Roshella, 25, consulted a gynaecologist recently as her menses was unusually delayed. To her dismay, she found that she was seven weeks pregnant.

The busy executive is healthy but has irregular menses that can sometimes be painful and heavy. She had relied on the rhythm method or fertility awareness as well as condoms as her forms of contraception.

As she and her long-time partner plan to get married and start a family only in three years' time, they made the hard decision to abort the baby.

During the surgery, a perforation of the womb was suspected. Key-hole surgery was performed to confirm it and the perforation was sutured to control the bleeding.

Roshella made a full recovery, but not all women are as lucky.

Worldwide, 56 million pregnancy terminations occur each year. The majority of women resort to terminating their pregnancies because they were not aware of using modern contraceptives. While the operation is generally safe in experienced hands, complications do arise.

Infection can occur in about one in 25 cases, as with adhesions in the cavity of the womb. Incomplete abortion occurs in about one in 25 cases and further intervention may be necessary.

Uncommon but serious complications such as heavy bleeding and injury to the bowel, bladder and major blood vessels can occur. Death can also happen, particularly in illegal "back street" operations, but is very rare.

To avoid another unplanned pregnancy, Roshella was advised at the follow-up session to consider other forms of contraceptives, as well as screening and the vaccination for cervical cancer.

Awareness of contraceptives empowers women to better plan for children. While many couples are ambivalent about starting a family, it is better to be decisive.

Couples who wish to conceive should consider attending a pre-conception consultation session with their family doctor or obstetrician to discuss the factors that may affect their pregnancy, such as their health history, the medications they may be taking and their lifestyles.

The women should then start taking folic acid supplements, which reduce the risk of major birth defects of the baby's brain and spine.

Those who do not wish to conceive should consider using contraceptives to avoid unintended pregnancies, particularly if they have medical conditions, are smokers, or take alcohol or drugs.

A wide range of contraceptive options are available here. The more popular ones are combined hormonal contraceptives such as the Pill, which is taken daily. Another option is the intrauterine device (IUD), which is typically a small T-shaped device that fits inside the cavity of the womb.

Other contraceptives include progesterone injections given every three months, or implants that are inserted under the skin of the inner upper arm and have to be replaced every three years, and barrier methods, such as using condoms during sex.

While barrier methods are not the most effective, they can reduce the risk of some sexually transmitted infections.

The Pill is an effective form of contraceptive, but it is not advisable for obese women, smokers above 35 years old, or women who have migraine with aura.

In Roshella's case, the Pill has the added advantage of regulating her menses, making it less painful or heavy.

For some women, the Pill may also improve acne and facial hair issues. Furthermore, the use of the Pill is associated with a lower risk of ovarian and endometrial cancer.

One of the main health risks is developing deep vein thrombosis (DVT) and pulmonary embolism (PE) - a blood clot in the leg and lung respectively.

But this risk of getting blood clots - about nine to 10 in 10,000 women using the Pill - is lower compared with pregnant women.

Any associated risk of breast cancer is likely to be small and will reduce over time after stopping the Pill.

However, Roshella was concerned she may forget to take the Pill on time. She opted for the IUD instead.

The advantages of the IUD are that it is highly effective, does not rely on one having to remember to take any tablets, and is not affected by other medication, diarrhoea or vomiting.

There are two main types, copper IUD, which purely functions as a preventive measure and may lead to heavier and more painful menses, and the hormonal intrauterine systems (IUS), which tend to reduce menses flow.

There are two main types of hormonal IUS - Mirena, which lasts for five years, and the smaller Jaydess, which can be used for three years.

Roshella decided on the latter as she plans to start a family in about three years' time. This was inserted into her womb in a clinic. A pelvic ultrasound scan was performed to confirm the location of the IUS after insertion. Roshella was also counselled on the possibility of irregular light bleeding in the first three to six months of using the device as the IUS will thin out the lining of the womb.

She was reassured that IUS use is not linked to breast cancer, DVT, PE, myocardial infarction, ectopic pregnancy and sub-fertility.

With proper planning, women can avoid the risks of abortion. Using the right contraception can also help to resolve other problems they may have, such as heavy bleeding.

• Dr Tan Toh Lick is an obstetrician and gynaecologist at Thomson Women's Clinic (Jurong East) and Thomson Wellth Clinic (Scotts Medical Centre).