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| The once-a-week pill has no side effects except for delayed periods in some cases (Picture by Rashbehari Das) |
Blood group
Q: I am planning to get married soon. My blood group is B positive. Would marrying a woman of the same blood group harm our baby in any way?
A: The basic blood groups are A, B, AB and . ABO incompatibility can affect a baby but it is very rare. Rh incompatibility is more common.
People are either Rh (Rhesus) factor positive or negative. About 85 per cent of the population is Rh positive. If the woman is Rh negative and the man Rh positive, the baby is likely to be Rh positive. The Rh-negative mother forms antibodies to the Rh-positive baby’s blood. These antibodies can cross the placenta and destroy the baby’s red blood cells. First-born babies are mildly affected. The severity increases with subsequent pregnancies. To prevent this, an injection of Rh-immune globulin (Rhogam) can be given, if needed, at 28 weeks of pregnancy, to destroy any foetal red blood cells that might have entered the mother’s bloodstream. Another dose is administered within 72 hours after delivery. This prevents formation of any antibodies that could harm a subsequent Rh-incompatible pregnancy.
Easy pill
Q: I want to start the once-a-week contraceptive pill. What is it called?
A: Centchroman, a nonsteroidal chemical developed as a once-a-week contraceptive pill, is marketed in India as Saheli, Centrom and Novex. It is taken on day 1 and day 4 of the first cycle. If day 1 is a Monday, the pill is taken on Monday and Thursday. It is continued every Monday and Thursday for three months. After that it is taken every Monday as long as contraception is desired. In less than 10 per cent of women, it may cause delayed periods. It appears to have no other side effects. If the periods are delayed for more than 15 days, contact a gynaecologist.
Best option
Q: I am not yet married, but am in a relationship. Can I have a loop inserted to avoid pregnancy?
A: A loop (intrauterine contraceptive device) can theoretically be inserted in a woman who is nulliparous (has not ever been pregnant). I would, however, advise you to start on oral contraceptive pills (OCPs) with the advice of a gynaecologist. But if your partner uses a condom, you will be protected both against pregnancy and sexually transmitted diseases (STDs).
On OCPs
Q: I have been married for three years and was taking OCP Femilon since I did not want to have a baby. I stopped the pills for a while when I was living away from my husband. But now, we are together again and I want to become pregnant. However, I am worried the pills might have made me sterile.
A: OCPs do not cause subsequent sterility. Their effects are reversible once the tablets are discontinued. Now that you are living with your husband, you should try to have regular intercourse every alternate day to increase your chances of success. The egg is actually released 14 days before the onset of the next period. This is the day of maximum fertility. If you record your temperature regularly the first thing in the morning, you will see that it rises by 0.5 º when ovulation occurs. In the meantime, have your husband get a semen analysis done just to make sure everything is all right. Try naturally for two years before going in for interventions.
Morning after
Q: How do I get emergency contraception? Do I swallow the pills for 21 days after that?
A: The pills for emergency contraception are marketed over the counter (OTC) in many countries. In India, they are sold as Pill 72, Prevent, etc. You can follow the instructions on the package insert. One pill is swallowed as soon as possible after unprotected intercourse and the other 12 hours later. Bleeding should follow for about five days. This is what it is purported to be, an emergency method. It is not meant for regular use.
Fit, not fat
Q: I am 22 years old, and I have pimples, skinny arms and a poor appetite. My mother says I have no personality as I do not eat enough. She says I will not get a job.
A: Personality should not be confused with obesity. You will definitely make an impact if you are fat but you are more likely to suffer the consequences of obesity like diabetes, hypertension and arthritis. Also employers prefer “fit” to “fat”. Our brain has an inbuilt mechanism that regulates appetite. Consciously resetting it at a higher level of satiety may not be advisable. Get up and jog (four km in 45 minutes) every morning. Do a few push-ups and lift some light weights daily. Your arms and appetite will probably improve. Even your pimples might disappear!
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in