Family planning: How subdermal implant helped scores of women in Africa, Europe 

Dorothy lifts her left arm and shows it off -- a subdermal implant. It's this matchstick-sized device that has changed her life for the better. It has freed her from the clutches of unplanned pregnancy.

Gone are the days when she gave birth to five children in five years. This 22-year-old woman from Uganda didn't know anything about family planning or the reasons why her children were growing weak and struggling hard to survive. Dorothy was unaware that spacing her pregnancies could save her life and protect the health of the babies who rely on her. She also didn't know she had the right to contraception.

But things have changed today thanks to the contraceptive implant.
Dorothy is in any case lucky -- she is in Africa. So are the women in Europe, who can take advantage of the subdermal implant. In India this method is yet to be adopted.

Currently, an Indian couple has to buy 120 condoms, 15 cycles of oral contraceptives and four injections of Depo Provera/DMPA every year. But the subdermal implant guarantees prevention of unwanted pregnancy for three years at least.

According to the Population Foundation of India (PFI), the subdermal implant is 99 per cent effective in terms of cost and use in comparison to other contraceptives.

"This is one of the best contraceptives available, because this is long-lasting and can be removed whenever a woman wants to conceive. If a woman wants to delay pregnancy by three years or five years, depending on the priority, she has to just get the subdermal implant done," PFI Executive Director Poonam Muttreja told IANS.

The implant is inserted under a woman's skin in the inner area of her arm.

"It only takes a few minutes to place it and feels just like an injection. No stitch is required. After it has been inserted, the doctor or a nurse checks the woman's arm to ensure that the implant is in the right position. Women are also trained on how to feel the implant with their fingers," Muttreja added.

There are certain advantages to this method. A woman can use it even if she is breastfeeding her child. Besides, the implant helps in reducing painful periods. And she can conceive when the implant is removed.

Medical experts say that the main work of the implant is to stop the ovaries from releasing an egg each month (ovulation). It also thickens the mucus in a woman's cervix, which makes it difficult for sperm to move through and reach an egg. The implant thins the uterus lining; so it is less likely to accept a fertilised egg.

"A woman can have an implant inserted at any time during the menstrual cycle if she is not pregnant. If the implant is placed during the first five days of period then she will immediately be protected from pregnancy," a family planning expert told IANS.

"If the implant is placed on any other day, then the woman will not be protected for the first seven days. So additional methods of contraception, like condoms, will be required during this time," the expert added.

According to PFI, Indian family planning programmes must adopt this method of contraception. India had promised during the FP2020 -- the global partnership on family planners -- to reach 48 million new users in addition to sustaining the existing 100 million users of family planning methods. The implants can be effective to boost the family planning programme in India.

"Worldwide subdermal implant has become very popular and it is important for India to adopt it. India has introduced the injectable contraceptives. Implants too should be adopted," Hrishikesh Pai, Secretary General of the Federation of Obstetrics and Gynaecology Societies of India, told IANS.

Incidentally, the Indian Council of Medical Research (ICMR) -- India's apex medical research institute -- has recently concluded its survey on the implants and will soon publish the results.

Stating that there is hardly any failure in the subdermal implant, Pai said: "Some medicines may make an implant less effective, including those used to treat HIV, epilepsy and tuberculosis. If a woman is using these medicines then it is recommended that she opts for additional methods, such as condoms."

The implant has helped hundreds of thousands of women in Africa and Europe. The result was proper spacing in child births. The children born have been healthy, capable of surviving against the odds. So why not in India?