Family Planning

Family PlanningRosebella Butoy, R.M.Lucita Root, R.M.Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesFamily Planningallows people to attain their desired number of children and determine the spacing of pregnancies (World Health Organization)

Family Planningthrough use of contraceptive methods and the treatment of infertility

Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesFamily Planning: Key FactsAn estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception.

Family Planning: Key FactsSome family planning methods help prevent the transmission of HIV and other sexually transmitted infections.

Family Planning: Key FactsFamily planning reduces the need for unsafe abortion.

Family Planning: Key FactsFamily planning reinforces peoples rights to determine the number and spacing of their children.

Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesPhilippine Family Planning ProgramA national mandated priority public health program to attain the country's national health developmenta health intervention program

Philippine Family Planning Programan important tool for the improvement of the health and welfare of mothers, children and other members of the family.

Philippine Family Planning ProgramIt also provides information and services for the couples of reproductive age to plan their family according to their beliefs and circumstances through legally and medically acceptable family planning methods.

Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesFamily Planning: Basic PrinciplesResponsible Parenthood Respect for LifeBirth Spacing Informed ChoiceResponsible ParenthoodEach family has the right and duty to determine the desired number of children they might have and when they might have them

Responsible ParenthoodBeyond responsible parenthood is Responsible Parenting Responsible Parenting is the proper upbringing and education of children so that they grow up to be upright, productive and civic-minded citizens

Respect for LifeThe 1987 Constitution states that the government protects the sanctity of life. Abortion is NOT a FP method.

Birth Spacinginterval between pregnancies (which is ideally 3 years)Birth SpacingIt enables women to recover their health

Birth Spacingimproves women's potential to be more productive and to realize their personal aspirationsallows more time to care for children and spouse/husband

Informed ChoiceUpholding and ensuring the rights of couples to determine the number and spacing of their children according to their life's aspirations

Informed ChoiceReminding couples that planning size of their families have a direct bearing on the quality of their children's and their own lives

Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesFamily Planning: BenefitsPreventing pregnancy-related health risks in womenReducing infant mortalityHelping to prevent HIV/AIDS

Family Planning: BenefitsEmpowering people and enhancing educationReducing adolescent pregnanciesSlowing population growthPreventing pregnancy-related health risks in womenToo Young (below 18 years of age)Too Old (35 years old and above)

Preventing pregnancy-related health risks in womenToo Many (have 4 or more pregnancies)Too Close (birth interval of less than 3 years)Too Ill (having chronic diseases or disorders)

Preventing pregnancy-related health risks in womenBy reducing rates of unintended pregnancies, family planning also reduces the need for unsafe abortion.

Reducing infant mortalityRecent studies indicate that the lowest risks for fetal death, pre-term delivery, small for gestational age, neonatal death, and low birth weight occur when births are spaced from 3 to 5 years. (Demographic and Health Surveys, 2002)

Helping to prevent HIV/AIDSFamily planning reduces the risk of unintended pregnancies among women living with HIV, resulting in fewer infected babies and orphans.

Helping to prevent HIV/AIDSMale and female condoms provide dual protection against unintended pregnancies and against STIs including HIV.

Empowering people and enhancing educationFamily planning enables people to make informed choices about their sexual and reproductive health.

Empowering people and enhancing educationHaving 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 pregnanciesPregnant adolescents are more likely to have preterm or low birth-weight babies. Reducing adolescent pregnanciesBabies born to adolescents have higher rates of neonatal mortality. Many adolescent girls who become pregnant have to leave school.

Slowing population growthFamily planning is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts.

Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesFamily Planning: TypesNatural MethodsArtificial Methods - Hormonal contraceptive Methods - Barrier MethodsLong acting and Permanent Methods

Natural MethodsFertility Awareness-Based (FAB) MethodsLactational Amenorrhea Method (LAM)

Fertility Awareness-Based Methodfamily planning methods that focus on the awareness of the beginning and end of the fertile time of a womans menstrual cycle.

Fertility Awareness-Based MethodThese methods involve: Determination of the fertile and infertile periods of a woman within the menstrual cycle.Observation of the signs and symptoms of infertility and fertility during the menstrual cycle.Fertility Awareness-Based MethodsIncludes:Billings Ovulation Method (BOM)Basal Body Temperature (BBT)Symptothermal Method (STM)Standard Days Method (SDM)Billings Ovulation Methodbased on the daily observation of what a woman sees and feels at the vaginal area throughout the day.

Billings Ovulation MethodCervical mucus changes indicate whether days are fertile or infertile and can be used to avoid or achieve pregnancy. With perfect (correct) use, this method is 97% effective. Basal Body Temperaturebased on a womans resting body temperature (i.e. body temperature after 3 hours of continuous sleep) which is lower before ovulation until it rises to a higher level beginning around the time of ovulation.

Basal Body TemperatureHer infertile days begin from the fourth day of the high temperature reading to the last day of the cycle. All days from the start of the menstrual cycle up to the third high temperature reading are considered fertile days. With perfect use, this method is 99% Symptothermal MethodBased on combined technology of the Basal Body Temperature and the Billings Ovulation Method.98% effective if correctly used.

Standard Days MethodBased on a calculated fertile and infertile period for menstrual cycle lengths that are 26 to 32 days.

