Advantages and various methods of family planning | Complete guide

Introduction

Family planning helps people have the desired number of children, which as a result improves the health of mothers and contributes to the nation’s social and economic development in most developing countries. It is common practice for women to have too many children, too close to one another. As a consequence, the population size of the country has grown dramatically but economic growth has not kept in parallel with it. Such an unbalanced population size will inevitably have a negative impact on the well being of the nation. Family planning is one of the strategies which is proving to be effective in tackling these problems.

FAMILY PLANNING AND ROLE OF COMMUNITY PHARMACIST

It is defined as a continuous process that you as the counsellor provide to help clients and people in your village make and arrive at informed choices about the size of their family (i.e. the number of children they wish to have).

General principles of counselling

• These are the important principles and conditions necessary for effective counselling:
• Privacy — find a quiet place to talk.
• Take sufficient time.
• Maintain confidentiality.
• Conduct the discussion in a helpful atmosphere.
• Keep it simple to use words people in your village will understand.
• First things first do not cause confusion by giving too much information.
• Say it again repeat the most important instructions again and again.
• Use available visual aids like posters and flip charts, etc.

Individual counselling

 You will find that in most cases individuals prefer privacy and confidentiality during communication or counselling with you. It is important to respect the needs and interests of a client by finding a private room or place where you can talk with them.

Couple counselling

Couple counselling is when you give a counselling service to a couple or partners together. This is particularly common when they are thinking of using irreversible family planning measures, such as voluntary surgical methods. Read more

Group information sharing

Group information sharing is used when individual counselling is not possible, or if there are people in your village who are more comfortable in a group (Figure 3.3). In this situation, after greeting everyone in a friendly manner, you would explain to them the benefits of family planning, discuss briefly common myths and mistaken beliefs about family planning, and then inform the group about how to obtain appropriate contraception.

Objectives of Family Planning

Family planning helps people to attain certain objectives.

For example:

1. To regulate the intervals between pregnancies
2. To control the time at which births occur in relation to the ages of the parents

• To determine the number of children in the family

1. To avoid unwanted births
2. Reduce infant mortality rate.
3. Reduce infant mortality rate.

• Control of communal diseases.

Definition

The World Health Organization definition is this:

“Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through the use of contraceptive methods and the treatment of involuntary infertility.

Description

• Family planning is when both the husband and wife together discuss and mutually decide how many children they would like to have and when so that they can give sufficient love, care, attention and good education to each of their children.
• Family planning is achieved through the use of contraceptive methods and the treatment of infertility (inability to have children).
• Planning when and how many children to have is the couple’s responsibility, not just the man’s or woman’s.
• Family planning is just as important for newly married couples as it is for those who already have one or more children. It enables young people to delay their first child till they are prepared to take up the responsibilities of raising a child.

Benefits of Family Planning

 

Benefits for a mother

• Is able to breastfeed longer (this reduces the risk of breast and ovarian cancer).
• Is at a lower risk of dying from complications during pregnancy and childbirth.
• Gets more time to take care of the baby.
• Gets more time to be physically, emotionally, and financially prepared for her next pregnancy.
• Is at a lesser risk of miscarriage, stillbirth (when a woman gives birth to a dead infant), preterm delivery and low birth weight baby.
• Has more time for herself, her children, husband, and can participate in educational, economic and social activities

Benefits for children

• Are more likely to be born strong and health
• Get more attention and care from their parents.
• Maybe breastfed for a longer period of time, which allows them to reap the benefits of breastfeeding, including:
• Better nutrition
• Protection from childhood diseases
• Attention from the mother

Benefits for the father

• May feel an increased sense of satisfaction from safeguarding the health and well-being of his wife and children.
• Has more time between births, allowing him time to plan finances before the next child.
• Has more time for his wife which will contribute to a better relationship.

Benefits for family and family finance

The needs of every family member are met. Everyone in the family is provided with food, clothing, housing, and education Family planning contributes to financial security because a smaller well-spaced family:

• Helps families spend less money and build up savings over time.
• Makes education for the children more affordable, and better-educated children can then take better care of their parents later in life.
• Reduces maternal and child illnesses, allowing money that would otherwise be used on their treatments to be used for constructive purposes.
• Moreover, if the mother is healthy, she can participate in economic activities

Benefits for the community

“Committing human and financial resources for improving family planning services will not only improve the health and well-being of women and children, but it will also support efforts to achieve a sustainable global population” (WHO).

