Preeti (25), a housewife with a three-year-old child, does not want another baby at least for next two years. She has a PPIUCD (post partum intrauterine contraceptive device) in place. But after hearing about the injectable contraceptive, which prevents pregnancy for three months, she wants to try it.
She is among the first lot of women, who were last week administered the injection of Depo Medroxy progesterone acetate (DMPA), a birth-control hormone at a district hospital in Bhopal in Madhya Pradesh under the National Family Planning programme as a part of NDA’s flagship scheme National Health Mission (NHM).
To be provided free of cost, the DMPA has been introduced under ‘Antara’ by the Union Health Ministry.
Twenty-eight-year-old Renu, also from Bhopal, too has decided to opt for ‘Antara’. “I came to know about it through the TV.
“Though my mother-in-law is against it as she wants another baby soon, my husband and me want a gap between my first and second child. Unlike pills and other birth control methods, the injection seems a safe method,” said Renu after consulting with gynecologist Kirti Dale at the district hospital.
Dr Dale is Antara Master trainer and so far the Shivraj Chauhan Government has trained at least 300 such medical practitioners under whose supervision the scheme will be implemented in the State. A single-shot injectable contraceptive is injected to the muscle to provide protection against conception for three months.
Dr Nirmala Tiwari, gynecologist at Vidisha district hospital said that that most women can safely use these contraceptives including women who breast-feed, as early as six weeks postpartum and if the woman is not breastfeeding, it can be administered within six weeks postpartum as well.
The Government doles out Rs 100 each to the ASHA worker and the beneficiary.
DMPA is a sixth form of birth control options being provided free of cost by the Government to reduce unmet need of spacing and give wide choice of birth controlling methods to women under the national family planning programme for the 145 high fertility districts spanning over seven high populous States. (See box 2)
These are Madhya Pradesh, Bihar, Rajasthan, Chhattisgarh, Jharkhand, Assam and Uttar Pradesh, all with Total Fertility Rate (TFR) of three and above. TFR is average number of children a woman bears in her lifetime. According to an estimate, at least 4.2 crore couples have unmet need of contraception.
One more basket of choice, DMPA is gradually catching up with the women visiting the Government hospitals for family planning. For instance, take the case of Rani (22), a housewife from Madhya Pradesh’s Vidisha. The mother of ten-month-old baby doesn’t want any child for next five years.
“Soon after delivering the baby, I opted for the IUCD. But I am not comfortable with it as I am experiencing the menstrual cramps and prolonged bleeding which is hampering my day-to-day household chores. I have come to know about this injection, from ASHA worker of my area. The doctor has said that it will keep me tension free for three months,” said Rani who was accompanied by her husband, a driver, at the hospital.
A senior official from the Health Ministry said that it will help women who are not able to convince their partners to use contraceptives. Also, the availability of more contraceptive choices like injections may help reduce the maternal mortality rate and infant mortality rate in these districts which constitute 28 per cent of the total population and contribute to around 30 per cent of maternal deaths and almost 50 per cent of infant deaths. It is estimated that currently, an estimated 42 million women worldwide are using injectables as a method of choice. (See Box 1)
On concerns that the injectable contraceptive cause side effects like menstrual changes, irregular bleeding, prolonged/heavy bleeding, amenorrhea (stopping of menstruation), weight gain, headaches, changes in mood or sex drive, and decrease in bone mineral density, the doctors say that like any medicines, these too are bound to have some adverse implications.