World Contraception Day: Here's why you shouldn't have a second child too soon after the first

A report recently shared by the Union Health Ministry suggested a massive rise in India’s population, thanks to a 35% dip in use of contraception.

Reasons for these are as follows: Reluctance by men to use contraception and women not using modern contraception methods to prevent unwanted pregnancies

Data from National Family Health Survey shows that along with India’s total fertility rate dropping in the past decade, the country also witnessed a drop in contraceptive use (any method), from 56.3% in 2005-06 to 53.5% in 2015-16.

“In the last few years, there has been a growth in the total population, with a high proportion of young people. For this reason, there in a greater need for contraception and family planning. Use of condoms and oral contraceptive pills are on rise but the number of male/female sterilizations have gone down. Because of irresponsible advertisements in media, emergency contraception has become a way of life. Very few people know the difference between emergency contraceptive pills and regular contraceptive pills,” says Dr Ashwini B Gandhi of Mumbai’s Hinduja Hospital.

Dr Kiran Coelho of Mumbai’s Lilavati Hospital adds, “The use of any modern method of family planning amongst women of child-bearing age (15 to 49) has decreased by 6% over ten years.  These are alarming developments since we have been investing consistently in promoting the use of contraceptives to bring our population under control and stabilise its growth.”

While the lack of awareness in regular contraception is worrisome, another topic – postpartum contraception – is even less well-known, which primarily affects women more than it does men. The reason for this is simple: many couples decide to go ahead and have their second child within a year after having the first. There are several individuals – both in rural and urban India – who talk of a sibling who is a year younger.

“Postpartum contraception involves the use of contraceptive methods to prevent unplanned and closely spaced pregnancies during the first 12 months following childbirth. Closely spaced pregnancies and births contribute to some of the world’s highest infant mortality rates.  They also affect the mother’s health and increase the risk of maternal mortality. The effects of unplanned pregnancies are often seen for several months postpartum, with an increased risk of maternal depression and parenting stress . So postpartum contraception assumes an important role in family planning,” explains Dr Coelho.

Dr Gandhi adds that there are some methods that can be used by couples after having the first child, in case they want a second. “Hormonal methods, available by prescription only, can also be used. However, women must wait four weeks after delivery to start using methods that use estrogen, such as the combination birth control pill, the ring and the patch, because estrogen increases their risk for blood clots during the early postpartum weeks. These methods are not recommended for nursing mothers until their milk is well-established because estrogen may reduce the quantity and quality of breast milk,” she adds.

The fundamental issue about contraception is that despite resources available on mainstream and social media, most individuals pick up half knowledge. “There are many prevailing myths and misconceptions. Youngsters should be able to reach out to friendly health care providers and expert counselors to clear their doubts,” says Dr Gandhi.

“There is need to raise awareness of and access to contraception in both rural and urban India amongst adolescents and young adults,” concludes Dr Coelho.