• Family Planning Improves the Economic Well-Being of Families and Communities
• With fewer children to support, families can accumulate greater assets and invest more

in their children’s health and well-being.

• This results in healthy and more productive individuals leading to healthy and

productive community.

Family planning services

Providing contraception to help women and men plan and space births, prevent unintended pregnancies and reduce the number of abortions.

Offering pregnancy testing and counselling. Helping clients who want to conceive. Providing basic infertility services. Providing preconception health services to improve infant and maternal outcomes and improve women and men health. Providing sexually transmitted disease (STD) screening and treatment services to prevent tubal infertility and improve the health of women, men, and infants.

Carrying out a pregnancy test

The preparation of couples for the arrival of their first child

Teaching home economics and nutrition

Providing adoption services

Family Planning Methods

In your community you have an important role to play, helping people choose a contraceptive method that is personally and medically appropriate for them. To do this effectively, it’s important to understand the various ways and methods by which unwanted or unplanned pregnancy can be prevented. These contraceptive methods are generally classified into natural and artificial (modern) methods. Natural family planning uses changes in the body to identify when a woman is fertile and could become pregnant. This is also known as a fertility-based awareness method.

Natural Family Planning (NFP) Methods

Natural family planning (NFP) is the method that uses the body’s natural physiological changes and symptoms to identify the fertile and infertile phases of the menstrual cycle. Such methods are also known as fertility-based awareness methods.

Types of natural family planning methods

1. Periodic abstinence (fertility awareness) method
2. Use of breastfeeding or lactational amenorrhoea method (LAM)
3. Coitus interruptus (withdrawal or pulling out) method.

Periodic abstinence (fertility awareness) methods

During the menstrual cycle, the female hormones oestrogen and progesterone cause some observable effects and symptoms:

• Oestrogen produces alterations in the cervical mucus, which changes from thick, opaque and sticky to thin, clear and slippery as ovulation approaches.

Progesterone produces a slight rise in basal body temperature (the temperature at rest) after ovulation. Otherwise, the function of progesterone on the cervical mucus is just the opposite effect of oestrogen it makes the cervical mucus thick, opaque and sticky. Observation of these changes provides a basis for periodic abstinence methods.

There are three common techniques used in periodic abstinence methods, namely:

1. Rhythm (calendar) method
2. Basal body temperature (BBT) method
3. Cervical mucus (ovulation) method.

Rhythm (calendar) method

 A regular menstrual cycle is when monthly bleeding happens every month or 28 days.

An irregular menstrual cycle is when monthly bleeding is variable from month to month, for example, it can vary from 25 to 32 days in some women.

This method is the most widely used of the periodic abstinence techniques. A calendar method is a calculation-based approach where previous menstrual cycles are used to predict the first and the last fertile day in future menstrual cycles. This method requires a good understanding of the fertile and infertile phases of the woman’s menstrual cycle. It is based on the regularity of the menstrual cycle and the fact that an ovum (egg) can only be fertilized within 24 hours of ovulation.

Example 1

A woman’s last six menstrual cycles were 28, 26, 29, 27, 29 and 27 days. Using this information, calculate and instruct her about how to use the calendar method to prevent pregnancy.

Answer

Her shortest cycle is 26 days.

Her longest cycle is 29 days.

The first day of her fertile phase is 26 – 18 = 8.

Last day of her fertile phase is 29 – 11 = 18.

Basal body temperature (BBT) method

The basal body temperature method is based on the slight increase in the body temperature of women at rest by about 0.3–0.5°C during and after ovulation, due to the action of an increased level of progesterone secreted by the corpus luteum.

The rise in body temperature sustained for three consecutive days indicates that ovulation has occurred, and it remains at this increased level until the start of the next menstrual cycle.  In this section, you will learn about when the rise in body temperature occurs, and what women need to know in order to use this method properly.

Advantages  

No side-effects for this method.

Encourages discussion about family planning between couples.

Disadvantages

• High failure rate if the couple does not clearly understand the method. Requires several days of abstinence.
• Needs a longer duration to practice, understand and use properly.
• A false interpretation of indications in the case of fever, as this may mislead the result of BBT.
• A special thermometer may be required.

Method of BBT

To use the basal body temperature method effectively, you need to know and teach women how to read a thermometer and record the results on a special chart or graph paper.

Cervical mucus method (CMM)

The cervical mucus method (or Billings method) is based on the recognition and interpretation of changes in cervical mucus and sensations in the vagina, due to the effect of changes in oestrogen levels during the menstrual cycle.

This method is also an ovulation method used by women trying to get pregnant and have a child.

