“YOU’RE PREGNANT.” For a foreign domestic worker (FDW) in Singapore, this usually happy news may mean something else – specifically, termination of work contract and even repatriation back home.
See, pregnancy for work permit holders in Singapore is a violation of work permit conditions. In 2010, it was reported that at least 100 foreign domestic workers were sent home due to pregnancy. It’s no wonder when an FDW finds out that she’s in the family way, she might try to hide her pregnancy until she could go home to her country where she can choose between giving birth freely or getting an abortion. If she is found to be pregnant by her employers, she is likely to be sent home.
For many domestic workers, especially those who are their families’ sole breadwinners, being sent home is a worse fate because it also means they will be blacklisted from working again in Singapore.
As a doctor, I feel none of the options above are acceptable. What is want to do is teach our domestic workers – and all women who do not intend to have kids now – how to avoid an unplanned or unintended pregnancy. You can do that with one word: contraception.
Contraception or “Family Planning” is what we do to avoid getting pregnant or to space our pregnancy. I know some may not be happy reading this (contraception has a lot of critics), but for me – as a medical doctor and a woman – it is a better option than getting an abortion.
A fetus or baby can only develop once a female egg and a male sperm meet and fuse together. Contraception actually prevents the female egg from being fertilised by a male sperm; hence, no fetus or baby will be created after intercourse.
DIFFERENT CONTRACEPTION METHODS
There are different methods of contraception. But contraception is not a “one type fits all” so while the following information will give you a basic understanding of different contraception methods, I strongly advise that you consult your doctor on what kind of contraception is best suitable for you.
Contraception methods can be natural or unnatural, and temporary or permanent.
Natural method simply means that you are not taking anything or undergoing manipulation or operation to prevent pregnancy. But be warned: natural methods are the most ineffective.
The different types of natural methods:
Calendar or Rhythm Method:
In this widely used method, a woman has to keep track of her menstrual cycle, wherein there are “safe” and “unsafe” days to have intrcourse. Unsafe days mean a higher chance of getting pregnant during this period; hence, the couple must not engage in sex during this period.
There are different kinds of contraception.
But contraception is not a "one type fits all."
Basal Body Temperature (BBT):
With BBT, a woman needs to monitor and chart her temperature.BBT is the lowest body temperature taken during rest. This is usually measured
upon waking up, when the body has fully rested. During ovulation, the body temperature increases. Post-ovulation, it decreases, which means it is safe to have sexual intercourse.
Coitus interruptus or Withdrawal Method:
The couple can have sexual intercourse but once the man senses that he is ready to release his semen, he has to “withdraw” his penis out of the vagina. Some couples feel this is difficult to do – the man may not pull out in time, thus releasing his semen inside the vagina.
Cervical Mucus Method:
This requires the woman to check the quality of her vaginal discharge, whether there’s a lot and elastic or it is dry and scanty. Vaginal secretion tends to become more copious (marami) and elastic as ovulation draws near. After ovulation, it becomes dry and scanty (kaunti) which means it’s safe to have intercourse.
Breastfeeding: This naturally suppresses ovulation due to hormones involved in milk production. However, the protection it provides is variable (paiba-iba) and dependent on the frequency of the breastfeeding and the time lapse from giving birth. Once a woman’s menstruation starts, then it’s time to change to a different contraception method.
Condom: A rubber or a sheath around the male penis which should be placed prior to vaginal insertion. This will collect and prevent the semen from entering the vagina upon ejaculation. This method is effective and may also protect you from sexually transmitted diseases (STD).
Diaphragm: A latex cup that is placed in the vagina which prevents the passage of the semen into the cervix.
Cervical cup: Similar to the diaphragm but placed instead over the cervix.
Spermicidal Foam: Vaginal foams, suppositories, jellies, films, foaming tablets, and creams which must be placed in the vagina before intercourse. They work by killing the sperm.
Oral contraceptive: Also known as “pills”. These are to be taken continuously for 21 days, stopped for 7 days, then start the cycle again. Alternatively, 28-day pills must to be taken continuously for 28 days.
Injectable: The injection of a hormone to prevent ovulation. This injection must be taken every three months.
Implants: The surgical insertion of the implant that is noted to be very effective in preventing pregnancy. Protection lasts up to three years.
Intrauterine Device (IUD): The insertion of a T-shaped devise into the cervix and kept in place. It is said to be very effective in preventing pregnancy.
Sterilisation: In females, this can be accomplished by either a) bilateral tubal ligation to block the fallopian tubes, which prevents female eggs from passing or b) hysterectomy or removal of the uterus.
Vasectomy: In males, surgery will be performed in the small tubes within the scrotum to prevent the passage of the sperm.
Again, I would like to highlight that this is just an overview of the different types of contraception which are currently available to anyone seeking to prevent pregnancy. It is still up to your doctor to assess which method is most suitable for you.
My advice, especially to those who are not ready to get pregnant: Think about your decisions in life before doing anything that you may regret in the future. Remember, some things once done cannot be undone.