INTRODUCTION
Family planning is the planning of when to have children, and the use of birth
control and other techniques to implement such plans. Other techniques commonly used
include sexuality education, prevention and management of sexually transmitted infections,
pre-conception counseling and management, and infertility management.
Family planning is sometimes used as a synonym or euphemism for the use of birth
control, however, it often includes a wide variety of methods, and practices that are not birth
control. It is most usually applied to a female-male couple who wish to limit the number of
children they have and/or to control the timing of pregnancy (also known as spacing
children). Family planning may encompass sterilization, as well as abortion.
Family planning services are defined as "educational, comprehensive medical or
social activities which enable individuals, including minors, to determine freely the number
and spacing of their children and to select the means by which this may be achieved".
Birth control, also known as contraception and fertility control, are methods or
devices used to prevent pregnancy. Planning, provision and use of birth control is called
family planning. Birth control methods have been used since ancient times, but effective and
safe methods only became available in the 20th century. Some cultures limit or discourage
access to birth control because they consider it to be morally, religiously, or politically
undesirable.
The most effective methods of birth control are sterilization by means of vasectomy in
males and tubal ligation in females, intrauterine devices (IUDs) and implantable
contraceptives. This is followed by a number of hormonal contraceptives including oral pills,
patches, vaginal rings, and injections. Less effective methods include barriers such as
condoms, diaphragms and contraceptive sponge and fertility awareness methods. The least
effective methods are spermicides and withdrawal by the male before ejaculation.
Sterilization, while highly effective, is not usually reversible; all other methods are reversible,
most immediately upon stopping them. Safe sex, such as the use of male or female
condoms, can also help prevent sexually transmitted infections. Emergency contraceptives
can prevent pregnancy in the few days after unprotected sex. Some regard sexual
abstinence as birth control, but abstinence-only sex education may increase teen
pregnancies when offered without contraceptive education, due to non-compliance.
In teenagers, pregnancies are at greater risk of poor outcomes. Comprehensive sex
education and access to birth control decreases the rate of unwanted pregnancies in this age
group. While all forms of birth control may be used by young people, long-acting reversible
birth control such as implants, IUDs, or vaginal rings are of particular benefit in reducing
rates of teenage pregnancy. After the delivery of a child, a woman who is not exclusively
breastfeeding may become pregnant again after as few as four to six weeks. Some methods
of birth control can be started immediately following the birth, while others require a delay of
up to six months. In women who are breastfeeding, progestin-only methods are preferred
over combined oral contraceptives. In women who have reached menopause, it is
recommended that birth control be continued for one year after the last period.
About 222 million women who want to avoid pregnancy in developing countries are
not using a modern birth control method. Birth control use in developing countries has
decreased the number of maternal deaths by 40% (about 270,000 deaths prevented in 2008)
and could prevent 70% if the full demand for birth control were met. By lengthening the time
between pregnancies, birth control can improve adult women's delivery outcomes and the
survival of their children. In the developing world women's earnings, assets, weight, and their
children's schooling and health all improve with greater access to birth control. Birth control
increases economic growth because of fewer dependent children, more women participating
in the workforce, and less consumption of scarce resources.
DATA AND DISCUSSION
CONTRACEPTIVE METHODS
1. Natural Contraceptive Method
a ) Rhythm Method
Rhythm Method is a method of avoiding conception by which sexual
intercourse is restricted to the times of a womans menstrual cycle when ovulation
is least likely to occur.
Biological Principle
Prevents the sperms from fertilising the ovum
Procedure
Married couples avoid engaging in copulation during the womans fertile
period, that is, the period when the woman is about to ovulate. It is most likely that
an ovum is present in the Fallopian tube. Instead, they calculate when the woman
is most unlikely to have an ovum in her Fallopian tube (when she has not ovulated,
and is not about to ovulate). This period of time is called the safe period. A
married couple should only have sexual intercourse during the safe period which,
theoretically, will not result in pregnancy.
Advantages
i.
ii.
A woman does not need to take medication or use hormonal manipulation.
No procedures or fittings by a physician are required.
Disadvantages
i. It can be difficult to estimate or know precisely when a woman is fertile,
allowing increased chances for unplanned conception.
ii. Natural methods are not as effective as some forms of contraception.
iii. Ovulation test kits are used by some couples using natural methods of
contraception, and the cost of these kits is another potential disadvantage.
iv. Being unable to have intercourse at certain times of the month is a
disadvantage for some women.
