W.H.O. defines family planning as a way of thinking and living that is adopted voluntarily upon the basis of knowledge attitude and responsible decision making by individual or couple in order to promote the health and well being of the individual and the community.
Each year, approximately 210 million pregnancies occur worldwide
About 22% of these pregnancies will end in elective, induced abortions
Contraceptive availability and use significantly decrease the rate of abortion
Making informed decision on personal fertility
Having children by CHOICE and not by CHANCE
Reasons for Family Planning
Circumstances for women seeking family planning are varied
Counselors should not make assumptions about women
Most women electing abortion choose to terminate their pregnancies
These women usually want to delay or prevent pregnancy again
Some women desired pregnancy, but for medical reasons have terminated it
Women with spontaneous abortions may want to get pregnant right away
Some women with a spontaneous abortion may want to delay pregnancy
To help the woman understand the factors that led to the abortion so that she can avoid repeating the situation
Gives women freedom to improve their quality of life
Reduces maternal mortality and morbidity helping women avoid unwanted pregnancy and potentially unsafe abortion
Promote women’s health by:
limiting births to the healthiest childbearing years
avoids more births than are good for the body
allows spacing between pregnancies which also benefits infant health
Key Messages on Healthy Timing and Spacing of Pregnancy
Recommendation for spacing after a live birth
After a live birth, the recommended interval before attempting the next pregnancy is at least 24 months in order to reduce the risk of adverse maternal, perinatal / postnatal and infant outcomes.
Recommendation for spacing after a miscarriage or induced abortion
After a miscarriage or induced abortion, the recommended minimum interval to next pregnancy is at least six months in order to reduce risks of adverse maternal and perinatal / postnatal outcomes.
Recommendation for adolescents:
Adolescents need to Abstain or use an effective FP method of their choice continuously until they are 18 years old before trying to become pregnant
Advantages of Family Planning
Free expression of sexual desires
Reduces incidence of unwanted pregnancies
Reduces incidence of unsafe abortion/ maternal morbidity/mortality
reduces incidence of unwanted babies
Stabilizes the community
Improves living standards of society
Improves psychological wellbeing
Indication or family planning
Individual
Birth Spacing
Temporary ill-health in either partner
Chronic systemic disease (wife)
Previous obstetric complications
Diseases transmissible to fetus
Previous abnormalities in offspring
Early marriage
Singles (adolescent / youth)
Failure of family planning method Use
No method is 100% effective
Woman may not consistently remember to take or use
Woman may be influenced by popular myths and discontinue use
Woman may experience unacceptable side effects and discontinue use
Woman’s husband or family may not approve of her using contraception
Religious leaders in the community may not support the use of contraception
The woman may have had non-consensual sex
Counselors do not adequately explain to the woman about methods
National policies limit use of contraception
Contraceptive methods are too expensive for the woman
Clinics cannot provide a reliable supply of the woman’s method
Services are not located in the community or not open conveniently
Protocols limit access
FAMILY PLANNING METHODS
A Barrier or Non-Presecriptive (4-8 per 100 women)
Condom – Male made of latex with spermicide
Female polyurethrane
Protect against STDs and cervical cancer.
Spermicides/jellies, Foams
Diaphragms
Sponges
Cervical Caps
B. Surgical Method by Vasectomy
C. Hommonals – can be combined or single hormonal pill (efficacy 3 per 100 women)
Pills – mini pills
male pills – standard pills
Injectables – Depo provera – 3 monthly
Noristeral – 2 monthly
Implants (biodegradable and effective for 1-3 year) – Norplant – one monthly injections – Jardel, Unimplant implanone
D. Intrauterine Devices
a. Cupper device – Curt, ML 375, etc.
b. Non Cupper bearing – Lipples Loop Soft
c. Impregnated device (with hormonal)
Side effect: ectopic preg, PID, perforation etc
E. Immunological Methods :Vaccines (e.g. anti-HCG) still undergoing development
F. Natural family planning.
Periodic Abstinence (Avoidance of intercourse during fertile period)
Calendar (Rhythm) method-fertile period based on menstrual cycle (20 days from longest cycle; 11 days from longest cycle); 9 per 100 women years
Billing’s method-quality of cervical/vaginal mucus; 3 per 100 women years
Basal Body Temperature (BBT) -rise / fall in BBT of 0.5C indicates onset/end of fertile period; 1 per 100 women years
Natural mthd
. Helps the couple understand their mutual fertility;
Enables couples to achieve or avoid a pregnancy;
Promotes the mutual love of the couple;
Is morally acceptable;
Does not require regularity of the menstrual cycles;
Can be successfully applied during breastfeeding, premenopause and discontinued use of the birth control pill;
Is invaluable for infertile couples, both for achieving pregnancy, and as a tool in the diagnosis and treatment of reproductive disorders;
This is the extract from my presentation.
