Just a drop of semen
Vian was in deep sleep when he received a panic call from Myra at 1 a.m. She was crying. She missed her periods and it’s been a week now.
‘But I did not ejaculate inside you Myra, don’t worry,’ Vian re-assured Myra, asking her to sleep for now and he will find out some way in the morning.
But Myra has read on the internet that even one drop of semen was enough to lead to pregnancy. She was inconsolable and disconnected the phone.
Vian and Myra started dating a few months back and had sex for the first time last month. It was all so spontaneous and they didn’t think much about using a birth control. And now, there was panic all around.
Vian’s room mate and good friend Abeer too woke up from the phone call. He overheard his talk and asked him if he needed help. Vian started crying too and told him what had happened.
‘I am very scared bro. I don’t want Myra to get pregnant. Don’t know what to do,’ Vian told Abeer.
‘Don’t worry, my uncle Dr. Kumar is a gynaecologist. I can connect him to you. Just visit him at his clinic. He can help you,’ assured Abeer.
Should we, should we not?
Vian heaved a sigh of relief and texted Myra. Myra was at first hesitant to go to a gynaecologist. She had these thoughts – What if my parents find out? What if someone sees me there? But Vian assured her she is safe with him. They both agreed to meet outside her college.
‘I too feel scared Myra. But come think about it. We both have been stressed for more than a week. We need to act fast. It’s better we talk to someone we can trust and not just a random person. Let’s go to the doc as I trust he will help us,’ Vian said.
Myra finally agreed after a lot of hesitation. Since it was early in the morning, there were not many patients around. After giving out her details at the reception, they both waited for a little while.
Vian was getting dizzy seeing all the pictures of babies at the clinic but he maintained his calm. His mind was restless with these thoughts – What if Myra is really pregnant? Will the doctor take her blood sample to test? I don't want to get married yet - hope Myra will not ask me to get married if she is pregnant! I am just 22. Not even finished my college! Will she have to get an abortion? Everyone will come to know!
With these thoughts on his mind, Vian and Myra went inside Dr. Kumar’s clinic.
The long wait
Dr. Kumar greeted Myra and Vian and listened to their problem patiently. He immediately asked Myra to take a pregnancy test at the clinic. He handed over a kit to her and asked her to go to the bathroom and take the test. A nurse was there to guide her further. All she had to do was pass her urine on the kit and bring it back.
Meanwhile Dr. Kumar said to Vian, ‘Making love is a fantastic part of life, but sex is also linked to pregnancy. A single sperm can result in an unintended pregnancy. I don’t want to scare you but in the heat of the moment, it’s possible to forget about contraception. But that one time is enough to land you in trouble.’
‘I am sorry doctor. I should have used a condom,' said Vian, for whom the wait for Myra’s results seemed a bit too long.
After what seemed like a century, Myra returned looking happy. The nurse told her that her pregnancy test was negative. Her periods could have been delayed by stress or other reasons.
What a relief it was to both of them!
Safe sex
‘Now that you are both relaxed, it may be worth increasing your knowledge on having having safer sex?', asked Dr Kumar.
‘Absolutely!’, they both chuckled.
Prevention is always better than being sorry later. Practice safe sex and know your choices for birth control. Both men and women have plenty of options to avoid unwanted pregnancy, said the doctor. Let’s talk about them in detail.
Birth control options for men - condoms and more?
‘The responsibility of birth control and contraception is not just for women. In fact men have a very easy way to prevent unwanted pregnancy - just use a condom. They are easily available, economical and have no side effects at all,’ Dr Kumar said.
So, a condom is a rubber sheath that fits over the penis to stop sperm from getting into the vagina. It's like a very thin and stretchy tube-shaped bag, with a teat at the closed end to collect the sperm.
Condoms come in different sizes, styles and shapes. Condoms can be made out of latex, polyurethane, or lambskin. You can get them lubricated or unlubricated.
They are easily available, cost effective and also prevent Sexually Transmitted Infections/Diseases (STD/STI). To add spice to your sex life, try condoms in many flavours and variations like ultra thin, chocolate/strawberry flavoured etc.
‘What else are my options,’ asked Vian.
‘Not many at this age I would say. Make condoms your best friend Vian,’ replied Dr. Kumar. He then explained other methods of male contraception.
Pull out - not sure!
In this method of withdrawal, the man takes his penis out of the woman's vagina before he ejaculates. This way, the pregnancy is prevented as the sperm does not enter vagina.
