FAMILY PLANNING AND CONTRACEPTION: AN OVERVIEW

CONTENT

INTRODUCTION

IMPORTANCE OF FAMILY PLANNING

TYPES OF FAMILY PLANNING

 

INTRODUCTION

Family planning is defined as is the process by which couples and sexually active minors prevent unwanted pregnancies and inturn decide the timing, number and spacing of their children through the use of contraception.  Wth over 200 million women still lacking access to modern methods of family planning, a lot is still required to be done especially in our environment in other to prevent unwanted pregnancies and its attendent complications. Among the reason for lack of universal access to family planning include:

1. Limited choice of methods,

2. Fear of experiencing side-effects

3. Poor quality of available services

4. Cultural or religious opposition

5. Users and providers bias,

6. Barriers from the subjects husband

7. Limited access to contraception,  particularly among young, single and poor people.

 

IMPORTANCE OF FAMILY PLANNING

1. It gives the couple the power to determine the exactly how they want to structure their family

2. It prevents unsafe abortion by preventing unwanted pregnancies and by so doing prevents complications associated with abortion including death.

3. It protects women predisposed to high risk pregnancies from unwanted and dangerous pregnancies that can lead to unnecessary death to the mother and the unborn baby.

4. It prevents closely spaced pregnancy and short inter delivery interval both of which contribute significantly to the death of infants and children. Since it prevents death of mothers at risk of pregnancy complications from untimely death, it also prevents the death of children who may be born to such mothers from the risk of early childhood death.

5. By limiting the number of children according to the parents wish, it helps parents to invest in their children properly and train them to the peak of their desire. Children from a small family size stay in school longer than those from a large family size.

6. It improves the financial state of the parents by preventing unwanted pregnancies and unplanned children.

7. It reduces pregnancies in minors and adolescent, thus ensuring they stay in school and secure a future for themselves at the same time preventing complications commonly associated with pregnancies in minors such as preterm labor and obstructed labor.

8. It slows population growth and helps reduce the rate at which a nation’s resources is stretched or depleted.

9. Some family planning methods prevent sexually transmitted diseases including HIV and others confer many other non contraceptive benefits to the user.

 

TYPES OF FAMILY PLANNING

Family planning can broadly be divided into:

1. Natural methods of family planning

2. Modern methods of family planning

NATURAL METHODS OF FAMILY PLANNING

These are methods that do not require the use of any contraceptive product but relies on the natural changes in the woman’s body to determine when a woman is fertile or not. Generally tasking and often requiring a lot of discipline, these methods are not routinely offered unless a woman refuses a modern method of contraception. With these methods, a woman can time intercourse so as to conceive or to avoid getting pregnant. They include in the order of effectiveness

1. Periodic abstinence or fertility awareness methods

2. Lactational amenorrhea method and

3. Withdrawal method

MODERN METHODS OF FAMILY PLANNING 

This refers to the use of birth control methods or contraceptives to disrupt the natural process of conception thus allowing couples to have sex at will and without restrictions. They include various devices, tablets, injections, gels and even surgical procedures designed to prevent conception by altering or disrupting the basic steps necessary for fertilization. 

 

CHOOSING THE IDEAL CONTRACEPTIVE

There is no such thing as an ideal contraceptive. This is because an ideal contraceptive ought to be:

1. Highly effective

2. Cheap

3. Should have no side effects

4. Should not be required before each intercourse

5. Should not be renewed too regularly or too often

6. Shoud be acceptable to all persons irrespective of culture and religion

7. Should be easily accessed by all persons and be easily administered without the need of a health care personnel

8. And should have other non contraceptive benefits when used

Since no contraceptive method combine all these features, all persons requiring contraceptives must be allowed to make his or her own choice after counseling them on all methods of contraception. During counseling, the following features of each contraceptive methods must be discussed:

1. EFFECTIVENESS/EFFICACY

The effectiveness or efficacy of a contraceptive method is best assessed by the failure rate of the method in view. This depends solely on two factors;

A) How the method works

B) How easy it is to use the method

2. FAILURE RATE

This is defined as the number of pregnancies per 100 woman-years (HWY), i.e. the number of pregnancies if 100 women were to use the method for one year. This is also known as the pearl index. Since the failure rate is a measure of the effectiveness of a contraceptive method, it stands to reason that the higher the failure rate of a contraceptive method the less effective the method is.

A) Perfect user failure rate: This refers to the failure rate observed when a method is used specifically as prescribed by the manufacturer. This is due to the failure inherent in the way the method prevents pregnancy or to an error made by the provider while administering the method. In general, methods that prevent ovulation generally have the highest effectiveness and the lowest perfect failure rate.

B) Typical user failure rate: In contrast to the above, this refers to a failure rate observed due to errors typically made by an average person while using the method. This therefore depends solely on how easy it is to use the contraceptive method. This has an important impact on the compliance, discontinuation rate and the overall effectiveness of the contraceptive method. In general, methods that require frequent usage especially before intercourse have higher typical failure rate than methods which last over a long period, that are indepedent of sex and are administered by heath workers.

3. SIDE EFFECTS

Since most users of contraception are young and healthy, most contraceptives are safe and are hardly followed by any complications. But in truth all contraceptive methods have some side effects, a few of which may be disastrous in poorly selected few individuals. This propmted the WHO to publish a guideline on the use of contraception based on the safety of each contraceptive method for various specific medical conditions. This guideline must be used to counsel clients on the suitability of each contraceptive method in order to ensure their safety and their satisfaction.

Although it is a shame that most women who discontinue the use of any particular contraceptive often do so due to perceived risks or fear of risks rather than a real risk or complication, it is important that all clients are informed about all methods of contraception and their side effects and are encouraged to choose a particular method based on this information, in order to reduce the rate of discontinuation of any contraception. They should also be encouraged to present in the family planning clinicand request to change any contraceptive method any time they experience side effects or they feel uncomfortable with the one they are using so as to prevent an unwanted pregnancies that are way too common following the discontinuation of one method of contraception.

 

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