Professional Documents
Culture Documents
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 use of contraceptive
methods and the treatment of involuntary infertility. A womans ability to space and limit her
pregnancies has a direct impact on her health and well-being as well as on the outcome of each
pregnancy.
Key facts
An estimated 225 million women in developing countries would like to delay or stop
childbearing but are not using any method of contraception.
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 peoples rights to determine the number and spacing of their
children.
Family planning allows people to attain their desired number of children and determine the
spacing of pregnancies. It is achieved through use of contraceptive methods and the treatment of
infertility (this fact sheet focuses on contraception).
Benefits of family planning / contraception
Promotion of family planning and ensuring access to preferred contraceptive methods for
women and couples is essential to securing the well-being and autonomy of women, while
supporting the health and development of communities.
Preventing pregnancy-related health risks in women
A womans ability to choose if and when to become pregnant has a direct impact on her health
and well-being. Family planning allows spacing of pregnancies and can delay pregnancies in
young women at increased risk of health problems and death from early childbearing. It prevents
unintended pregnancies, including those of older women who face increased risks related to
pregnancy. Family planning enables women who wish to limit the size of their families to do so.
Evidence suggests that women who have more than 4 children are at increased risk of maternal
mortality.
By reducing rates of unintended pregnancies, family planning also reduces the need for unsafe
abortion.
Reducing infant mortality
Family planning can prevent closely spaced and ill-timed pregnancies and births, which
contribute to some of the worlds highest infant mortality rates. Infants of mothers who die as a
result of giving birth also have a greater risk of death and poor health.
Helping to prevent HIV/AIDS
Family planning reduces the risk of unintended pregnancies among women living with HIV,
resulting in fewer infected babies and orphans. In addition, male and female condoms provide
dual protection against unintended pregnancies and against STIs including HIV.
Empowering people and enhancing education
Family planning enables people to make informed choices about their sexual and reproductive
health. Family planning represents an opportunity for women to pursue additional education and
participate in public life, including paid employment in non-family organizations. Additionally,
having smaller families allows parents to invest more in each child. Children with fewer siblings
tend to stay in school longer than those with many siblings.
Reducing adolescent pregnancies
Pregnant adolescents are more likely to have preterm or low birth-weight babies. Babies born to
adolescents have higher rates of neonatal mortality. Many adolescent girls who become pregnant
have to leave school. This has long-term implications for them as individuals, their families and
communities.
Slowing population growth
Family planning is key to slowing unsustainable population growth and the resulting negative
impacts on the economy, environment, and national and regional development efforts.
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.
Contraceptive use
Contraceptive use has increased in many parts of the world, especially in Asia and Latin
America, but continues to be low in sub-Saharan Africa. Globally, use of modern contraception
has risen slightly, from 54% in 1990 to 57.4% in 2014. Regionally, the proportion of women
aged 1549 reporting use of a modern contraceptive method has risen minimally or plateaued
between 2008 and 2014. In Africa it went from 23.6% to 27.6%, in Asia it has risen slightly from
60.9% to 61.6%, and in Latin America and the Caribbean it rose slightly from 66.7% to 67.0%.
Use of contraception by men makes up a relatively small subset of the above prevalence rates.
The modern contraceptive methods for men are limited to male condoms and sterilization
(vasectomy).
Global unmet need for contraception
An estimated 225 million women in developing countries would like to delay or stop
childbearing but are not using any method of contraception. Reasons for this include:
gender-based barriers.
The unmet need for contraception remains too high. This inequity is fuelled by both a growing
population, and a shortage of family planning services. In Africa, 23.2% of women of
reproductive age have an unmet need for modern contraception. In Asia, and Latin America and
the Caribbean regions with relatively high contraceptive prevalence the levels of unmet need
are 10.9 % and 10.4%, respectively (World Contraceptive Reports 2013, UNDESA).