‘However, it is not a reliable method as men need to be really in control and some of the sperm may still get inside the vagina through pre-cum/pre-ejaculate (the fluid that the penis releases before ejaculation),’ said Dr. Kumar.
‘Yes, withdrawal is not reliable at all. We will never let him use this method. I was scared all the time after having sex with this method,’ added Myra.
Dr Kumar smiled. He continued, ‘Another method to avoid pregnancy for males is called Vasectomy, which is a permanent method of birth control. It is a surgical procedure that involves cutting or blocking two tubes so that sperm can no longer get into the semen. This is a permanent form of birth control so only have a vasectomy if you are absolutely sure you don’t want to have children in the future.’
Female condoms and pills
It was time for the doctor to talk about birth control options for women. ‘Myra, you have plenty of options here. Let me tell you about these one by one,’ said Dr. Kumar.
‘Ok. I am all ears too,’ added Vian.
‘Myra, do you know there are condoms for females too?’ asked Dr. Kumar.
‘Wow really? I was not aware,’ Myra replied.
‘Me neither,’ said Vian.
The female condoms, as the name suggests are condoms that are used by females to prevent pregnancy. They are a barrier method of not just birth control but also in preventing STIs and STDs.
The material and basic function of a female condom are the same as that of the more popular male condom. It is worn by a woman inside her vagina for sexual intercourse. This condom has a ring-like formation on either end that takes the penis and its ejaculate during sexual intercourse. They are also now available in the Indian market at various pharmacies.
‘I will look for it. That way I don’t have to depend on Vian. I can use mine too!,’ said Myra.
‘I just searched online and found they are available on many ecommerce websites. I have already added one to my cart,’ added Vian.
Next comes the Birth control pill.
It’s a pill that women need to swallow every day to avoid unwanted pregnancy. Combined birth control pills contain two hormones, estrogen and progestin. 'Mini-pills', or progestin-only pills, only contain progestin.
The birth control pills are very good at preventing pregnancy. You can stop taking it if and when you plan to conceive. The best part of these pills are that you take them and there is no interruption during sex.
How do they work?
Birth control pills work by releasing naturally-occurring hormones estrogen and progestin to prevent pregnancy. These hormones stop sperm from fertilizing an egg by stopping ovulation. Ovulation occurs when an ovary releases an egg, making it available for sperm to fertilize. The hormones in the pill also thicken cervix mucus, meaning it is more difficult for the sperm to get to the egg.
Also, females are not dependent on men for their choice of reproduction. There are some extra benefits too – some birth control pills also make the periods lighter and reduce menstrual cramps.
Side-effects of the pill
Myra was listening intently when Vian asked, ‘Are there any side-effects or downside of pills?’
‘Well, on the downside, it does not prevent STDs/STIs. You have to take it every single day. You miss one pill and there are high chances you can get pregnant. They can also be expensive as compared to the other methods of birth control.
Some women also suffer side effects like weight gain and nausea with these hormonal birth control pills. Though there are a few non-hormonal varieties available in the market such as Saheli,’ Dr. Kumar replied.
‘But each body is different. So you can weigh the pros and cons and decide and decide which method you would like to follow,' he added.
Injections and IUDs for women
‘Let me tell you about the injectable method of birth control for females,’ Dr. Kumar said.
‘It is known as Depo-Provera – a well-known brand name for a contraceptive injection that contains the hormone progestin. It is given as an injection every three months. The medroxyprogesterone acetate present in it suppresses ovulation, keeping your ovaries from releasing an egg. It also thickens cervical mucus to keep sperm from reaching the egg.’
‘It works well if you don't want to take a birth control pill everyday but it may have some side effects.’
‘So it just works for three months? Not longer?’ asked Vian.
‘Yes. Right now we have only the option of three months,’ Dr. Kumar said.
‘Wow Myra has so many options. Are there more doctor?’ Vian asked
‘Yes, a few more and then you are ready to leave,’ smiled Dr. Kumar.
So next comes Intrauterine devices or IUD. It is a small contraceptive device which is inserted into the uterus. It is a long-term reversible type of contraception and is considered the most effective reversible birth control on the market.
There are two types of IUDs, a copper IUD and hormonal IUD. Many hormonal ( Mirena, Kyleena) and non hormonal Intrauterine devices (IUD) (Copper T) which work for 5 to 10 years.
