Lack of proper training on Long Acting Reversible Contraceptives (LARC)
leads to a high rate of accidental pregnancies within the first year of use. In
South Africa as many as 600 000 women experience unwanted pregnancies due to
contraceptive failure. Globally the rated of accidental pregnancies is 40%. This should not have to be.
'Fit and forget' methods
Speaking during a contraceptive
round-table discussion, Dr Gregory Petro, Chief Specialist in
Obstetrics and Gynaecology at New Somerset Hospital says one of the common
reasons why women are not on long acting birth control methods is because of
the lack of knowledge. Dr Petro also urged health workers not to have myths on
contraceptives, as this further discourages people from using them.
Other common factors that minimise the
effectiveness of birth control methods are incorrect insertions and drug
interaction. Some medication such as Efavirenz based antiretroviral
therapy (ARV), have been fingered as culprits that weakens a contraceptive's effectiveness.
In cases where patients are on other medications Dr Petro advises the
use of barrier methods of pregnancy prevention such as condoms.
Read: 8 contraception weak spots
Despite some challenges associated
with the various types of LARC, Dr Petro says with the right use to their
specific function they do work. “With correct administration and insertions
LARC have a high rate of effectiveness. And we generally refer to them as the
fit and forget methods because they are long term,” says Dr Petro.
The panel also addressed myths
associated with the implants, a controversial long acting contraceptive which was
introduced in the country in 2014. Specialists in Obstetrics and Gynaecology
were unequivocal in their call for more training of health workers on how to
correctly insert and remove implants to prevent severe side effects.
Inadequate training of health workers
especially in the public sector has been pointed out as one of the reasons
behind the implants being an infamous pregnancy prevention choice.
Counselling and education
Obstetrician Gynaecologist in
KwaZulu Natal, Dr Mala Panday, says the side effects of implants can vary from abnormal
bleeding to implants inserted too deep. “About 1 in 5 women who had implants
inserted experience excessive bleeding after the procedure, this makes about 20
% of all patients on this method,” she explained. Dr Panday also mentioned that
1 in 3 women have indicated that they experienced no bleeding at all while
others have reported to have normal menstrual cycles.
Another specialist in Obstetrics
& Gynaecology at the University of Pretoria and Steve Biko Academic
Hospital, Dr Zozo Nene, says there needs to be a protocol to manage bleeding
caused by contraceptives at all public clinics.
Read: Better contraception needed
“There should be protocols of
bleeding on walls at every clinics, ” says Dr Nene. She mentioned that women
not being advised properly on the choices they have available is a cause for concern.
Dr Nene also urged for health workers to give special attention to counselling
women and educating them on the options they have available for effective
“Women should be told that if they
experience any problems with the implants, they need to go back to the person
who has made the insertion in the first place”, she advices.
However, there have been concerns
that most nurses are given training on implant insertions only and not trained
on removal of such devices. In cases like this, Dr Petro has urged for up
referrals to be made for patients.
Long term contraception more effective
The right contraception for you
I need information about contraception