Why are Indians using fewer condoms?

Why are Indians using fewer condoms?

by Nirmalya Dutta

With 1.2 billion people, India's barely a nation that can afford to be lax about contraception but according to the health ministry, condom usage has dropped by 38% – from 2.6 crore in 2007 – to 1.6 crore in 2010-11. Also the statistics should be taken with a pinch of salt because these statistics only reflect the condoms distributed free of charge by the government and doesn't reflect the rise in condom sales produced by private companies. The United Nations Family Planning Association's (UNFPA) India president Sujatha Natarajan told TOI, said the decline could be because of a host of reasons such as preference for permanent methods of contraception and dip in social marketing and distribution of condom. 'In 2006-07, the investments in media campaigns for use of condoms were very high because it was related to combating HIV-AIDS. The investments have subsequently come down,' she said, adding that the people had more contraceptive choices now.'

What is contraception?

Contraception refers to artificial methods to prevent pregnancies. There are various ways this is done – condoms, diaphragms, oral contraceptives, behavioural birth control methods and spermicides. Condoms are the most cost-effective, easily available contraceptives and also help prevent HIV-AIDS and other STDs. Because of cultural barriers, the sex education scenario in our country is abysmal and there's a need to improve it to prevent early pregnancies. Early pregnancies aren't only dangerous for the mothers but have a causal link with poor children's development and infant mortality.

Barrier birth control – condoms and diaphragms

Condoms are without a doubt one of the greatest inventions of mankind. Not only are they the most cost-effective way to prevent unwanted pregnancies but they also stop the transmission of various STDs including the dreaded HIV/AIDS. When used properly, condoms have a 98% success rate!  (How not to use a male condom) Nowadays, female condoms are also widely used. Much like their male counterparts, they work on the same barrier principle. And they're believed to be more pleasurable as well, though costlier.

Diaphragms work on the same barrier principle as condoms and need to be inserted into the vagina at the mouth of the cervix (the opening to the uterus, based at the highest point of the vagina). Remember, that it's a very small opening so there's no fear of the diaphragm going into the uterus. (Read: Condoms: Frequently Asked Questions)

Pros and cons: They are easily available, inexpensive and work effectively when used properly. The con is that there's a certain stigma attached to buying them in many countries (including ours) and might be overlooked in the heat of the moment. The availability of the right size can also be a problem. Some also live under the impression that they decrease pleasure and aren't as good as the real thing.

Birth control pill

Birth control or oral contraceptive pills are a reliable method of contraception and works by suppressing ovulation – the release of an egg from the ovary. Contraceptive pills are classified depending on their composition. In India, there are two types of pills available. 

Combined pills: Contains a combination of oestrogen and progestin. These are the synthetic form of the same hormones present in the female body. These pills are also useful in reducing the intensity of menstrual discomfort. Another type of pill available is the Mini Pill. They contain only progesterone, they are milder in action and have lesser side-effects. If used correctly and consistently, the pill is projected to be about 99.7 to 99.9 % effective in preventing pregnancy. The failure rate of hormonal methods of contraception, including the pill is usually lower than non-hormonal methods such as condoms and intrauterine devices.

Pros and cons: When taken correctly, regular and emergency pills work most of the time. However, they can also cause problems and it's believed they can cause weight gain, decrease libido and cause other problems since they alter a woman's hormonal levels. It's also important to remember that unlike the barrier method, pills do not prevent the transmission of HIV and other STDs. (Read: Prescription Birth Control – The Pill)

Behavioural birth control

Behavioural birth control is an umbrella term for various practices which we perform to prevent pregnancies. It includes the withdrawal method, fertility awareness and complete methods.

The withdrawal method refers to the man 'withdrawing' when he is about to ejaculate. This method is quite unreliable. 4% of accidental births occur because of failure of this method. The fertility awareness method refers to the woman keeping a close track on her ovulation time and avoiding sexual contact during those days. The third method is of course complete abstinence.

Pros and cons: Behavioural methods of birth control might be free of cost, but they are extremely hard to practise and have the highest fail rate of all contraceptives. It's extremely hard to keep a track of the so-called 'safe days' because many women have irregular periods. 

Now that you know about the various contraception methods and their pros and cons, choose the one that best suits you and your partner. Remember, it is better to be safe than sorry! 

For more articles on contraception, visit our Sexual Health section and for videos check out our YouTube Channel.