Photo / Sample
2.
Male Contraceptive Methods
a ) Condom
A condom is a sheath-shaped barrier device that may be used during sexual
intercourse to reduce the probability of pregnancy and spreading sexually
transmitted infections (STIs/STDs) such as HIV/AIDS.
Biological Principle
Prevents sperms from entering the vagina during ejaculation.
Protects against sexually transmitted diseases.
Procedure
A thin rubber sheath is rolled onto the erect penis of a male before intercourse
and physically blocks ejaculated semen from entering the body of their sexual
partner
Advantages
i. When used correctly and consistently, condoms are a reliable method of
preventing pregnancy.
ii. Condoms help to protect both partners from sexually transmitted diseases
(STIs), including chlamydia, gonorrhoea and HIV.
iii. You only need to use them when you have sex they do not need advance
preparation and are suitable for unplanned sex.
iv. Chances of obtaining medical side effects from using condoms are slim.
v. Male condoms are easy to get hold of and come in a variety of shapes, sizes
and flavours.
Disadvantages
i. Some couples find that using condoms interrupts sex to get around this, try
to use the condom as a part of foreplay.
ii. Condoms are very strong but may split or tear if nor used properly.
iii. Some people may be allergic to latex, plastic or spermicides you can get
condoms that less likely to cause an allergic reaction, such as a polyurethane
ones.
iv. When using a male condom, the man has to pull out after he has ejaculated
and before the penis goes soft, holding the condom firmly in place.
Photo / Sample
b ) Withdrawal Method
Coitus interruptus, also known as the rejected sexual intercourse, withdrawal
or pull-out method, is a method of birth control in which a man, during intercourse,
withdraws his penis from a woman's vagina prior to orgasm (and ejaculation), and
then directs his ejaculate (semen) away from the vagina in an effort to avoid
insemination.
Biological Principle
Prevents sperms from entering the vagina during ejaculation.
Procedure
The penis is withdrawn from the vagina during copulation before the release of
semen or ejaculation to avoid sperms from entering the vagina.
Advantages
i. No prescription is necessary.
ii. Can be used when no other method is available.
iii. It is free.
iv. No medical or hormonal side effects.
v. Can help partners be more aware of and learn about their sexual
responsiveness.
Disadvantages
i. Does not protect against sexually transmitted diseases (STIs).
ii. Nervousness and sexual interruption may lessen pleasure.
iii. Not recommended for teens and sexually inexperienced men because it takes
a lot of experience before a man can be sure to know when hes going to
ejaculate.
iv. Requires great self-control, experience and trust which some men may lack of
especially during sex.
v. Unreliable because pre-ejaculate (pre-cum) may leak out of the penis before
ejaculation and may contain sperm which can fertilize an egg, causing pregnancy.
Photo / Sample
c ) Vasectomy
Vasectomy is a surgical procedure for male sterilization and/or permanent
contraception. For those who are not a fan of the use of needles when anaesthesia
is applied, they can ask for a no-needle anaesthesia option where anaesthesia
will be applied to the patient without the use of needles. For those who are not a
fan of scalpels and being cut by any sharp tools, a no-scalpel vasectomy is a
good option. A sharp hemostat (as opposed to a scalpel) is used to puncture the
scrotum hence, resulting in a smaller incision or puncture wound which limits
bleeding and hematomas.
Biological Principle
Since sperms are not present in the semen during ejaculation, fertilisation will
not take place.
Procedure
During the procedure, the male sperm ducts (vas deferens) are severed and
then tied/sealed in a manner so as to prevent sperm from entering into the seminal
stream (ejaculate) and thereby, prevent fertilisation.
Advantages
i. A permanent and very effective form of birth control.
ii. Healing process does not take a long time.
iii. Does not interfere with other things, such as testosterone producation, semen
production or erectile tissue function.
iv. Males will not notice a difference while doing intercourse even after the
surgery.
v. Will not affect neither the male nor their sexual partner from feeling pleasure or
reach orgasm during sex.
