Contraception – Male condom

The main purpose of contraception (or birth control) is to prevent an unplanned pregnancy. You should know and understand the different types of methods available to you, the risks and benefits of each, and any possible side effects, so that both you and your partner can able to make an informed choice. Contraception can be broadly divided into:

  1. Temporary or permanent methods – permanent birth control is accomplished through sterilization (tying or removal of the fallopian tubes) or hysterectomy (removal of womb / uterus). The rest of the methods are classified as temporary or reversible.
  2. Short term or long-term methods – short term methods are condoms and oral pills. Long term methods are injectables, intrauterine device and hormonal implants.

The condom is a sheath that looks like a small, elongated balloon and is usually made of thin latex rubber, polyurethane or natural membranes. The man wears this sheath over the erect penis during intercourse. The sheath will prevent the sperm from being deposited in the vagina following ejaculation. The condom may also be effective in preventing spread of some sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV), chlamydia, gonorrhoea, genital warts etc. It is the only form of temporary birth control available for men.

Advantages

  • Generally effective for contraceptive use (88-98%), provided it is use in a proper and consistent way.
  • It is readily available, inexpensive, and easy to use. Women can buy and carry condoms.
  • No medical consultation is required to start using it. It can be purchase easily and widely available.
  • It provides good protection against some STIs.
  • There are no systemic side effects from condom use.
  • Since the condom prevent the deposition of semen in the vagina, the woman will have less leaking (discharge) following intercourse.

Disadvantages

  • There is a need for the condom to be available and the extra time and effort required to put in on prior to intercourse. This may decrease the spontaneity of sex for some couples.
  • It may lessen the women or male’s sensation since the penis does not touch the vaginal walls directly.
  • It may irritate the woman’s vagina due to the friction from the condom. The lubricant may or may not help in relieving it.
  • Some women or men can be allergic to the material used to manufacture the condom.
  • The condom may break or leak, resulting in unplanned pregnancy

General instructions for use

  • There are many brands of condoms and you should try to find the best fit for you. You should check the expiry date before using it. Be careful when opening the condom packet. You should not use teeth, sharp fingernails, scissors, or other sharp instruments to open it as these may damage the condom. Push the condom to one side and gently tear along the corner or edge. It should be easy to open the pack.
  • Once you remove the condom from the pack, check for defects such as holes, tears or if it feels unusual (stickiness), do not use it. Open another pack and repeat the steps above. You should not unroll the condom to check it because this could damage it and make it difficult to put it on.
    Use a new condom for every act of intercourse. Put the condom on after the penis is erect and before any contact is made between the penis and any part of the partner’s body.
  • If using a spermicide, put some inside the condom tip.
  • The teat end should be pointing up and you should always pinch the tip enough to leave a small space for semen to collect when you start rolling the rim of the condom over the penis until the base. The pinching will make sure to eliminate any air in the tip to help keep the condom from breaking.
  • If you are using water-based lubricant, you may put more on the outside of the condom.
  • After ejaculation and before the penis gets soft, hold the rim of the condom, and carefully withdraw the penis.
  • To remove the condom, gently pull it off the penis and make sure the semen does not spill out.
  • Dispose it in a proper way. Because condoms may cause problems in sewers, do not flush it down the toilet.
  • If the condom breaks, there is a chance you can become pregnant. You should consider taking emergency contraception or see your doctor immediately for advice. You should also get tested for STIs if you are not sure of your partner’s infective status.

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Contraception – Hormonal implant (Implanon)

The main purpose of contraception (or birth control) is to prevent an unplanned pregnancy. You should know and understand the different types of methods available to you, the risks and benefits of each, and any possible side effects so that both you and your partner can able to make an informed choice. Contraception can be broadly divided into:

  1. Temporary or permanent methods – permanent birth control is accomplished through sterilization (tying or removal of the fallopian tubes) or hysterectomy (removal of womb/uterus). The rest of the methods are classified as temporary or reversible.
  2. Short term or long-term methods – short term methods are condoms and oral pills. Long term methods are injectables, intrauterine device and hormonal implants.

