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  • Contraception and the Asian Woman

    Awareness of contraception amongst British Asian women still seems to be an issue. Cultural and ethical views about sex and its practice inhibit open discussion about the matter. With the increase of non-marital sexual relationships amongst British Asians, it is important that Asian women do increase their knowledge about this aspect of their lifestyle.

    Contraception and the Asian Woman

    "I never used contraception as I had no idea what it was"

    To understand the attitudes of a woman from a South Asian heritage towards contraception, it is necessary to be aware of her cultural background. A strict sexual morality forbids many Asian women from around the world from having pre-marital and extra-marital sexual relationships.

    However, Asian women in Britain live in a modern society and more and more Asian women are becoming sexually active whereas culturally in the past it was something they did only after marriage. We have all been given some form of sex education at school, however, when leaving school nothing prepares you for the reality of society and living in an ever changing nation.

    Large numbers of Asian women still feel uncomfortable asking questions about sex and discussing different methods of contraception, and therefore a very much unaware of what is available.

    Radha, who is 58, explains: “When I lived in India and got married, I never used contraception as I had no idea what it was. Women used to tell me that after having sexual intercourse, they would run to the toilets and urinate to prevent being pregnant. I thought it was silly at first but I done it as I was not educated.”

    Radha then migrated to the United Kingdom 30 years ago and says: “It was then when I moved to the U.K and was expecting my second child, a female member of my family mentioned ‘the pill’ and I was shocked with the vast range of contraception available.”

    Like Radha, Asian women were not aware of contraception as it was never discussed openly with their families.

    Baljit says: “Back in my day, my family never discussed contraception or sex for that matter, I never knew about contraception, I dared not to ask. It was only when I fell pregnant; I was told about different methods of contraception by a nurse at my local family clinic.”

    Now, living in the 21st century Asian women have evolved from shy traditional women to modernised independent women. Yet many Asian women are worried that their family doctors may judge them for having sex before marriage and, in some cases, may even leak information to the community. Therefore, this deters them from seeing their doctor as it may not be an option for them.

    Surita, a young student born and bred in Birmingham, expressed her views: “It would be really embarrassing and uncomfortable for me to discuss the options available as I felt he [doctor] could tell my parents. I was just scared… they were going to find out.”

    She adds: “It is the same for walking in to my family clinic; I’m worried if I see an ‘aunty’ or someone my family knows. I don’t want to bring shame on my family.”

    When asked about what type of contraception she uses, Surita says: “My partner and I use condoms; it’s far much easier for him to go buy them.”

    Many older Asian women in this day and age still find it difficult to talk to professionals, friends, family and even to their partners, whereas, the younger generation of Asian women who are more confident about their lifestyle choices and do not mind discussing and expressing their concerns with health professionals.

    Sharan 22 years old says:

    “Even though my doctor is Asian and knows my mum, I will talk openly about the options available. I do feel embarrassed as I would rather prefer talking to a nurse but at the end of the day my health comes first.”

    When asked why there is lack of knowledge regarding contraception, Sharan answers: “It is lack of communication within Asian families; I think Asian parents are afraid to talk to their children as they might feel they are encouraging them to have sex. I feel parents should guide their children and prepare them for the big wide world and by doing so children become aware of options available but more importantly not afraid to seek medical advice.”

    Sadia a pharmacist living in Scotland says: “Asians probably think because we are health professionals that we might pass judgement towards them. This is not the case. The issue of sex is still regarded as taboo in Asian society today.”

    Contraception available today comes in a multitude of forms and can suit your lifestyle. Some is not even used solely for contraceptive purposes, but also for regulation/pain relieving purposes.

    Here is a brief summary of what contraception is available in the UK.

    MethodSome Risks and Side-Effects
    Sterilisation Surgery for Women

    The tubes between the ovary and the womb (the fallopian tubes) are cut or blocked with rings or clips. This stops the eggs released by the ovary from reaching the uterus. This permanent
    method of contraception involves an operation and should be considered
    irreversible.

    - Pain
    - Bleeding
    - Complications from surgery
    - Ectopic (tubal) pregnancy (when a fertilised egg implants outside the womb, usually in a fallopian tube).
    Sterilization Surgery for Men- Pain
    - Bleeding
    - Complications from surgery
    Implant

    About the size of a thin matchstick, a doctor or nurse will insert it under the skin of the upper arm using local anaesthetic. It contains the hormone progestogen, which prevents the ovary from releasing an egg and thickens the cervical mucus to act as a barrier to sperm.

    - Acne
    - Fluid retention
    - Breast discomfort
    - Changes in period

    Advantages- it does not interfere with sex. It lasts for three years but can be removed at any time by a doctor or nurse and normal
    fertility will return.

    The contraceptive implant is more than 99 per cent effective.

    Intrauterine Device (Coil)

    The brand name of the IUS used in the UK is Mirena.

