Laparoscopic sterilisation becomes most effective form of birth control

The growing popularity of sterilisation as a method of birth control was underscored at the first Asian Congress on Gynaecological Endoscopy, convened in Bombay last month. For birth control experts, this was perhaps the only silver lining in the otherwise gloomy set of statistics that emerged from the conference. In the aftermath of the post-Emergency backlash, family planning has lost its political sanction which has sent the country's birth-rate skyrocketing to 65 per thousand - even more that the rate in China.However, in the decade ending 1980, the number of couples practising birth control through sterilisation rose from 20 million to 50 million. The conference came to the conclusion that sterilisation - in addition to being the safest and most effective form of birth control, is also the most widespread. The popularity is especially high among females where the operation - laparoscopic sterilisation- is simpler, less time-consuming and less troublesome.Quick Method: Laparoscopic sterilisation is a method which allows tubectomy to be performed without the 15 centimetre incision required for the traditional operation. A one centimetre incision is made immediately below the navel and the laparoscope, a narrow optical instrument with illumination at one end, is inserted into the abdomen. The surgeon, without actually opening up the woman, is able to see her insides, and, by using a fine remote-controlled instrument, to operate on her fallopian tube. A tiny clip or a rubber-like silastic band is then clipped onto the tube, and the woman is effectively sterilised. "Laparoscopic sterilisation is an incredibly quick and painless operation," says Dr S.D. Khandwala, a laparoscopic specialist who was involved in the organisation of the conference. "The actual operation takes only 10 minutes and the woman can then go home and do any work she likes with no restrictions on her diet or sex." The traditional operation, on the other hand, involves three days hospitalisation, a lengthy rest period and only light activities for a number of days. Khandwala: A"The beauty of this method is that you're making a normally complicated operation so simple and accessible," says Ira Lubell, executive director of the New York-based association for Voluntary Sterilisation Inc., a corporation which offers advice, programmes and equipment for family planning to 60 countries, "You can just walk in, get sterilised and walk out, its very simpleness attracts women who couldn't otherwise afford to take time off from bread-earning."But laparoscopic sterilisation, which was first introduced to the country seven years ago, is yet to catch on as a large-scale method of birth control. The primary reason for this, Khandwala points out, is that the Government is chary about importing the instrument's optical system, which is the only component not available in the country. The total cost of the machine, Rs 20,000, is also a stumbling block in the way of its becoming the primary tubectomy method in the country. In addition, the laparoscope requires a skilled surgeon, with both specialised training and continuous practice on the machine. But this, according to Khandwala, is not a real hurdle, since India boasts a strength of over 5,000 gynaecologists, who with a little extra training could handle the operation. "It is, at present, more a matter of convincing the Government about the usefulness of this method," he said. "In Gujarat and Maharashtra, where it has been encouraged, over 1 lakh laparoscopic sterilisations have been done in camps in the past two years."Enthusiasm: The almost painless method of sterilisation, in fact, cashes in on the relative enthusiasm of the female to be sterilised. The male, not directly affected by pregnancy or childbirth, is normally more difficult to motivate. After the Emergency, in fact, while all sterilisations dropped sharply, it was only the female sterilisations that picked up again, with male operations hovering at a negligible level. Birth control experts argue that the female, needing no external motivation or prompting, will go in for sterilisation if the right facilities are provided, as with laparoscopes. "Women come to our clinics regardless of whether there is a cash incentive or not," said a doctor at a birth control clinic, "There is no doubt that even with the incentives removed they will continue to pour in, it's only the men who respond to higher and lower incentives." But male sterilisation, even after the advent of the laparoscope, is the cheapest, quickest, and simplest long-term method to control the population growth rate. While the actual sterilisation rate has dropped to rock bottom due to governmental neglect after the Emergency, this is still the most attractive method for a country with limited finances. India's gynaecological endoscopists, however, are trying hard to convince the Government to develop laparoscopy on a nation-wide level. "There is no competition between the different forms of sterilisation." says Khandwala, "but it can be seen from Gujarat's experience that female sterilisation should be developed hand in hand with the other forms of birth control, and the laparoscope is the answer." Anticipating that the Government's response is bound to be positive, the Indian Association of Gynaecological Endoscopists has already started training gynaecologists from all over the country. "The magic wand of the laparoscope," says Khandwala, "will save India's womanhood from a life of drudgery, and, at the same time, help solve the country's population explosion."Published By: AtMigration Published On: Nov 25, 2013 15:40 IST--- ENDS ---

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Laparoscopic sterilisation becomes most effective form of birth control

The growing popularity of sterilisation as a method of birth control was underscored at the first Asian Congress on Gynaecological Endoscopy, convened in Bombay last month.

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