Birth-control pills are constantly in the news with various side effects from their prolonged use coming to light every single day. Where does that leave you if you’re not looking to conceive? Natural birth-control methods have been used for generations, yet not all of them are equally effective. So which ones should you opt for?

Should You Even Consider Natural Labour /Child Birth Control Methods?

While natural birth-control methods might not be as effective as commonly used artificial methods like male or female condoms or birth-control pills. But, if any of the modern Fertility Awareness-Based Methods (FABM) are followed accurately, the protection can be as much as 97–99 percent.

What you should know, however, is that if you make an error in your calculations or take a misstep, the protection that may have been 98–99 percent drops to just about 75 percent or lower, depending on how far off your accuracy is.² While protection in the high 90s is good enough for most, if you need to improve the effectiveness of the method, be doubly sure to follow all the rules. Besides this, you might want to consider a different approach if

• You have a medical condition that could pose a risk to the child if you got pregnant
• You have irregular periods
• You’re on a medication that disrupts production of cervical mucus
• You’ve recently stopped taking hormonal contraception
• You’ve recently had a miscarriage or abortion
• You’ve recently given birth or are breastfeeding
• You travel through different time zones
• You have a vaginal infection such as thrush or STI
• You’re a heavy drinker

The above-mentioned factors could lower the effectivity of this form of contraception or affect your health adversely. Besides, do remember, while these natural birth-control methods might protect you against conceiving, they do not deflect sexually transmitted diseases. So if you are not in an exclusive monogamous sexual relationship, or are concerned that either of you might be carrying an infection of some kind, you would do well to also use a barrier like a condom.

1. Temperature And Cervical Secretion-Monitoring Method

These options are examples of FABM. The temperature method involves the use of a basal thermometer which indicates a small rise in body temperature after ovulation. Do note that ear and nose thermometers are not accurate enough for this method. The method involves taking your temperature every morning, ideally at the same time, before you get out of bed and especially before you eat or drink anything.

For 3 days in a row, your temperature might be higher than all of the previous 6 days. This increase in temperature is very small, generally around 0.2 C (0.4 F). It’s likely that at this point, you’re no longer fertile.

The cervical secretion-monitoring method, meanwhile, involves keeping a check on the change in the amount and texture of your cervical secretions (cervical mucus) during different times in your menstrual cycle. To do this, gently insert your middle finger into your vagina, pushing it up to around your middle knuckle.

For the first few days after your period, you might notice that your vagina is dry and doesn’t produce a lot of mucus. As your hormonal levels rise to prepare for ovulation, it might turn moist, sticky, white and creamy. This indicates the start of the fertile period of your menstrual cycle. Immediately after ovulation, your cervical mucus is likely to get wetter, clearer, and slippery, resembling the texture of a raw egg white. Eventually, your mucus should return to being thicker and more sticky. 3 days post this, you should no longer be fertile.

Combining these two methods has been found to prevent pregnancy. In fact, one study found that it is an effective option for family planning/birth control. During the fertile days, intercourse must be done with some form of birth control or protection. Alternatively, abstinence may be practiced for those days. Of the women enrolled in the study, only 1.8 in every 100 became pregnant over a 13-cycle window. Here, too, the researchers emphasized that effectiveness depends on adhering to the guidelines for observations/tracking of these parameters.

2. Calendar-Based Method

You could also determine your most fertile days by tracking your menstrual cycle closely. The modern FABM way of doing this is called the Standard Days Method. If you’re someone with a cycle of 26–32 days, this calendar-based method may work for you. What it does is to spot the fertile window, occurring between days 8 and 19 of your cycle. This generally refers to 7 days before your ovulation and 2 days after, when you’re most likely to get pregnant. Once you have zeroed in on the exact dates, you need to either abstain from having sex on these days or use a suitable contraceptive. In one study of the method across the Philippines, Peru, and Bolivia over 13 cycles, researchers found that when used correctly, the method resulted in only a 4.75 percent cumulative probability of conception. It could thus be a sound natural alternative.⁵

The only caveat here for this method is that if a woman’s cycle is irregular or unpredictable, the accuracy and therefore effectiveness of natural birth-control drops. As such, you could combine this method with the temperature and cervical secretion-monitoring method, both of which are generally considered more effective, as seen also in the pregnancy rates in the studies mentioned.

