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Unplanned Pregnancy & ECP

Unplanned Pregnancy & ECP

Let us talk about crossing the line between a boy and a girl. Things do happen between college boys and girls, or young unmarried couples, or married couples. I would like to mention about my clinical experience in this regard. While working on my pilot project in Gurgaon ‘AshaUSA Mini Medicine Citi’, we ran several OB/GYN clinics in Gurgaon. I used to have discussions with OB/GYN lady doctors, and it became very obvious to me that many young couples (boyfriends-girlfriends) were coming from Delhi to Gurgaon for medical termination of pregnancy (MTP). While from Gurgaon, I was sure that they were going to the other side of the town or to Delhi for medical termination of pregnancy. My colleagues told me that at times they got as much as 20 cases per day for medical termination of pregnancy.

What we need to understand is that while our younger generation is going through their college education and further higher education, especially the girls cannot afford to be pregnant or afford to have a baby. A scenario that would totally change direction of their life if they were to have a baby. It will put a stop to their future education. While it is perfectly acceptable in US culture to have a baby without father or before marriage, but it is not acceptable in Indian culture.

It is not like our time movie scene where finally boy smiles at the girl and girl smiles at the boy and then parents smile at boy and girl, and then suddenly ‘The End’ of the movie. This is 21st century. In 2020 boys and girls expect to kiss each other and sleep with each other. Unfortunately, our parents are not aware of fast changing environment and they have not prepared our younger generation for safety in a relationship. I became aware of such issues very early in my medical school.

Our Indian community is fast changing. Young boys and girls are becoming fairly independent and they have excellent means of communication now. With the prosperity of middle-class families, they have hi-tech means to interact with each other. Let us not forget that now our younger generation have very easy exposure to the western culture where it is a tradition between boys and girls to start dating at age 13.

In USA it is not like what they show in American movies. Simple rules of dating are there to protect our children and the same time let them spend some time with their peers. I have two children, a girl and a boy and we followed the same rules despite being raised in India traditionally. Parents in USA bring their boys and girls together. Children can see movies together or they can go to malls for a walk for couple of hours. Almost all dating happen on weekends and holidays. We leave them at 4pm and pick them up at 8pm. As they get older and older, we let them spend more and more time together, individually or as a group.

Almost everywhere in United States, parents put a curfew of 12 midnight for 11th and 12th graders because by the time children get to 11th and 12th grade, they drive their own cars. So, we want them to be home before midnight. Also, at the same time we do educate our children about what it means to be intimate, what are the risks involved, and what precautions everybody needs to take. We provide them with all the latest technology to be safe (gadgets to immediately request for police or locate their location) iPhones can easily tell where our children are.

Obviously, parents are deeply involved, and we do help our children to choose their dating partners wisely. While children are very open and communicate well with one of the parents, either mom or dad about their personal interaction with boys and girls. But In India, it is a very secretive thing. It is very hard for girls or boys to let their parents know as they are scared of their parents’ reactions. India is still very traditional. They do not want their daughters or sons to be intimate emotionally or physically before marriage. They still believe in arranged marriage and some control over their children’s life. They means well for their children.

This is a reality every parent has to face that after age 12-13 (about 6th to 8th standards in schools) both boys and girls go through strong hormonal changes and huge emotional changes also. Attraction to the opposite sex is dramatic and attraction can almost be obsessive. We need to adapt to the modern way of living while preserving our culture and our values. We need also to respect the feelings, emotions and likings and dislikings of our children. This interaction is also important for their self-confidence, self-esteem, and the future psychological development. Also, dating is a fundamental fact and to have desire to date was true in our time and it is true in our children’s time. It was not practical or possible in our time but today at some level it is possible also with modern means of communications.

Now everything has changed for our younger generation – the mobile phones, the money, the communications, and exposure to way of life in the western world. So, in such a situation, we should not discourage our children not to date rather we need to have a friendly discussion with our children and set some rules. While all said and done, I need to talk about emergency contraception also.

For such situations, United States has finally came up with a pill what we call the Plan B One-Step pill (1.5 mg, take one pill by mouth within 3 days of being intimate: sooner the better). This is the first emergency contraception Federal Drug Administration (FDA) in USA approved to be available in the stores without doctors’ prescription. It is a backup plan that helps prevent pregnancy from happening after unprotected intimacy or birth control failure and in not for routine use. One thing is the plan B One-Step is approved for over the counter by women more than equal to 15 years of age. It means that the young women in US do not need any doctor’s prescription

In India, Cipla markets it as Pill 72 (2 tablets of 0.75 mg, take by mouth within 3 days i.e. 72 hours of being intimate: sooner the better).

“Any woman wo has had unprotected intimacy for any reason can use emergency contraception.”

It contains levonorgestrel, the same ingredient used in many birth-control pills. It works in a similar way. If you are already pregnant, it will not work, but if you are already pregnant and if you take it, it is not going to hurt the existing pregnancy either. Of course, you cannot use it as a regular birth-control. It should not be used that way!!!

It is not effective as a regular birth-control to be used consistently and correctly. So, it is important to have another reliable source of birth-control that is right for you. Note that, it will not protect you from HIV infections.

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