Contraceptive methods
Modern methods
Method
Description
How it works
Effectiveness to
prevent
Comments
pregnancy
Combined
Contains two
Prevents the
>99% with
Reduces risk of
Method
Description
oral
hormones
contraceptive
(estrogen and
s (COCs) or
progestogen)
the pill
How it works
Effectiveness to
prevent
Comments
pregnancy
correct and
release of
consistent use
eggs from the
ovaries
92% as
(ovulation)
commonly used
99% with correct
and consistent
use
Progestogenonly pills
(POPs) or "the
minipill"
Contains only
progestogen
hormone, not
estrogen
Thickens
cervical
mucous to
block sperm
and egg from
meeting and 9097% as
commonly used
prevents
ovulation
Implants
Small, flexible
rods or capsules
placed under
the skin of the
upper arm;
contains
progestogen
hormone only
Thickens
cervical
mucous to
block sperm
>99%
and egg from
meeting and
prevents
ovulation
Progestogen
only
injectables
Thickens
cervical
Injected into the
mucous to
muscle every 2
block sperm
or 3 months,
and egg from
depending on
meeting and
product
prevents
ovulation
Monthly
injectables or
combined
injectable
contraceptive
Injected
Prevents the >99% with
monthly into the release of
correct and
muscle,
eggs from the consistent use
contains
ovaries
estrogen and
>99% with
correct and
consistent use
97% as
commonly used
endometrial and
ovarian cancer
Health-care
provider must
insert and remove;
can be used for 3
5 years depending
on implant;
irregular vaginal
bleeding common
but not harmful
Delayed return to
fertility (about 14
months on the
average) after
use; irregular
vaginal bleeding
common, but not
harmful
Irregular vaginal
bleeding common,
but not harmful
Method
s (CIC)
Description
progestogen
How it works
(ovulation)
Effectiveness to
prevent
Comments
pregnancy
97% as
commonly used
Small flexible
Copper
plastic device
component
Intrauterine
containing
damages
device (IUD):
copper sleeves sperm and
>99%
copper
or wire that is
prevents it
containing
inserted into the from meeting
uterus
the egg
Longer and
heavier periods
during first
months of use are
common but not
harmful; can also
be used as
emergency
contraception
A T-shaped
plastic device
Suppresses
inserted into the
the growth of
Intrauterine
uterus that
the lining of
device (IUD) steadily releases
>99%
uterus
levonorgestrel small amounts
(endometrium
of
)
levonorgestrel
each day
Decreases amount
of blood lost with
menstruation over
time; Reduces
menstrual cramps
and symptoms of
endometriosis;
amenorrhea (no
menstrual
bleeding) in a
group of users
Forms a
Method
Female
condoms
Description
How it works
Effectiveness to
prevent
Comments
pregnancy
and consistent
barrier to
coverings that
prevent sperm use
fit over a man's
and egg from 85% as
erect penis
meeting
commonly used
against sexually
transmitted
infections,
including HIV
Sheaths, or
90% with correct
linings, that fit
and consistent
Forms a
loosely inside a
use
barrier to
woman's
prevent sperm
vagina, made of
and egg from 79% as
thin,
meeting
commonly used
transparent, soft
plastic film
Also protects
against sexually
transmitted
infections,
including HIV
>99% after 3
months semen
evaluation
Male
sterilization
(vasectomy)
Permanent
contraception to
block or cut the
vas deferens
tubes that carry
sperm from the
testicles
Keeps sperm
out of
ejaculated
semen
3 months delay in
taking effect while
stored sperm is
still present; does
not affect male
9798% with no sexual
performance;
semen
voluntary and
evaluation
informed choice is
essential
Female
sterilization
(tubal
ligation)
Permanent
contraception to
block or cut the
fallopian tubes
Eggs are
blocked from
meeting
sperm
>99%
Voluntary and
informed choice is
essential
Lactational
Temporary
Prevents the
Method
Description
How it works
contraception
for new mothers
whose monthly
bleeding has not
returned;
release of
amenorrhea requires
eggs from the
method (LAM) exclusive or full ovaries
breastfeeding
(ovulation)
day and night of
an infant less
than 6 months
old
ProgestogenEmergency
only pills taken
contraception to prevent
Prevents
(levonorgestr pregnancy up to ovulation
el 1.5 mg)
5 days after
unprotected sex
Women track
their fertile
periods (usually
Standard
days 8 to 19 of
Days Method
each 26 to 32
or SDM
day cycle) using
cycle beads or
other aids
Effectiveness to
prevent
Comments
pregnancy
and consistent
use
98% as
commonly used
95% with
Prevents
pregnancy by consistent and
correct use.
avoiding
unprotected
vaginal sex
during most
fertile days.