Disadvantages
i. Inflammation or infection may occur on the incision sites but these can be
treated with medication.
ii. Sperm from the sperm ducts may leak into the surrounding tissue and form a
small lump on the side of the sperm ducts. Can dissolve on its own, with rest and
medication or can be surgically removed.
iii. Male reproductive tract stores sperm in areas other than the testes therefore,
sperm must have time to leave the body after surgery, so alternate forms of birth
control should be used for two to three months after surgery, or until the doctor
confirms sperm count as zero.
iv. If the male does want to impregnate his sexual partner, reverse vasectomy is
difficult and more complicated than the initial procedure.
Photo / Sample
3.
Female Contraceptive Methods
a ) Diaphragm
The diaphragm is a cervical barrier type of birth control. It is a soft latex or
silicone dome with a spring molded into the rim. The spring creates a seal against
the walls of the vagina.
Biological Principle
Stops sperms from entering the uterus.
Very reliable if fitted properly and used with a spermicide.
Procedure
Upon inserting or removing a diaphragm, one should first wash one's hands to
avoid introducing harmful bacteria into the vaginal canal. The rim of a diaphragm is
squeezed into an oval or arc shape for insertion. A water-based lubricant (usually
spermicide) may be applied to the rim of the diaphragm to aid insertion. The
diaphragm must be inserted sometime before sexual intercourse, and remain in
the vagina for 6 to 8 hours after a man's last ejaculation. Upon removal, a
diaphragm should be cleansed with warm mild soapy water before storage. The
diaphragm must be removed for cleaning at least once every 24 hours and can be
re-inserted immediately.
Advantages
i.
ii.
iii.
iv.
v.
The diaphragm is often not felt by either partner during sex.
Fairly easy to be used.
You only use it during sex.
You can use it when you have your period.
Reusable; it can be washed and used again.
Disadvantages
i.
ii.
iii.
iv.
v.
Some women may find it difficult or do not like putting it on.
Some may find it uncomfortable if the size is not right.
May have a higher risk of urinary tract infections.
Does not give the best protection against sexually transmitted diseases (STIs).
Mild allergic reactions to the rubber or spermicide may occur.
Photo / Sample
b ) Female Condom / Femidom
A female condom (also known as a femidom) is a device that is used during
sexual intercourse as a barrier contraceptive to reduce the risk of sexually
transmitted infections (STIssuch as gonorrhea, syphilis, and HIV, though its
protection against them is inferior to that by male condoms) and unintended
pregnancy.
Biological Principle
Prevents the entry of sperms into the vagina.
Prevents sexually transmitted diseases (STIs).
Procedure
Put lubricant on the outside of the closed end. Find a comfortable position.
(Stand with one foot on a chair, sit on the edge of a chair, lie down, or squat.)
Squeeze together the sides of the inner ring at the closed end of the femidom and
insert it into the vagina as done with a tampon. Push the inner ring into the vagina
as far as it can go until it reaches the cervix. Pull out finger and let the outer ring
hang about an inch outside the vagina.
Advantages
i.
ii.
iii.
iv.
v.
Protects from sexually transmitted diseases (STIs).
Can be put in any time before sex.
Can be used with oil-based products.
No side effects.
No additional spermicide is needed.
Disadvantages
i. May interrupt sex as you need to make sure the mans penis stays inside the
female condom.
ii. Can get pushed inside the vagina.
iii. Not as widely available as male condoms.
iv. May split or tear if not used properly.
v. More expensive than male condoms.
Photo / Sample
c ) IntraUterine Device (IUD)
An intrauterine device (IUD or coil) is a small contraceptive device, often 'T'shaped, often containing either copper or levonorgestrel, which is inserted into the
uterus. They are one form of long-acting reversible contraception which are the
most effective types of reversible birth control.
Biological Principle
Irritates the uterine lining, thus preventing the implantation of a zygote in the
endometrium.
Procedure
The small T-shaped device is inserted into the uterus to prevent the
implantation of a zygote.
Advantages
i.
ii.
iii.
iv.
v.
Effective in preventing pregnancy.
Most cost-effective method of birth control over time.
Easy to use
Does not require interruption of foreplay or intercourse.
Does not require cooperation of sexual partner.
Disadvantages
i.
ii.
iii.
iv.
v.
Expensive.
Not able to remove IUD by yourself or your partner.
Does not provide protection against sexually transmitted diseases (STDs).
