Family Planning
Family Planning
Family Planning
FAMILY
- It refers to two or more individuals who depend on
one another for emotional, physical, and financial
support.
FAMILY PLANNING
- To regulate the number and spacing of children in a
family through the practice of contraception or other
methods of birth control.
KEY FACTS
214 million women of reproductive age in developing countries who want to avoid pregnancy
are not using a modern contraceptive method.
Some family planning methods, such as condoms, help prevent the transmission of HIV and
other sexually transmitted infections.
Family planning/ contraception reduces the need for abortion, especially unsafe abortion.
Family planning reinforces people’s rights to determine the number and spacing of their
children.
By preventing unintended pregnancy, family planning/ contraception prevents deaths of
mothers and children..
BENEFITS
Preventing pregnancy-related health risk in women
Reducing infant mortality
Helping to prevent HIV/AIDS
Empowering people and enhancing education
Reducing adolescent pregnancies
Slowing population growth
Who provides family planning/
contraceptives?
It is important that family planning is widely available and easily accessible
through midwives and other trained health workers to anyone who is sexually
active, including adolescents.
Midwives are trained to provide (where authorised) locally available and culturally
acceptable contraceptive methods.
Other trained health workers, for example community health workers, also provide
counselling and some family planning methods, for example pills and condoms.
For methods such as sterilization, women and men need to be referred to a clinician.
Methods of contraception
1. SPACING METHODS
A.NATURAL METHODS
B.BARRIER METHODS
i. Physical barrier method
ii. Chemical barrier method
iii. Intra-uterine devices
iv. Hormonal methods
v. Post conceptional methods
2. TERMINAL METHODS
C.VASECTOMY
D.TUBECTOMY
1. SPACING METHODS
Help in prevention of pregnancy as long as they are used
These methods can help in timing and spacing of pregnancies, preventing
unwanted children.
These methods are temporary methods.
A. NATURAL METHODS
Do not involve the use of any man made devices
These methods are useful for timing and spacing of pregnancies.
1. COITUS INTERRUPTUS /
WITHDRAWAL
In this method. The penis is withdrawn from the vagina before ejaculation. In this way semen
is prevented from entering the uterine cavity and pregnancy does not take place.
Since the penis is withdrawn and ejaculation takes place outside the vagina, this method is
called INTERRUPTUS or WITHDRAWAL METHODS.
MERITS
• Involves no cost
• It does not require any other device
• With self-control and discipline it can be fairly effective
DEMERITS
• Required a great deal of self-control
• Thus failure rate is very high
• Slightest delay in withdrawal can lead to pregnancy.
2. SAFE PERIOD / CALENDAR METHOD
Based upon the process of ovulation and menstrual cycle which helps in determination of the
safe period when coitus can be done and unsafe period when coitus can be avoided to prevent
pregnancy.
MERITS
• It does not require any man made device
DEMERITS
• Require self-control by the partners during the highly unsafe period
• Not suitable for the women who does not have regular periods
• Failure rate is high
• Require great deal of will power and motivation
3. ABSTINENCE
The only method that is 100% effective.
Delay sexual activity until financially, emotionally and physically ready for the
responsibilities of child-bearing.
MERITS
• It protects you from STD and pregnancy
DEMERITS
• Coping for peer pressure
4. BASAL BODY TEMPERATURE
Indicates the woman's temperature at rest.
Before the day of ovulation and during ovulation, BBT falls at 0.5F; it increases to
a full degree because of progesterone and maintains its level throughout the
menstrual cycle.
The woman must record her temperature every morning before any activity.
1.CONDOM
a thin rubber sheath which is use by men. It is rolled over the erect penis before
having sex.
This rubber sheath prevents the entry of semen into the vagina.
The condom must be held carefully when taking out the penis from the vagina.
It is available free of cost from urban or rural family welfare centers.
TYPES:
DRY CONDOM
DELUXE CONDOM
SUPER DELUXE CONDOM
MERITS
It is most simple and effective methods
Easy to use
Disposable
No medical supervision is required
Protects from sexually transmitted disease.
DEMERITS
If not used correctly, it may slip or get tear of and the semen gets spilled into
vagina
In some rare cases the person may have allergic to rubber
Some people may not enjoy sex because of interference with the sensation.
PHYSICAL BARRIER METHODS
2. DIAPHRAGM
Used by women in her vagina to form a barrier in front of the cervix. The
diaphragm is a dome shaped and is like a shallow cap.
It is made of soft synthetic rubber or plastic with a stiff but flexible rim around the
edge. It is also known as DUTCH CAP.
MERITS
Very effective
Failure rate is low
There is no risk or any kind of contraindication
DEMERITS
It requires the assistance of doctor and any other health personnel
It requires a privacy and time to place it in the vagina
It requires periodical check up
It requires facilities for its proper care and storage
PHYSICAL BARRIER METHODS
3. VAGINAL SPONGE
It is a small polyurethane foam sponge, diffused with spermicide. The sponge is
shaped in a way that it can be filed on to the cervix and has a loop on its outer
surface which can be to pull out the sponge after use.
Should be inserted before the coitus.
It should remain be there for at least 6 hours after coitus.
Sperms are trapped on in the sponge and are destroyed.
It is better than not to use any method.
CHEMICAL BARRIER METHODS
These method usually kills the sperms and this way chemical
contraceptives help in preventing the pregnancy.
DEMERITS
Most be inserted deep down and in all such points where sperms are likely
to reach.
Must be applied each time before sex.
May cause irritation and burning.
INTRA UTERINE DEVICES
These are the devices which are placed in the uterine cavity. Earlier these
devices were made up of silk worm gut, silk and gold.
