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A Misplaced Conception

Women activists denounce injectible as insensitive contraception After the infamous Norplant and Quinacrine contraceptive trials, it's now injectibles which have become the focus of women activists' ire.

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A Misplaced Conception
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Synthetic preparations of the hormone progesterone, injectibles prevent conception by disrupting the natural hormone balance. Surplus progesterone, scientists believe, inhibits ovulation; makes the cervical mucus thick and scant, creating a barrier for the sperm; and makes the uterus lining less suitable for embryo implanting. And unlike the pill, supposed to be taken everyday, one dose of Net-En can keep pregnancy at bay for three months. Besides, explains N.C. Saxena, chief of reproductive health unit at the Indian Council of Medical Research (ICMR), progestin injectibles are suitable for breast-feeding women for whom oral pills are contraindicated. At any rate, argues H.S. Juneja, director of the Mumbai-based Institute for Research in Reproduction (IRR), no contraceptive is free from side-effects, which are rarely fatal. In comparison, risk from unwanted pregnancies is much higher.

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The ICMR thus considers injectibles efficacious and safe. Even institutions like the United Nations Population Fund, the Population Council and the who have endorsed it. Last December, a meeting convened by the IRR recommended their introduction in future family welfare programmes (fwp), albeit in a phased manner.

But women's groups like the Delhi-based Saheli and others like Sehat, Chingari and Jagori, insist that long-acting, hormonal and invasive contraceptives like injectibles are unsuitable for women, particularly in the developing world. In a recently-published investigative report titled Enough is Enough: Injectable Contraceptive Net-En: A Chronicle of Health Hazards Foretold, Saheli damns injectibles because their safety and efficacy haven't been sufficiently demonstrated and lists several side-effects, a few of which can turn fatal in the absence of expert medical attention.

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Dismissing Saheli as a group of ultra-radical feminists, ICMR scientists contend that the supposed hazards of injectibles are exaggerated and that globally it's used by 12 million couples. Saheli's counter: in the developing world, only 3 per cent of married contraceptive users use this method. ICMR scientists do concede that it would be foolish to introduce injectibles in the fwp without a good paramedical infrastructure in place. That, says Saheli, would be prohibitive. The cost of each injection, at

Rs 126, is already high. When you factor in infrastructure, the costs go up further.

For policymakers, argues Saheli, spacing methods are significant in reducing birth rates since they're provider-controlled. With controlling numbers being uppermost in official mindset, women's health and well-being comes later or not at all.

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