A genital infection may spread into the uterus.
May cause painful and heavy periods.
Photo / Sample
b ) Spermicide
Spermicide is a contraceptive substance that destroys sperm, inserted
vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide
may be used alone.
Biological Principle
The spermicide kills sperms ejaculated into the vagina.
Not reliable, as some sperms which are not killed will enter the uterus.
Procedure
The spermicide should be inserted deep into the vagina and directly on the
cervix.
Use the correct amount, according to the product directions.
Use another dose for each act of intercourse.
After you have applied or inserted the spermicide, wait the correct amount of
time before having intercourse so that the spermicide can begin to work.
Advantages
i.
ii.
iii.
iv.
v.
No prescription is needed.
No hormones, and nothing needs to be taken daily.
Spermicide may act as a lubricant.
Available in several forms for personal convenience.
Easy to obtain.
Disadvantages
i.
ii.
iii.
iv.
v.
May cause pregnancy if not used correctly.
Some spermicides may leak or be messy.
Some types or brands may irritate the vagina or the penis.
May interrupt intercourse.
Provides no protection against sexually transmitted diseases (STDs).
Photo / Sample
c ) Contraceptive Pills
The combined oral contraceptive pill (COCP), often referred to as the birth
control pill or colloquially as "the pill", is a birth control method that includes a
combination of an estrogen (estradiol) and a progestogen (progestin).
Biological Principle
Prevents ovulation by inhibiting the secretion of FSH and LH so that follicle
development does not occur.
Procedure
Begin the day of or the day after your abortion, delivery or miscarriage or start
the following start of your menstrual cycle.
Never forget to take your pill. If youve forgotten to take it for that day, take it as
soon as you remember it.
Advantages
i.
ii.
iii.
iv.
v.
Does not interrupt sex.
Makes your period regular, lighter and less painful.
Reduces your risk of cancer of the ovaries, womb and colon.
Reduces symptoms of PMS.
Helps to reduce acne.
Disadvantages
i.
ii.
iii.
iv.
May cause temporary side effects when first taken.
Can increase your blood pressure.
Does not protect you against sexually transmitted diseases (STDs).
An increased risk of serious health issues, such as breast cancer.
Photo / Sample
d ) Contraceptive Implants
A contraceptive implant is a type of birth control. It is a small flexible tube
measuring about 40mm in length which is inserted under the skin (typically in the
upper arm) by a health care professional.
Biological Principle
Inhibits ovulation.
Procedure
Small, hormone filled, flexible silicone tubes, capsules or rods which are
inserted under the skin in the upper arm. They slowly release a hormone that is
effective for up to 5 years. The implant must be inserted by a trained health
Professional.
Advantages
i.
ii.
iii.
iv.
v.
A very effective choice of birth control.
Very useful for women who know they dont want to get pregnant for a while.
Can be useful for women who cant use oestrogen-contained contraception.
Useful for women who find it difficult to take a pill at the same time every day.
Implant can be removed at any time and natural fertility will not be disrupted.
Disadvantages
i.
ii.
iii.
iv.
v.
May feel some bruising, tenderness or swelling around the implant.
In the first year, periods may become irregular.
Common side effect of the implant is your periods stop (amennorhoea).
Medication taken may make the implant less effective.
Does not protect against sexually transmitted diseases (STDs).
Photo / Sample
e ) Tubal Ligation
Tubal ligation or tubectomy [also known as having one's "tubes tied" (ligation)]
is a surgical procedure for sterilization in which a woman's Fallopian tubes are
clamped and blocked, or severed and sealed, either method of which prevents eggs
from reaching the uterus for implantation. However, fertilization can still occur in the
Fallopian tubes. Tubal ligation is considered a permanent method of sterilization and
birth control.
Biological Principle
A released ovum cannot reach the part of the Fallopian tube where sperms
are
present.
Thus, the sperms cannot fertilise the ovum.
Procedure
Both the Fallopian tubes are severed and sealed or clamped and blocked,
depending on method preferred.
Advantages
i.
ii.
iii.
iv.
v.
No contraception routine is required.
Does not interfere with intercourse.
No significant long-term side effects.
Permanent protection against pregnancy.
Allows for sexual spontaneity.
Disadvantages
i.
ii.
iii.
iv.
v.