Effectiveness of CMM

The effectiveness of the cervical mucus method is about 97% if women use it correctly.

Advantages of CMM

The advantages of this method are similar to those associated with the use of the basal body temperature method.

 Disadvantages of CMM

CMM has a high failure rate because it needs several days of abstinence and a lot of experience in using the method to be effective. It is also difficult to use this method in the case of vaginal infections, as the cervical mucus secretions may be misleading.

Method of CMM

• You will need to carefully instruct women to be able to:
• Use a chart to record their mucus pattern.
• Look at their cervical mucus in the morning, and every time after using the toilet,
• using a clean cloth or tissue paper to determine the colour and consistency of the mucus. Touch the secretion to determine its stretchmarks and slipperiness.
• Feel how wet the sensation is in their genitalia when they are walking.
• Abstain from sexual intercourse on the day when mucus appears, regardless of its consistency, until the third evening after the ‘peak day’

Lactational amenorrhoea method (LAM)

The lactational amenorrhoea method (LAM) is the use of breastfeeding as a contraceptive method. Lactational means breastfeeding and amenorrhoea means not having monthly bleeding. In this case, there is a delay in ovulation caused by the action of prolactin hormone from the effect of lactation or breastfeeding. An infant’s suckling of the nipple sends neural signals to the mother’s hypothalamus (part of the brain), which influences the anterior pituitary gland to secrete prolactin to stimulate the breast for milk production.

• The woman’s menstrual period must not have returned.
• The baby must be exclusively breastfed frequently, day and night. Exclusive breastfeeding means the infant receives no food or fluids other than breastmilk.
• The baby must be less than six months old. This is because from six months onwards the baby needs to begin receiving complementary foods while continuing to be breastfed. The reduction in the amount of suckling at the breast may affect the hormonal mechanism, resulting in ovulation and menstruation returning, indicating a return of the woman’s fertility.

Coitus interruptus (withdrawal or pulling out) method

Coitus interruptus or withdrawal is a traditional family planning method in which the man withdraws or pulls out his penis from his partner’s vagina and ejaculates outside, keeping his semen away from her genitalia.

Mechanism of action of the withdrawal method

Coitus interruptus prevents fertilisation by stopping contact between spermatozoa in the sperm and the ovum or egg.

Advantages of the withdrawal method

• It is important for you to teach this method as part of natural family planning methods.
• It costs nothing and requires no devices or chemicals.
• It is available in any situation and can be used as a back-up method of contraception.

Disadvantages of the withdrawal method

• It has several disadvantages. Interruption of the excitement of sexual intercourse may result in the incorrect or inconsistent use of this method, as well as decreasing sexual pleasure for both partners.
• A high failure rate may be due to a lack of self-control, and semen containing sperm may leak into the vagina before the person ejaculates.
• There is a further possibility of premature ejaculation by the man. In addition, the couple is not protected from STIs, including HIV.

ADVANCED METHODS

• The pill
• Minipill
• Injections
• Male condom
• Female condom
• Implants
• IUD
• Female sterilization
• Vasectomy
• Breastfeeding method
• Standard Days Method WithdrawaL
• Emergency contraceptive pills

The pill

• Safe
• Effective when a pill is taken every day
• Less monthly bleeding and cramps
• A pill with hormones in it that is taken every day.
• Prevents release of the egg, and blocks sperm from meeting an egg.

Usage

• Take one pill every day.
• When you finish a pack of pills, start a new pack the next day.

If you miss a pill

• Take the missed pill as soon as possible.
• Okay to take 2 pills at the same time.
• If you miss more than 2 days of pills in a row, use condoms for 7 days and keep taking pills. If you miss these pills in week 3, ALSO skip the reminder pills and start a new pack.

Minipill

• Safe
• Good method while breastfeeding
• A pill with a hormone in it that you take every day.
• Blocks sperm from reaching the egg.

If breastfeeding can start 6 weeks after childbirth. Take one pill at the same time every day. When you finish a pack of pills, start a new pack the next day.

 Late taking the pill, for women who are breastfeeding:

Take a pill as soon as you remember, and continue taking pills.

 Late taking the pill, for women who are not breastfeeding:

If you take a pill more than three hours late, use condoms for the next 2 days and keep taking pills.

Injection

• Safe
• Hormone injection is given every 2 months (NET-EN) or 3 months (DMPA)
• Very effective when injections are on time
• Use can be kept private.
• Hormone injection.
• Prevents release of the egg.
• Get an injection every 2 months (NET-EN) or 3 months (DMPA).
• If breastfeeding can start 6 weeks after childbirth.
• Works best if you get your injections on time.

