Combined oral contraceptive pills (COCs) Emergency Contraceptive Pills (ECPs) (IUD)

• Effective and reversible without delay • Help prevent pregnancy when taken • Permanent method for men who are • A small, flexible device with either copper sure that they do not want more children. • Can be used at any age and whether or not within 3 days of unprotected sex or a or hormone, placed inside the womb. mistake with a family planning method. a woman has had children. • Think carefully before deciding. • Copper IUD can be inserted right after childbirth • Safe and suitable for nearly every woman. • Safe for all women. • Use another method for the first 3 months, until the (within 48 hrs), as well as at other times by a trained • They do not disrupt existing pregnancy or harm the vasectomy is effective. Get a semen analysis done provider. • Serious side-effects are very rare. after 3 months. baby if a woman is already pregnant. • Serious complications are rare. Pelvic infection may Not safe for women up to 6 months. • Some women may experience nausea or vomiting • Very effective after 3 months (but not 100% effective). occur if a woman has certain sexually transmitted or a change in time of expected monthly bleeding. • No effect on sexual performance or desire. infections such as chlamydia or gonorrhoea when the IUD is inserted. • ECPs should not be used as a regular method of Contraceptive Injections contraception.

• Effective and safe. Hormonal Implants Tubectomy • Can be used at any age and whether or not a • One or several small rods or capsules woman has had children. Centchroman placed under the skin of a woman’s upper • Permanent method for women who are • Spotting and irregular bleeding often occur in the arm by a trained provider. sure that they do not want more children. • Non-hormonal pill. Good choice for first several months, then often monthly bleeding breastfeeding mothers who want to take pills. • Very effective for 3 to 7 years, depending on which • Think carefully before deciding. stops. Side effects include gradual weight gain, and implant has been inserted. mild headaches. These are not harmful. • Maybe started immediately after childbirth. • Very effective (but not 100% effective). • Can be used at any age and whether or not a woman • Safe during breastfeeding, beginning 6 weeks after • Effective and reversible without delay. has had children. • No long-term side effects. No effect on sexual performance or desire. childbirth. • Take one pill twice a week for first three months and • A woman can have a trained provider take out the thereafter once a week. implants at any time. Then she can become pregnant • Can be done right after childbirth up to 7 days and then any time after 6 weeks, as well as at other times. • Menstrual disturbances like prolonged cycles and with no delay. Progestin only pills (POPs) scanty bleeding may occur in some women. • Unexpected light bleeding or spotting may occur or monthly bleeding may stop. This is not harmful. • Good choice for breastfeeding mothers • Do not move to other parts of the body. methods who want pills, immediately after • Safe during breastfeeding, even immediately after childbirth (MEC 2015). Lactational Method (LAM) childbirth. • A woman learns to tell the fertile time of Take one pill every day and at the same time for her monthly cycle. greatest effectiveness. • A method based • During the fertile time a couple avoids vaginal sex, or on fully or nearly fully breastfeeding, for up to 6 they use another method such as . • If not breastfeeding, spotting and unexpected light months after childbirth. Condoms bleeding are common. These are not harmful. • Can be effective if used correctly. Usually only • LAM is effective when the following three conditions • Help prevent pregnancy and some somewhat effective, however. • Safe and suitable for nearly all women including are fulfilled: those with high BP or migraine headaches. STIs, including HIV/AIDS, when correctly • Requires partner’s cooperation. 1. The mother’s monthly bleeding has not returned. used every time. Choices of 2. The baby is fully or nearly fully breastfed and is • No physical side effects. fed often, day and night. • Easy to use with a little practice. • Certain methods may be hard to use during fever or contraceptive 3. The baby is less than 6 months old. • Effective if correctly used every time. vaginal infection, after childbirth, or while • Before she can no longer use LAM a woman should breastfeeding. methods plan for another method. Sources: • Population Council. The Balanced Counseling Strategy Plus: A There are many choices of contraceptive methods available. Ask your doctor and choose the one that is best suited for you! Toolkit for Family Planning Service Providers Working in High HIV/STI Prevalence Settings (Third Edition). [Internet] 2015 [cited 2021 Mar 25]. Available from: https://www.popcouncil.org/uploads/pdfs/2015RH_BCS-Plus_ MethodBrochures_en.pdf. Category COCs POPs ECPs Contraceptive Hormonal Centchroman Condoms IUD/ Vasectomy Tubectomy LAM • The National FP guidelines. Available from: injections implants (male, female) systems https://nhm.gov.in�› family-planning › guidelines • WHO, Family Planning- A Global Handbook for Providers 2018 edition Single/unmarried couples ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ X X X

Couples wanting children ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ X X X

Breastfeeding X ✓ ✓ X ✓ ✓ ✓ ✓ X X ✓ (less than 6 weeks baby)

Breastfeeding X ✓ ✓ ✓ ✓ ✓ ✓ ✓ X X ✓ (More than 6 weeks baby)

Breastfeeding ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ X X X (more than 6 months baby)

Couples not wanting any ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ X more children

✓ Preferred Method | X Contraindicated Method Kyuki baat samajhdari ki hai

COCs: Combined Oral Contraceptives; POPs: Progestin only contraceptives pills; ECPs: Emergency Contraceptive Pills; IUD: Intrauterine device; By Pankh. A FOGSI initiative LAM: Lactational Amenorrhea Method * Emergency contraceptive pills should not be used as a regular method of contraception