88% with
common use
(Arevalo et al
2002)
family planning
method based on
the natural effect
of breastfeeding
on fertility
Can be used to
identify fertile
days by both
women who want
to become
pregnant and
women who want
to avoid
pregnancy.
Correct, consistent
use requires
partner
cooperation.
Method
Description
Woman takes
her body
temperature at
the same time
Basal Body
each morning
Temperature before getting
(BBT) Method out of bed
observing for an
increase of 0.2
to 0.5 degrees
C.
TwoDay
Method
Symptothermal
Method
Women track
their fertile
periods by
observing
presence of
cervical mucus
(if any type
color or
consistency)
Women track
their fertile
periods by
observing
changes in the
cervical mucus
(clear texture) ,
body
temperature
(slight increase)
and consistency
of the cervix
How it works
Effectiveness to
prevent
Comments
pregnancy
99% effective
If the BBT has
with correct and risen and has
Prevents
consistent use. stayed higher for
pregnancy by
3 full days,
75%
with
typical
avoiding
ovulation has
unprotected use of FABM
occurred and the
(Trussell,
2009)
vaginal sex
fertile period has
during fertile
passed. Sex can
days
resume on the 4th
day until her next
monthly bleeding.
96% with correct Difficult to use if a
and consistent
woman has a
use.
vaginal infection
Prevents
or another
pregnancy by
condition that
avoiding
changes cervical
unprotected
mucus.
86%
with
typical
vaginal sex
Unprotected coitus
during most or common use. may be resumed
(Arevalo, 2004) after 2
fertile days,
consecutive dry
days (or without
secretions)
Prevents
pregnancy by
avoiding
unprotected
vaginal sex
during most
fertile
Method
Description
How it works
Effectiveness to
prevent
Comments
pregnancy
(softening).
Traditional methods
Traditional
Methods
Women monitor
their pattern of
menstrual cycle
over 6 months,
Calendar subtracts 18 from
method or shortest cycle
rhythm
length (estimated
method
1st fertile day) and
subtracts 11 from
longest cycle length
(estimated last
fertile day)
91% with
The couple
correct
prevents
May need to delay or
and
pregnancy by
use with caution when
consistent
avoiding
using drugs (such as
use.
unprotected
anxiolytics,
vaginal sex during
antidepressants,
the 1st and last
NSAIDS, or certain
75%
with
estimated fertile
antibiotics) which may
common affect timing of
days, by
use
abstaining or
ovulation.
using a condom.
Tries to keep
sperm out of the
woman's body,
preventing
fertilization
Traditional
Methods
away from her
external genitalia
commonly
used
(Trussell,
2009)
ejaculating while
inside the vagina.
WHO response
male: 88.6%
female: 79.7%
note: almost three-quarters of the world's 775 million illiterate adults are found
in only ten countries (in descending order: India, China, Pakistan, Bangladesh,
Nigeria, Ethiopia, Egypt, Brazil, Indonesia, and the Democratic Republic of
the Congo); of all the illiterate adults in the world, two-thirds are women;
extremely low literacy rates are concentrated in South and West Asia and SubSaharan Africa (2010 est.)
Fp programs:
Family planning programs are a key component to comprehensive sexual and reproductive
health. They provide essential and often life-saving services to women and their families. By
enabling women to delay pregnancy, avoid childbearing, or space births, effective family
planning programs are not only fundamental to womens health, they also allow women and
families to better manage household and natural resources, secure education for all family
members, and address each family members healthcare needs. The best programs have also been
found to increase equity between women and their partners and enhance communication and
negotiation skills within couples.
Yet recent data shows that an estimated 225 million women globally have an unmet need for
family planning: in other words, they do not wish to have a child at this time, yet are not using
effective contraception. This lack of access to family planning methods is a major contributor to
the preventable deaths of 290,000 women annually due to pregnancy related causes.
Better accuracy
In the 1930s, researchers discovered that the fertile time occurs for
a few days during the middle of the cycle, and calculations were
developed to identify the fertile time. Since the 1970s, other
"minor" fertility sign indicators have been described ( changes in
the position of the cervix, for example.
New developments
The more options that are available to a couple, the more likely it
is that they will find a method that suits them. If fertility
awareness approaches were more openly discussed in family planning
clinics, couples may be more comfortable about discussing how they
are actually using their methods. Providers would then be in a better
position to counsel couples in how to use their method more
effectively.