If late for an injection:

• DMPA: Can still get an injection up to 4 weeks late.
• NET-EN: Can still get an injection up to 2 weeks late.
• If later, use condoms and return for injection as soon as possible.

Male condom

• Prevents both pregnancy and sexually transmitted infections including HIV/AIDS.
• Effective when used correctly every time you have sex.
• Easy to get and use.
• A thin rubber covering that fits over the erect penis.
• Is a barrier that keeps sperm out of the vagina.
• Put a new condom onto the erect penis before each sex act.
• Dispose of properly, in rubbish or latrine.
• No side-effects.

Female condom

• Prevents both pregnancy and sexually transmitted infections including HIV/AIDS
• Effective when used correctly every time you have sex
• Plastic covering inserted into the vagina before sex.
• Is a barrier that keeps sperm out of the vagina.
• Insert new female condom into the vagina before every sex act.
• Dispose of properly, in rubbish or latrine.
• No side-effects.

Implants

• Safe to use
• One of the most effective methods
• Lasts for 3 to 5 years
• Can be removed any time if you want to get pregnant
• Small tubes placed under the skin of the inner, upper arm.
• Hormones from the tubes blocks sperm from reaching the egg and prevents the release of the egg.
• Specially trained provider inserts and removes implants.
• Nothing to remember to do after insertion.
• Changes in monthly bleeding including irregular bleeding, spotting, heavier bleeding or no monthly bleeding, are common and safe.

IUD

• Safe to use
• One of the most effective methods and Can be used for up to 12 years.
• Small, flexible, plastic “T” wrapped in copper wire that is placed in the womb.
• Prevents sperm from meeting the egg.
• Specially trained provider inserts and removes IUD.
• Can be put in right after you have a baby as well as at other times.
• Nothing to remember to do after insertion.
• Some cramping and heavier bleeding during monthly bleeding in the first few months of use

Female sterilization

• Safe and permanent method for women or couples who will not want more children.

• One of the most effective methods
• Simple operation Female sterilization
• The specially trained provider makes one or two small cuts to reach the tubes that carry eggs to the womb.
• Cuts or blocks the tubes. The womb is not removed.
• Can be done right after you have a baby as well as other times.
• After procedure, nothing to remember and no side-effects.
• Do not need to be put to sleep during procedure.
• Usually you can go home a few hours after procedure.
• May have soreness for a few days after procedure.
• Monthly bleeding will continue as usual for you.

Vasectomy  

• Safe and permanent method
• for men or couples who will not want more children
• One of the most effective methods
• Simple operation
• Must use back-up method for first 3 months Tubes cut here Vasectomy.
• Specially trained provider makes two small cuts to reach the tubes that carry sperm.
• Cuts tubes. Testicles are not removed.
• Works by keeping sperm out of semen.
• 3-month delay in taking effect.
• Couple must use another method until then.
• After 3 months, nothing to remember.
• Do not need to be put to sleep during the procedure.
• Usually, you can go home a few hours after the procedure.
• May have bruising and soreness for a few days after the procedure.

Standard Days Method: Using a calendar or Cycle Beads

• Helps you know what days during the month you could get pregnant
• To prevent pregnancy, either avoid sex OR use condoms on those days
• Best used by women with regular monthly bleeding.
• Learning which days each month you could get pregnant (fertile days).
• Avoiding sex or use a condom during fertile days.
• Use cycle beads or calendar to count days of the cycle.
• Start with the first day of monthly bleeding.
• Days 8 through 19 of every cycle are ‘fertile days’.
• Avoid unprotected sex during fertile days.
• Partners must avoid sex or use condoms for 12 days in a row, every month.
• No side-effects.

Emergency contraceptive pills

• Prevent pregnancy after unprotected sex
• Work best when taken as soon as possible, up to 5 days after unprotected sex
• Do not cause abortion
• Pills are taken after unprotected sex to prevent pregnancy.
• Prevents or delays the release of the egg.
• Does not cause abortion.
• Can take up to 5 days after unprotected sex.
• Works best when taken as soon as possible after unprotected sex.
• Sometimes cause nausea, vomiting, vaginal spotting or bleeding for a few days

Final Words

In this details guide, we tried our best to guide you each and everything which can be beneficial and harmful in family planning. If you’ve still any confusion you can contact us back. We’ll come back with more interesting and informative content. Keep connected with us. Stay healthy and safe!