DEMERIT
They don’t protect against sexually transmitted infections (STIs).
Insertion can be painful.
The upfront cost can be expensive if you don’t have insurance. Though rare, there are
some risks.
HORMONAL METHODS
1. ORAL PILL
birth control pill works by stopping sperm from joining with an egg. When sperm joins with
an egg it’s called fertilization.
The hormones in the pill safely stop ovulation. No ovulation means there’s no egg for sperm
to fertilize, so pregnancy can’t happen.
The pill’s hormones also thicken the mucus on the cervix. This thicker cervical mucus blocks
sperm so it can’t swim to an egg — kind of like a sticky security guard.
TWO TYPES:
A. Combined Oral Contraceptives (COC’s)
Combination pills have 2 hormones: estrogen and progestin. Combination pills are the most
common type of birth control pill.
As long as you take 1 pill every day, you’ll be protected from pregnancy. You don’t have to take
your combination pill at the exact same time every day. But taking it at the same time is a good
idea because it helps keep you in the habit of remembering your pill.
DEMERIT
Does not protect against sexually transmitted infections, including HIV/AIDS.
Must be taken everyday
Less effective when taken with some medications
Raises risk of heart attack and stroke
Requires a prescription
HORMONAL METHODS
2. DEPO PROVERA
Pregnancy preventing hormone injection that last for three months.
The injection has synthetic progesterone and no estrogen. This stops the ovaries from
releasing eggs
It also thickens the cervical mucus and changes the uterine lining, so that its harder for
sperm to enter or survive in the uterus.
HOW TO USE:
Usually given in the arm or hip delivering a high level of progesterone into the body.
The first shot usually given during or a few days after the start of a menstrual period.
After 24 hours, the shot is effective birth control for the next 13 weeks
MERIT
Private
Effective after 24 hours
Does not require regular attention
Does not interrupt sex play
Has no estrogen
May decrease risk for ovarian and uterine cancers
Can be used starting six weeks after giving birth
DEMERIT
Causes loss of bone density, increasing the risk of osteoporosis
Does not protect against sexually transmitted infections, including HIV/AIDS.
Requires injection every 3 months
Delays the return to fertility
Could cause irregular bleeding
Leads to weight gain for many women
HORMONAL METHODS
3. IMPLANT
is a contraceptive method that is applied under the skin. It consists of a flexible rod that is
placed on the inside of the arm.
Its mechanism of action is based on releasing progestogens, i.e. hormones. Release takes
place continuously, preventing ovulation among other effects.
This contraceptive method is designed to be used for a prolonged period of time, without
the need to change it in 3 or 5 years. During all this time it continues to offer 99%
protection against pregnancy.
Once the implant is removed, the contraceptive effect disappears. Therefore, ovulatory
cycles resume normally.
MERIT
It’s one of the most effective birth control methods available.
Once inserted, the implant lasts 3 years before needing to be replaced.
No pre-sex prep or reminders.
It can be a bit costly upfront, but there are no costs beyond that for 3 years.
It can improve cramps, make periods lighter, or stop them entirely for some.
You can remove it at any time and your fertility will return as soon as it’s removed.
It’s safe for people who can’t use birth control that contains estrogen.
DEMERIT
It doesn’t protect against sexually transmitted infections (STI’s)
Insertion requires a visit to a healthcare professional.
The device must be removed after 3 years.
Though rare, the implant can migrate from the insertion site, making it difficult for a clinician to find
and remove.
HORMONAL METHODS
4. HORMONAL PATCH
It looks like a square bandage
It is applied to the abdomen, buttocks, upper arm or upper torso
The patch is used on a four week rotation: it changed each week for three and is absent
for the fourth week
Works by slowly releasing a combination of estrogen and progestin hormones through the
skin.
These hormones prevent ovulation (release of an egg from the ovary) and thicken the
cervical mucus, creating a barrier to prevent sperm from entering the uterus.
MERIT
Easy to use
Can be worn for three weeks
Effects fertility one month at a time
Does not interrupt sex play
DEMERIT
Does not protects against sexually transmitted infections including HIV/AIDS
Raises woman’s risk of heart attack and stroke
Requires a prescription
B. TERMINATION METHODS
Sterilization is only method which gives permanent protection from
conception . Either husband and wife can undergo sterilization by a simple
surgical operation.
VASECTOMY
TUBECTOMY
VASECTOMY
a small operation to prevent pregnant. It blocks sperm from getting to your semen
when you ejaculate. With no sperm leaving your body, you can’t get
someone pregnant. You can still have an orgasm and ejaculate.
The operation involves a small cut on both sides of scrotum then a small portion of
vas deferens (about 1cm) on either
During the procedure, local anesthesia is used. The doctor makes a small opening
in the skin of the scrotum. This allows the sperm tubes or vas deferens to be seen
and cut. The procedure itself takes about 15 minutes.
TUBECTOMY
also known as tubal sterilization, is a permanent method of contraception in women.
It is a surgical process that blocks the fallopian tubes, thereby preventing the egg released
by the ovary from reaching the uterus.
Tubectomy is a major surgical procedure in which the fallopian tubes are cut open and
clipped or tied up to block the passage of the egg into the uterus.
MERIT
More than 99% effective
Convenient and permanent
Decreases risk of ovarian cancer
Does not cause serious side effects
DEMERIT
Requires certainty and long-term planning
Failure rate is 0.5%
Increases the risk of ectopic pregnancy
Does not protect against STD
WHO (World Health Organization)
working to promote family planning by producing evidence-based
guidelines on safety and service delivery of contraceptive methods,
developing quality standards and providing pre-qualification of
contraceptive commodities, and helping countries introduce, adapt and
implement these tools to meet their needs.
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