    An intrauterine system (IUS) is a small, T-shaped plastic device that contains progestogen. It’s inserted into the womb by a specially trained health professional

    - Skin Problems
    - Mood swings
    - Small risk of getting an infection after it's inserted.
    - Breast tenderness

    Once it's placed in your uterus it works for five years. It's more than 99% effective. This means that fewer than one in every 100 women who use the IUS will get pregnant in a year.

    The Contraceptive Injection

    Protects you against pregnancy for eight weeks or 12 weeks, depending on the type you use. It prevents the
    ovary from releasing an egg. It must be given every three months. There are two versions of the contraceptive
    injection: Depo-Provera, which lasts for 12 weeks, and Noristerat, which lasts
    for eight weeks. The most popular is Depo-Provera.

    - Bleeding between periods
    - Weight gain
    - Sore breasts
    - Headaches
    - Bone loss with long-term use

    Advantage - it does not interfere with sex and you don’t have to think about contraception for three months after injection.

    Oral Contraceptives

    Combination pill, or "The Pill"

    The Pill is a tablet containing two female hormones. This is why it's often called the combined Pill. The two hormones stop you from ovulating (producing an egg) each month. And if you don't ovulate, you won't get pregnant.

    - Changes in your period
    - Changes in mood
    - Weight gain
    - High blood pressure
    - Blood clots
    - Heart attack
    - Stroke
    Skin Patch

    A small, thin, beige patch about 5cm by 5cm in size (much like a nicotine patch). It works by releasing daily doses of the female sex hormones through the bloodstream through the
    skin.

    - Similar to side effects for the combination pill
    - Skin irritation, Itching and soreness
    Vaginal Ring (NuvaRing)

    A flexible, transparent, plastic ring. It
    is placed in the vagina by the woman, and is left in place for three weeks. It releases the same hormones used in the combined pill.

    - Similar to side effects for the combination pill
    - Swelling of the vagina
    - Irritation
    - Vaginal discharge
    Male Condom

    A sheath, usually made of thin latex (synthetic rubber), that covers the penis during sexual intercourse; used for contraception and to prevent STDs.

    - Allergic reactions

    Condoms are about 85% effective. With proper use, they are even
    more effective (up to 99%).

    Diaphragm with spermicide (Spermicides kill sperm)

    A contraceptive diaphragm is a circular dome made of thin, soft latex (rubber) or silicone. You put it into the vagina before sex to prevent pregnancy .

    - Irritation
    - Bladder infection
    - It can take time to learn how to use them.
    Female Condom

    Lubricated polyurethane (plastic) tube that has a flexible ring at each end. One end of the tube is closed.

    - Irritation
    - Allergic reactions

    The female condom is about 95% effective when used properly every time.

    Emergency Pills (the 'Morning After Pill')

    This must be taken within 3 days (72 hours), but the sooner you take them, the more effective they are.

    - Abdominal (tummy) pain
    - Irregular menstrual bleeding (spotting or heavy bleeding) before your next period is due nausea (feeling sick) tiredness.

    Lack of awareness of contraceptive choices has fuelled rising abortion rates among Women of the South Asian heritage. The Departmental of Health abortion statistics in England and Wales 2011 shows that a staggering 32% of Asian women had one or more previous abortions.

    Ayesha who is 20 says: “If I don’t want to talk to my doctor, I know I can visit a sexual health clinic or look on the Internet. Knowing about contraception should be a must if you are having a full-on relationship.”

    Contraception protects you against pregnancy, but using condoms and contraception together can be an optimal way to protect yourself and your partner against both unintended pregnancy and STIs (Sexually Transmitted Infections).

    Side effects from contraception vary from person to person. Therefore, if one form does not settle with you, do not hesitate to consult a health professional to look at the other choices.

    It’s best to keep aware about changes in contraception too, as it will allow you to make an informed choice on what might be a better alternative to use.

    The fear of discussing and using contraception can lead to sexual health problems. According to the Health Protection Agency reports in 2009 a shocking 2,317 Asian women were diagnosed with Chlamydia in England, in 2011 this increased to 2,479. Could the lack of awareness be the root cause?

    An overwhelming 92% of us are unaware of the range of options available. Different methods suit different people – there is no one-size-fits-all with contraception. This is why it’s important to explore the best option for you with your nurse at the local family or sexual health clinic, the nurse at your GP’s surgery or your doctor.

    Remember it is your health that matters and finding out about which contraception is right for you, can make a big difference. For more information and support you can visit the Family Planning website.

    Which popular Contraception method do you use?

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    Aman is an outgoing individual with a genuine sense of humour, enthusiasm, a zest for life. She has a passion for the world of media, music and presenting. One of her favourite quotes is “Give a girl the right shoes, and she can conquer the world.” by Marilyn Monroe.

    Information sources for this article include www.nhs.co.uk, www.patient.co.uk, www.bpas.org and www.womenshealth.gov.


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