Family planning is the informed and voluntary decision that a couple takes to choose their desired family size and the timing of child bearing, using family planning methods (contraceptives).

Family planning enables couples to have the number of children they desire when they wish to have them, and allows couples to enjoy their sexual life without fear of unwanted pregnancies.

Recent research shows that ideal minimal birth interval (the time between birth date of one child and that of the subsequent child) should be from three to five years. Such an interval leads to a decrease in infant and child mortality and improves the nutritional status of mothers; especially in the developing countries.

Family planning has several benefits to both mother, child, and the family in general:

1. Decreases infant and child mortality rates and maternal mortality rates
2. Allows mothers to be physically better prepared for the next pregnancy
3. Enables parents to give more attention and care to the new child
4. Improves the emotional relationship between family membersFulfills the need of many mothers who want to delay their next pregnancy or those who want to stop conceiving
5. Reduces the number of unplanned or unwanted pregnancies
6. In general, contributes to maintaining a better quality of life

Demographic Health Studies data from many countries shows that women desire considerably longer birth intervals than they achieve. Using of family planning methods will help women and families meet their needs.

Family Planning Methods

Lactation Amenorrhea Method (LAM)

Condoms

Intra Uterine Devices (IUDs)

Oral Contraceptive Pills

Injectable Contraceptives

Implants

The Contraceptive Patch

Sterilization

Natural family planning methods

Lactation Amenorrhea Method (LAM)

Condoms  

Condoms are modern family planning methods; there are two types. Male condoms are thin sheets of rubber usually made of latex designed to cover the penis; female condoms are thin sheets of polyurethane plastic designed to form a pouch that lines and protects the vagina. Both can protect from Sexual Transmitted Infections (STIs) including HIV/AIDS. Condoms can be a good method for couples who don't have regular sex; one condom should be used for each sexual act. With perfect use male condoms are 97% effective and female condoms are 95% effective; with typical use the rate is 84-94% for male condoms and 79% for female condoms. To compare effectiveness with other methods click here.

Intra Uterine Devices (IUDs)

IUDs are small plastic devices inserted into the woman’s uterus to prevent pregnancy. There are several types of IUDs, such as the copper-bearing IUD (CuT 380A) which is the most commonly used and is effective for 10 years, Multiload and Nova T are effective for 5 years. Hormone-releasing IUDs contain the hormone progesterone (Progestasert®) or another progestin such as levonorgestrel (LNG-20) such as LevoNova®. These are effective 1 year and 5 years respectively. 

Inert IUDs are un-medicated and made of plastic or stainless steel. The IUD should be inserted by a trained service provider after a pelvic examination. IUDs are a highly effective method suitable for couples that want to postpone or prevent pregnancy. IUD effectiveness rate is 99%.  

Oral Contraceptive Pills

Oral contraceptive pills are modern family planning methods taken on a daily basis to prevent pregnancy. In general there are two types of pills: progestin only pills (POPs) contain one type of hormone, progesterone, and combined oral contraceptives (COCs) contains two hormones, progesterone and estrogen. Contraceptive pills are safe, easy to use methods, and they allow women to control their use, and fertility returns as soon as stopping them. However, before starting pills, women should seek medical advice before starting to use pills to assure they are an adequate method for her situation, especially if she is on medication or has certain health conditions. With perfect use POPs and COCs effectiveness rate is 99%, while with typical use its 95%.

Injectable Contraceptives

Injectable contraceptives are shots taken once a month or every three months to prevent pregnancy. There are two types of injectables: progestin-only injectables which contain the hormone progestin, and combined injectables that contain two types of hormones, progestin and estrogen. Injectables are safe, highly effective, and easy to use as they continue acting for a longer period of time. A woman can control whether she takes the method, however, any user should seek medical advice before using, especially if she is on medication or has certain health problems. Injectable contraceptives’ effectiveness rate is 99.6%.

Implants

Implants effectiveness rate is 99.9%.

Implants are contraceptive systems that are inserted under the skin of a woman’s upper arm to prevent pregnancy. They are safe, highly effective and easy to use, very convenient to women who need or prefer a long acting contraceptive with little follow-up. There are three types of implants: 

• Norplant: 6 round capsules the size of small matchsticks containing levonorgestrel; they prevent pregnancy for 5 years.

• Jadelle®: 2 rods containing levonorgestrel; they prevent pregnancy for 5 years.

• Implanon®: One small plastic rod containing etonogestrel; they prevent pregnancy for 3 years.

The Contraceptive Patch

The contraceptive patch is a small adhesive patch that contains two hormones: progesterone and estrogen; both hormones are continuously released from the patch and absorbed by the body. The patch prevents pregnancy for one week. It is safe, easy to use and effective.  Patch effectiveness rate is 99%.

Sterilization

Sterilization is a surgical method of family planning that can be used by men and women. Female sterilization is known also as tubal ligation, while male sterilization is known as vasectomy. Both are considered permanent methods and only suitable for couples who do not wish to have additional children for any reason. Sterilization is a highly effective surgical procedure.. Female sterilization provides an immediate effect, whereas male sterilization takes a period of 3 months or 20 ejaculations (which ever comes first). The effectiveness rate for female sterilization is 99.5% and 95% for male sterilization.

Natural Family Planning Methods

As the name indicates, these are family planning methods that do not depend on any artificial materials. They depend on controlling the act of sexual intercourse itself, either by withdrawal (when a man takes his penis out of the woman’s vagina just before ejaculation, inhibiting fluid from entering the vagina), or through fertility awareness methods. Fertility awareness methods include the calendar method and the standard days method (SDM), which require that a woman and/or her partner know the woman’s fertile period and abstain from sex or use another contraceptive during this time, such as condoms. In general, natural family planning methods are less effective than modern methods, and require commitment from couple in controlling their sexual activity. With perfect use withdrawal effectiveness rate is 96%, calendar method is 91% and SDM is 95%; with typical use effectiveness is 81% for withdrawal, 87% for calendar method, and 88% for SDM. To compare effectiveness with other methods click here.

References

1. Averting HIV and AIDS
2. Baby no Baby Images
3. The Comprehensive Reproductive Health/Family Planning Training Curriculum, EngenderHealth, 2004 (All methods)
4. Contraception Online
5. EngenderHealth
6. The Essentials of Contraceptives Technology, A Handbook for Clinic Staff, Johns Hopkins Information Program, 2001 (All methods)
7. Family Health International
8. Feminist Women's Health Center

9. Mac Graw Hill Higher Education:

10. Female Sterilization

11. Managing Contraception

12. The Population Council

    1. Implant

    2. Norplant

    3. Jadele Info

13. Netdoctor.co.uk

14. PATH & UNFPA, Female condom a powerful tool for protection: effectiveness rate for female condom (condom)