Dr. Sanchari Kundu–
Misuse of emergency contraception or abortion pills is a growing concern among health officials and women’s rights advocates in Bangladesh. Emergency contraceptives are meant to be used as a last resort after unprotected sexual activity to avoid getting pregnant. Even though they are less effective than traditional techniques and could have undesirable side effects, these pills are regularly used as a routine way of birth control in Bangladesh.
Emergency contraception has been used for a very long time. From ancient times, many different techniques have been employed to avoid getting pregnant after unprotected sex, including herbal cures, vaginal suppositories, and even animal intestines.
In the 1960s, researchers discovered that high doses of estrogen could delay ovulation and prevent pregnancy. These high estrogen levels did, however, come with some serious side effects, including nausea, vomiting, and blood clots.
In the 1970s, researchers discovered that a synthetic hormone called levonorgestrel could be used as an emergency contraceptive. High amounts of this hormone may potentially postpone ovulation and prevent pregnancy. The US FDA authorized the first specific emergency contraception tablet containing levonorgestrel in 1998.
Since that time, the Yuzpe technique and ulipristal acetate, two further emergency contraceptive pills, have been created (which uses a combination of estrogen and progestin). If used within a few days of unprotected sex, these strategies have been proven to be very efficient in avoiding pregnancy.
In Bangladesh, the Ministry of Family Health and Welfare approved the dual medication regimen of mifepristone and misoprostol for menstrual management in 2014 after successful pilot programs in 2009. Menstrual Regulation with Medication (MRM) is a non-invasive, non-surgical technique, and is allowed up to 9 weeks following the last menstrual period (LMP). It has become popular in Bangladesh in recent years.
A pregnant woman must first take a pill to have a medical abortion. Progesterone is a hormone that is necessary for pregnancy to develop normally. The body’s progesterone is blocked by mifepristone, which stops the development of the fetus. Following that, the woman must take 4 Misoprostol tablets all at once, either right away or up to 48 hours later. To empty the uterus, this medication produces cramping and bleeding. The treatment feels a lot like an early miscarriage and is similar to having a particularly painful, heavy menstruation.
One must be aware that abortion medications are only effective up to 9 weeks into a pregnancy. The use of abortion medications in the latter stages of pregnancy increases the risk of uterine rupture in women, which results in severe bleeding.
One issue influencing the misuse of emergency contraceptive tablets in Bangladesh is a lack of understanding about their proper use and effects. Many Bangladeshi women do not have access to trustworthy sources of contraception information; thus, they might not be aware of the risks associated with consistently taking emergency contraceptive pills.
Another element that contributes to the misuse of emergency contraceptive tablets is the lack of other birth control options in Bangladesh. Many Bangladeshi women do not have access to or are unable to purchase standard contraceptives like condoms or hormonal pills. Men are also frequently found to be reluctant condom users. As a result, some people may choose to regularly use birth control pills as a means of contraception.
The over usage of emergency contraceptive tablets has a severe influence on the health of women in Bangladesh. Headaches, nausea, and stomach pain are just a few of the undesirable side effects that these drugs may cause. They might also cause irregular menstrual cycles, which would make it harder for women to detect pregnancy or other health issues. Moreover, it could lead to unplanned pregnancies with serious side effects including bleeding, missed or ineffective abortions, and ectopic pregnancies.
Everyone should step up for better education and knowledge about the proper use and effects of these tablets to combat the misuse of emergency contraceptive pills in Bangladesh. Birth control methods should be accessible to everyone and cost-effective. Government funding should also go into family planning and reproductive health initiatives that give women the knowledge and tools they need to make responsible choices about their sexual and reproductive health.
Dr. Sanchari Kundu is a Physician and Social Worker