The Copper-T IUD, which is often sold under the name 'Multiload' is a non-hormonal birth control device that sits in your uterus or womb. It’s a t-shaped piece of plastic wrapped with a coil of copper-wire. The Copper-T IUD is a reversible form of contraception. Once you take it out you can aim to get pregnant.
The copper in the IUD works as a natural spermicide- it kills the sperm that come into the vagina. That way, eggs in the fallopian tubes won't get fertilized and you can't get pregnant.
‘Copper-T IUD looks like a good option to explore in future. Just get one and forget for five years, wow. No hormones ,’ said Myra.
‘Yes, but you have hormonal ones too,’ added Dr. Kumar.
The hormonal IUD is a small cylinder about as long as a matchstick that is put inside the uterus or womb. It's put in place by a doctor, and can stay in the body for up to five years. It works by giving off a steady low dose of the hormone progestogen (levonorgestrel).
More options?
‘Myra, there is another method called tracking ovulation. Just like the withdrawal method, it is not very reliable too. But let me tell you about it,’ Dr. Kumar said.
It is called Tracking ovulation - A female is most fertile at the time of ovulation (when an egg is released from your ovaries), which usually occurs 12 to 14 days before your next period starts. If you’re trying to prevent pregnancy, you should not have unprotected sex during the entire fertile window.
‘Thanks doctor. But my periods are so irregular. I don’t think it can work for me,’ Myra said.
‘Right. Don’t ever rely on this method. I have seen many cases of women getting pregnant using this method,’ Dr Kumar added.
‘Is there any permanent method of contraception for females too? Just like Vasectomy is for males?,’ asked Myra.
Yes, it is called tubal ligation. Common name for tubal ligation means ‘getting your tubes tied’. These tubes are fallopian tubes, which releases an egg every month during ovulation and travels through the fallopian tube to the uterus, said the doctor.
It is an irreversible, surgical procedure to prevent pregnancy. It is also called female sterilization. Go for this method if you are absolutely sure about not having children in future.
Emergency contraception - I-Pill or Unwanted 72
‘Doctor, what if, despite all the precautions, my condom breaks or we somehow end up not using it at all – is there any way out then?,’ asked Vian.
‘Yes, I have seen the ads on Unwanted 72 at many places,’ added Myra.
‘Yes, that is called an Emergency contraception pill or ECP. It is your way out in these situations but please be careful that it is strictly for emergency only. It is not meant for regular use,’ added Dr. Kumar.
The doctor then explained about Emergency contraception or I-Pill in detail.
Emergency contraception comes handy when you’ve had sexual intercourse without using contraception, even though pregnancy was not on your mind. Or your condom broke or some other contraception failure may have happened – like you forgot to take your pill.
In India, they are available by many names - I-Pill, Unwanted 72 and more. I-Pill or Unwanted 72 has to be taken only when you had unprotected sex and think that you could be pregnant. These should never be used as regular contraception methods. Also, you need to take them as soon as possible after the unprotected intercourse, preferably within 24 hours. After that they become less effective.
They are available over the counter, which means you can go straight to the pharmacy and get it without a doctor's prescription.
These pills I-Pill, Unwanted 72 and more have short-term side effects. That means it should not be used as a normal form of contraception, but only in case of emergency.
‘What does the ECP do that causes the pregnancy to not happen?’ asked Myra.
‘Good question. It stops or slows the release of an egg from your ovaries until the sperm are there in your body. Hence the time period of 72 hours is essential. It also prevents the sperm from fertilising an egg by changing the way the sperm moves in your body. It doesn’t work once the female egg has been already been fertilised by the sperm,’ said Dr. Kumar.
‘That's all for now, both of you. Hope you both with exercise precautions and have responsible and pleasurable sex. For any help in choosing birth control, please feel free to call me,’ Dr. Kumar said and signed off.
‘It was a good session doc, many thanks to you!’ both said.
Vian and Myra thanked Dr. Kumar. They left the clinic relieved and with more knowledge. Their first stop was a pharmacy where they bought strawberry and chocolate flavoured condoms – Myra’s favourite!
To protect the identity, the person in the picture is a model and names have been changed.
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Udaan Collaborative is a network of private sector stakeholders including general practitioner, gynecologist, pharmacists, and organizations who focused on making sexual and reproductive health (SRH) services more accessible and youth-friendly across India. It provides a digital platform with resources like a chatbot, helpline, and access to healthcare providers, aiming to offer young people a safe, private, and non-judgmental space for their health needs.