires trained physician (gynecologist or surgeon required for laparoscopy)
    • Does not protect against STDs (e.g., HBV, HIV/AIDS)

    Advantages of Laparoscopic Tubal Ligation:

    • Operative time is 2-3 minutes only
    • Patient can be discharged within two hours only.
    • Can be done even on very obese (i.e. 150 k.g. +) patient safely.
    • Specially helps in cases with previous LSCS/Laparotomy cases by simultaneously doing Adhesiolysis during Lap.T.L.
    • Success rate of Tubal Reversal rate (80-90 %) is better compared to reversal rate after Abdominal Tubal ligation operation.
    • Recorded video/CD/DVD helps to appreciate the quality of work done by Laparoscopic Surgeon.
 
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