Where There Is No Doctor 2011 293
INJECTIONS. In this family planning method, a
woman is given injections of hormones every 1 to 3
months, usually at a health center or family planning
clinic, by someone who knows how. The first injection
can be given any time a woman and her health worker
are reasonably sure the woman is not pregnant. The
injection protects against pregnancy immediately if it is
given within 5 days after monthly bleeding begins. If the
injection is given 6 or more days after the beginning of
monthly bleeding, the woman and her partner should use
condoms or not have sex for the next 7 days. For more
information see page 396.
IMPLANTS are small, soft tubes that are placed under
the skin on the inside of a woman’s arm. These tubes
contain the hormone progestin and prevent pregnancy
from 6 months to 5 years, depending on the type of implant. The tubes must be
inserted and removed by a trained health worker, usually at a clinic or family planning
center. They can be inserted any time a woman and her health worker are reasonably
sure the woman is not pregnant. If a woman is breastfeeding, implants can be
inserted 6 weeks after the baby was born. For more information see page 397.
METHODS FOR THOSE WHO NEVER WANT TO HAVE
MORE CHILDREN
STERILIZATION. For those who never want to have more children, there are
fairly safe, simple operations for both men and women. In many countries these
operations are free. Ask at the health center. Sterilization does not protect against
STIs, including HIV.
• For men, the operation is called a vasectomy. It can be
done simply and quickly in a doctor’s office or a health
center, usually without putting the man to sleep. Small
cuts are made here so that the tubes from the man’s
testicles can be cut and tied. The testicles are not
removed.
The operation has no effect on the man’s sexual
ability or pleasure. His fluid comes just the same, but
has no sperm in it.
• For women, the operation is called a tubal ligation,
which means to tie the tubes. One method is to
make a small cut in the lower belly so that the tubes
coming from the ovaries, or egg-makers, can be cut
and tied. It can usually be done in a doctor’s office
or health center without putting the woman to sleep.
Although usually successful, there is a higher risk of
infection in the operation for women than for men.
This operation has no effect on the woman’s menstrual
periods or sexual ability, and may make having sex more
pleasant because she does not have to worry about pregnancy.