3. Using Fertility Tests

This approach relies on easy-to-use home kits that generally contain a device that can tell you what your most fertile days are. This is done by measuring the levels of luteinizing hormone or estrogen metabolites in your urine and requires you to record the beginning of her cycle, i.e the first day of your menstruation and continue recording each day until the 6th day when you will be asked to take a urine test first thing in the morning. Depending on the brand of the test, you might have to do a test for 10–20 days. The device will then indicate when your fertility rate is low, high, and at its peak. It will also, on an average, give you a 2-5 day warning before the actual day of ovulation. During this period, it is recommended that you use protection or abstain from sexual intercourse. This method is simple and the use of calibrated measuring tools makes its accuracy good. In general, it is said to result in a 1–3 percent pregnancy rate over a year-long window, when used correctly.

That said, besides being expensive, the warning period might not be enough to prevent pregnancy and doesn’t look at the status of cervical mucus. Hence, it might be ideal to combine this method with the cervical secretion-monitoring method monitoring method to fine-tune your observations. It may also be supplemented by basal body temperature measurement to improve accuracy.⁸ One study even noted a pregnancy rate of 2.1 percent for every 12 months of correct use of this method. That translates to effective protection 97–99 percent of the time, and 97.9 percent protection in the case of the study.⁹

4. Lactational Amenorrhoea Method (LAM)

This method applies to breastfeeding mothers who breastfeed exclusively (only feed your baby breast milk) and have babies that are under 6 months of age. Post-childbirth, exclusive breastfeeding leads to the lack of menstruation in women. Both these factors lead to temporary infertility that some women use as a form of contraception.

When used correctly and consistently, less than 2 in 100 women who use this method will get pregnant in the first 6 months. However, do take care to use the method correctly and be sure not to feed your baby other foods because this may reduce your lactation. That said, it’s important to note that this method becomes unreliable when

• Breastmilk is substituted with other foods or liquids
• Your baby turns 6 months old
• You have a period

Additionally, it is possible for you to get pregnant before your periods start again since women generally ovulate 2 weeks before their period.¹⁰

5. Outercourse

This form of contraception refers to lovemaking without penetration into a vagina or anus. Partners can be sexual, intimate, and even orgasmic without engaging in intercourse. Hence, no semen, vaginal fluids, or blood is shared between them, making it an effective way to prevent pregnancy.¹¹

6. Herbal Medications

Herbs are also believed to be highly effective at reducing fertility in order to naturally and safely prevent pregnancy. Some herbs may affect the ovary, while others act upon the uterus, affect normal hormone production, or block certain hormones. Some herbs also have the ability to interfere with implantation and are useful as an emergency contraceptive. A few of these herbs are as follows:

• Queen Anne’s Lace (Daucus carota): Also known as wild carrot, Queen Anne’s Lace can be taken on as needed basis, making it useful for women who have sex infrequently. Research suggests that terpenoids in the seed block crucial progesterone synthesis in pregnant animals, which disrupts the implantation process, or if a fertilized egg has implanted for only a short period, it will cause the egg to be released without developing.¹² To try this method, eat 1 teaspoon of these seeds within 8 hours of unprotected intercourse and continue the course for a week. Be sure to thoroughly chew the seeds for maximum effectiveness.
• Neem: Neem can be used in three different forms for birth control -neem leaves, neem oil, and neem leaf extract. Neem oil kills sperm in the vagina within 30 seconds and remains active for five hours. It causes no irritation or discomfort like the chemical based spermicidal foams do. In addition, neem oil acts as a lubricant and it may also offer some protection from vaginal and sexually transmitted diseases. To try this method, use a water-based vaginal lubricant with ten percent neem oil added. Apply before intercourse to give the surface of the vaginal wall time to become coated with the material. If there was no neem lubricant available during intercourse, applying the lubricant soon after intercourse will prevent implantation.¹³
• Papaya: Unripe papaya has been used traditionally to prevent or terminate pregnancies. A ripe papaya cannot be used as it loses the phytochemicals that interfere with hormones. The papaya seeds can kill sperms, hence a daily intake of papaya seeds can decrease the sperm count in a healthy male. According to research, the seeds of Carica papaya have been experimentally found to inhibit spermatogenesis in males.¹⁴

There are several other herbs, which have partially or in combination with other natural birth control methods, reported to be similarly effective as a contraceptive. However, we have omitted them merely due to the lack of potential research regarding their efficacy. Do not continue using a herb if you start developing problems and also never increase the dosage of herbs more than the required amount. You should never disregard verified advice from a healthcare provider, regarding safety and efficacy of these natural birth control methods.