Hormone implant currently available is Implanon NXT®. It consists of a single plastic rod measuring 4 cm and contain a progestogen hormone called etonogestrel. Implanon is inserted surgically, just under the skin of the upper arm. The implant will release a minute amount of this hormone every day for 3 years. It works by preventing the monthly ovulation (the release of an egg from the ovary) during your menstrual cycle. It also thickens the vaginal mucus to prevent sperm from reaching the egg (fertilization). Continuous effect of the hormone will thin out the lining of the uterus (womb) to prevent attachment of a fertilized egg. Implanon does not contain any oestrogen.

Read moreContraception – Hormonal implant (Implanon)

Heartburn during pregnancy

Heartburn is a term used to describe a burning pain or discomfort in the chest and upper abdomen. The actual medical term for it is gastro-esophageal reflux disease (GERD). It is quite common for pregnant women to experience the symptoms of heartburn, which usually come and go until delivery. It can start anytime during the pregnancy period and may worsen as the pregnancy progresses (second or third trimester). While it can be uncomfortable or painful, heartburn by itself will not harm the baby.

Symptoms and signs

  • Burning pain in the center of the chest and the upper abdomen, frequently accompanied by an unpleasant taste in the mouth.
  • Belching (burping).
  • Nausea with or without vomiting.
  • Persistent throat irritation, with or without irritating dry cough.

Read moreHeartburn during pregnancy

Anaesthesia and Analgesia in Obstetrics and Gynaecology

Dr. William Morton demonstrated the first public administration of ether anaesthesia in the operating theatre of the Massachusetts General Hospital on the 16th October 1846
That day is remembered as a milestone in anaesthesia and celebrated as World Anaesthesia Day.
From that date onward, many progresses have been made in the field of anaesthesia, and more so specifically for the practice of obstetrics and gynaecology.

On the 16th August 1897, a German surgeon by the name of Dr. August Bier administered the first spinal anaesthetic. Spinal anaesthesia becomes one of the most popular methods of administering a patient pain free from surgery of the lower limbs, lower abdomen and Caesarean sections and is still widely used.

Read moreAnaesthesia and Analgesia in Obstetrics and Gynaecology

Suction evacuation for miscarriage

Suction & evacuation is a technique of emptying the uterus of a pregnancy. It can be used to terminate a pregnancy or to remove a fetus that has died. It involves the removal of a fetus and accompanying tissue of the pregnancy from the uterus with instrumental evacuation through the vagina and is usually performed in the first trimester of pregnancy.

Reasons for procedure

Read moreSuction evacuation for miscarriage

Vaccination and Pregnancy

It is important to ensure that you are adequately protected against certain infectious diseases during your pregnancy. In the community, people are protected against infectious disease because they have had the infections before and developed immunity to it. Some are protected against chickenpox, for example, because they had it when they were kids, causing their immune systems to make antibodies to the chickenpox virus. However, over time the antibody level may decline to a very low levels and the person may lose the protection against that particular infectious agent.

Alternatively, many in the community have been vaccinated and developed antibodies to that specific infectious agent contained in the vaccine. Many countries now have an immunization schedule that tries to cover as many infectious disease as possible, hoping to reduce the disease burden to the community and the health care system.

Read moreVaccination and Pregnancy

Caesarean Section

WHAT IS IT?
Delivery of a baby through an incision in the mother’s lower abdominal and uterine walls and is performed when a vaginal delivery is not possible or is unsafe. This procedure is also called a C-section or Lower Segment Caesarean Section (LSCS).

 

 

 

REASONS FOR PROCEDURE

Danger to the mother or baby from one or more of many causes, including:

  • Baby’s head too large to pass through the birth canal.
  • Baby in the wrong orientation – head up (breech) or transverse.
  • Failure of cervix to dilate (failed induction of labour).
  • Abnormal placenta location obstructing the birth canal (placenta praevia).
  • Failure of normal labour progress.
  • Situation where urgent delivery is indicated such as fetal distress or severe illness in the mother (such as severe hypertension or sudden fits).
  • Infection such as HIV or acute herpes genitalis infection in the mother.

Special situations: pregnancy resulting from assisted reproductive technology (ART), maternal request

Read moreCaesarean Section