Does not protect against sexually transmitted diseases (STDs).
Has risks associated with surgery.
Requires surgery.
Is very rarely reversible in men and women.
Might be a decision youll regret if you choose to have children at a later date.
Photo / Sample
f ) Depo-Provera Injection
Depot medroxyprogesterone acetate (DMPA) is a long-acting reversible
hormonal contraceptive birth control drug that is injected every three months. It is
a progestin-only contraceptive. It is marketed under the brand name Depo-Provera.
Biological Principle
Causes changes in the uterine lining that interfere with the implantation of a
zygote.
Procedure
A contraceptive injection for women that contains the hormone progestin. It is
given as an injection once every three months.
Advantages
i.
ii.
iii.
iv.
v.
You dont have to remember to take it every day or use it before sex.
It provides long-term protection as long as you get the shot every 3 months.
It does not interfere with intercourse.
Its highly effective.
Less expensive than birth control pills.
Disadvantages
i.
ii.
iii.
iv.
v.
May cause side effects.
Does not provide protection from sexually transmitted diseases (STDs).
May cause irregular menstrual periods.
Stop taking Depo-Provera several months ahead if you plan to get pregnant.
Regular doctor visits may be inconvenient.
Photo / Sample
CONCLUSION
Family planning is the planning of when to have children, and the use of birth
control and other techniques to implement such plans. Other techniques commonly used
include sexuality education, prevention and management of sexually transmitted infections,
pre-conception counseling and management, and infertility management.
Rhythm Method is a method in which two sexual partners avoid engaging in
intercourse during the womans fertile period, that is, the period when the woman is most
likely to have an ovum in her Fallopian tube. Instead, they calculate when the woman is most
unlikely to have an ovum in her Fallopian tube (when she has not ovulated, and is not about
to ovulate).
Male contraceptive methods include the vasectomy, the condom and the withdrawal
method. A vasectomy involves cutting and tying both the sperm ducts (vas deferens) of a
man. Though a minor operation, it is not reversible. Therefore, a man must be sure that he
does not want any more children. He can still release semen (ejaculate) but there is no
presence of sperm in the semen, just liquid.
The condom is a thin rubber sheath fitted over an erect penis before copulation. It
stops sperms from entering the womans body. It also protects against sexually transmitted
diseases. It is most commonly used, and is easy to obtain and use.
The withdrawal method is when the penis is pulled out from the vagina before the
release of semen (ejaculation). This method is not reliably since small quantities of semen
can leak out before ejaculation.
Female contraceptive methods include the diaphragm, the female condom / femidom,
the intrauterine device (IUD), spermicide, contraceptive pills, contraceptive implant, tubal
ligation and Depo-Provera injection.
The diaphragm is a dome-shaped rubber cup with a thick rim inserted into the vagina
to cover the cervix before copulation. Blocks entrance of sperms to the uterus. Must be fitted
with correct size at a family planning clinic. Very reliable if used with a spermicide.
The female condom, also known as the femidom, is a thin polyurethane sheath
fitted inside the vagina. Blocks the entrance of sperms to the uterus and prevents sexually
transmitted diseases (STDs).
An intrauterine device (IUD) is a plastic-coated copper coil which can be left in the
uterus for months. Strings attached to the lower end enable the coil to be removed through
the vagina. Quite reliable. The IUD prevents conception (pregnancy) by interfering with
implantation of the embryo in the uterine wall.
Spermicide is a chemical jelly, cream or foam during an operation. Very unreliable;
should be used together with a diaphragm.
Contraceptive pills contain progestogen (synthetic progesterone) & oestrogen which
shut down the pituitarys production of FSH so that no follicle develops in the ovary. Hence,
ovulation does not occur.
Contraceptive implants are capsules inserted just below the skin (usually, of the
upper arm) that releases progestin (a form of progesterone) over a three to four month
period. It inhibits ovulation. This is good for women who might forget to take the birth control
pill.
Tubal ligation is when the Fallopian tubes are tied and cut during an operation.
Released eggs cannot reach the part of the Fallopian tube where sperms are found. 100%
unreliable and permanent.
Depo-Provera Injection is an injection of synthetic progesterone given every three
months. It causes changes to the lining of the uterus that make implantation of a zygote
difficult.
