I have been practicing for the past 40 years. I started in 1976, an year after the emergency ended in India. A time when sterilizations were supposedly done forcefully, thus associating a bad name with Family Planning and creating a fear of every doctor in aam junta of our country. Even during a routine check up, it had to be justified to women that no litigation would be forced on them.
The name of Family Planning was changed to Family Welfare. Now it is Department of Gyne/Obs/Family Welfare.
We were 100 crores in 1999 ( remember the movie 100 crore made by Dev Anand)
2016 we are 130 crores despite abortions made legal in 1972.
Every woman who comes to center should not be abused psychologically, monetarily or physically & procedure can be done with minimum trauma using MR syringe.
If a doctor earns 5000/- plus in a fancy nursing home , same doctor can earn same amount by doing 10 minor procedures per day.
The investment to start a clinic is not much compared to a dental clinic or for eyes or for ear-nose-throat clinics etc which require sophisticated equipment.
Dry sterilization of instruments can be done using formaldehyde tabs.
Woman who comes to doctor full of fear and doubt is made to relax and procudure takes just 5 minutes or a bit more but some sedation injection is given to make doctor and patient at ease.
The woman is most motivated at this stage.
If given counselling to get fitted with intra uterine device , she may agree provided charges are reasonable and she does not have to buy it on her own.
Copper T is given by Govt. to Registered family welfare centers for Free.
She can be sent for lap ligation also-a procedure that is permanent compared to IUCD and takes only 15 minutes ,the woman is discharged within 2 hours of observation.
Now a days MTP pills are sold over the counter minus prescription and women are buying them because doctors are few and our women are scared.
It is written on packs to get in touch with doctor in case of pain or heavy bleeding.
2 reasons of maternal mortality in our country are infection and bleeding after delivery/abortion.
Pain and bleeding after MTP tablets are a signal that some pieces might have been retained and pieces get infected leading to discharge of pus along with blood,
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It is my request to my young colleagues that you do not have to go to rural areas to serve our women from 8-80 , half of our population.
There is lots to do right here within our cities.
Government allows doctors to do lots for family welfare
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Investment is minimal , work is plenty and women are abused by untrained midwives as in rural areas within Delhi ,there are no regulations about who poses to be a doctor and there are more than 1000 rural illegal villages within Delhi where no doctor wants to set up a shop ,but good news is that there are authorized colonies near every village.
A clinic can be set up in a 2 room set as a day care center to cater to a large population at the mercy of quacks.
No leader will preach family planning ,it being a dirty word for vote bank politics.
It is for us , the doctors to do counselling and treatment after guiding the woman along with her husband using a cafeteria approach.
Not every device or operation or pills are for every woman.
It has to be personal.
It has to be individualistic.