From medical student to obstetrician, oral contraceptives are a popular contraceptive for women in the United States, but the drugs have come under fire for side effects, including an increase in the risk of breast cancer.

In India, a government study in 2012 found that oral contraceptives in India are associated with a 1.5-fold increased risk of having a ruptured bowel during childbirth, a risk that increases to 8-fold for women who take at least three pills per day.

The study also found that the risk was twice as high for women taking six pills per month, compared to women who only took three pills.

More:India’s government said it would launch a national campaign to improve women’s health and access to birth control.