7. The Pull-Out Method

Also known as coitus interruptus or withdrawal, the pull-out method is one in which the man withdraws or pulls out his penis from his partner’s vagina before ejaculating. This method requires the man to keep his semen away from the woman’s genitalia while ejaculating. This method prevents fertilization by hindering any contact between the sperm and the egg.

While this is an easy, low-cost method, it relies heavily on the consistency and self-control of the man, lack of which can lead to pregnancy. In addition to this, the method does not take into account pre-ejaculatory fluid which doesn’t usually contain sperm but can sometimes contain a few. It might also pick up any sperm left in the urethra from a previous ejaculation. Hence, it is considered to be one of the least effective natural birth-control methods because it depends on the man’s ability to withdraw before he ejaculates. However, its effectivity goes up to 73 percent if used correctly.

If you’re a mother-to-be, you might need an episiotomy. This is a minor cut that widens the vaginal opening to encourage a smooth delivery. But it can be scary if you’re not sure what to expect! Here are nine things every expectant mother should know about an episiotomy.

1. Episiotomy Is Not A Routine Procedure Anymore

Once upon a time, an episiotomy was a routine part of giving birth. But now, the procedure isn’t recommended for everyone. Your doctor will determine if you should get one or not!¹ It all depends on your body and baby.

2. Only Some Cases Need One

If your baby is too big for your vaginal opening, an episiotomy may prevent painful tearing. It might also be necessary if your little one’s feet or bottom comes out first. This is an abnormal position, but an episiotomy can make the delivery easier.² The procedure also helps deliveries that need to happen quickly or require extra instruments.

3. There Are 2 Kinds Of Episiotomies

A midline or median incision is the most common episiotomy. This is a straight vertical cut that goes from the vagina to the anus. It’s also the easiest to repair. There’s also a mediolateral incision which is a diagonal cut. It has less potential of tearing through the anus but is harder to repair. Recovery might be slightly more painful, too.

4. The Procedure Isn’t Painful

Thanks to anesthesia, you won’t feel the actual cuts. The area around the vagina will be numb. After birth, the incisions will be repaired with dissolving stitches. But feeling mild to moderate pain during recovery is perfectly normal. Your doctor will let you know how you can safely relieve the pain.

5. It’s Done Right Before Delivery

An episiotomy is done right before you give birth. When the doctor sees that the baby is about to come out, the cut will be made. It’ll be stitched up after both the baby and the placenta have been delivered.

6. There Are Some Risks

Like all surgeries, an episiotomy presents a few risks. The cut might tear even more during delivery and reach the anus. You might also lose a lot of blood during the process or the cut might become infected. But depending on the situation, the benefits of an episiotomy might outweigh these risks.

7. Recovery Takes A Month

Episiotomy recovery takes up to a month. And since the stitches dissolve, you won’t need to go back to remove them. Instead, take it easy during this time. Bathing in warm water may help you feel more comfortable. If your baby is healthy, you can take the painkillers paracetamol and ibuprofen while breastfeeding. Avoid aspirin, though.

8. Preventing Infection Is Important

Taking care of the healing cut is crucial. This will avoid infections and even more complications. After every trip to the bathroom, clean the area. You can do this by washing it with warm water. And when you empty your bowel, wipe from front to back, away from the cut.

9. Reduce Your Need For An Episiotomy

To lower your chances of needing an episiotomy, focus on making your body stronger before delivery. Kegel exercises can be a huge help.¹⁰ You can also massage the perineum, the area under your vagina. Use vegetable-based massage oil for best results.¹¹ And don’t forget about prenatal yoga!

Don’t panic if you need an episiotomy. Your doctor can help you have a successful procedure and delivery. If you have concerns, be sure to ask questions.

References