Standard Days MethodCouples on this methods use a device, the color-coded cycle beads: to mark the fertile and infertile days of the menstrual cycle.Fertility Awareness Methods: AdvantagesEffective when use correctly and consistently.No physical side effects.No prescription required.Inexpensive.Fertility Awareness Methods: AdvantagesNo follow-up medical appointments required.Better understanding of the couple about their sexual physiology and reproductive functions.Encourage shared responsibility for family planning.Foster better communication between partners.

Fertility Awareness Methods: DisadvantagesMay inhibit sexual spontaneity.Except SDM, need extensive training.Require consistent and accurate record keeping and close attention to body changes.Fertility Awareness Methods: DisadvantagesFor BBT and STM require rigid adherence to daily routine of awakening at a fixed time.For SDM can be used only by women whose cycles are within 26-32 days.Offer no protection against STI, HIV and AIDS.

Lactational Amenorrhea MethodRelies on the condition of infertility that results from specific breastfeeding patterns. Use of breastfeeding as a temporary family planning method.Lactational Amenorrhea MethodLactational means related to breastfeedingAmenorrhea means not having menstrual bleeding99.5% effective

Lactational Amenorrhea Method: AdvantagesCan be started immediately after delivery.Economical and easily available.Does not require a prescription.No action is required at the time of intercourse.Lactational Amenorrhea Method: AdvantagesNo side effects or precautions to its use.No commodities or supplies are required.Fosters mother-child bonding.Serves as a bridge to using other methods.Consistent with religious and cultural practices.Lactational Amenorrhea Method: DisadvantagesFully and nearly fully breastfeeding pattern may be difficult for some women to maintain.Duration of the effectiveness limited to a brief 6-month postpartum period.No protection against STI, HIV and AIDS.

Hormonal Contraceptive MethodsOral contraceptives (combined and progestin-only)Progestin-only injectables

Oral ContraceptivesLow-dose combined estrogen-progestinProgestin only pillsLow-dose combined estrogen-progestinLow dose combined oral contraceptivesOn of the most popular reversible contraceptive combination developed to date.

Low-dose combined estrogen-progestinWomen worldwide in both developed and developing countries use it safely.Otherwise known as pills.Taken daily to prevent conception.99.7% effective if perfectly use.Low-dose combined estrogen-progestin: AdvantagesSafeReversibleConvenient, easy to useNo need to do anything at the time of sexual intercourseLow-dose combined estrogen-progestin: DisadvantagesRequires regular and dependable supplyClient-dependent inconsistent and not correct usage of taking pillsOffers no protection against STI,HIV and AIDSLow-dose combined estrogen-progestin: DisadvantagesNot most appropriate choice for lactating women.Effectiveness may be lowered when taken with certain drugs such as rifampicin and most anti-convulsantsProgestin only pills (POPs)Contain small amount of progestin only.Highly recommended oral contraceptive for breastfeeding women because its does not interfere with milk production.99.5% effective when perfectly use

Progestin only pills (POPs): AdvantagesCan be used by nursing mothers starting 6 weeks after childbirth.Quantity and quality of breast milk is not affected.No estrogen side effects.

Progestin only pills (POPs): AdvantagesWomen take one pill every day with no break. easier to understandCan be very effective during breastfeeding.Progestin only pills (POPs): AdvantagesEven less risk of progestin-related side effects acne, weight gainMay help prevent of having Benign disease, endometrial and ovarian cancer, and pelvic inflammatory disease.

Progestin only pills (POPs): DisadvantagesWomen who are not breastfeeding experience changes in menstrual bleeding.Less common side effects.Progestin only pills (POPs): DisadvantagesMust be taken at about the same time each day to be effective.Offers no protection against STI, HIV and AIDS.Effectiveness may be lowered when certain drugs for epilepsy (phenytoin and barbiturates) or tuberculosis (rifampicin) are taken.

Progestin-only injectable contraceptivesProgestin only preparation given intramuscularly.A three-month injectable contraceptive.Highly effective contraceptive method.99.7% effective if perfectly used.

Progestin-only injectable contraceptives: AdvantagesReversibleNo need for daily intakeDoes not interfere with sexual intercourseProgestin-only injectable contraceptives: AdvantagesPerceived as culturally acceptable by some womenPrivateHas no estrogen-related side effectsDoes not affect breastfeeding

Progestin-only injectable contraceptives: DisadvantagesReturn to fertility is delayed average is about 10 months from the last injectionRequires an injection every 2 to 3 monthsDoes not protect against STI, HIV and AIDSProgestin-only injectable contraceptives: DisadvantagesMenstrual irregularity during first few monthsAmenorrheaNot possible to discontinue immediately (until DMPA is cleared from the womans body)

Barrier MethodsMale condom

Male condomOnly FP method included in the Philippine Family Program that prevents both pregnancy and sexually-transmitted infections (STIs).

Male CondomA sheath made of thin, latex rubber made to fit over a mans erect penis.98% effective if perfectly used.

Male condom: AdvantagesProtects against STI, HIV and AIDSEasy to useUsually easy to obtainUsually inexpensiveMale condom: AdvantagesSafe, effective and portableHelps protect against cervical cancerAllows men to share more responsibility for family planningConvenient for short-term contraceptionMale condom: DisadvantagesSome men complain of decreased sensitivityInterrupts the sexual actSlipping off, tearing, spillage of sperm can occurMale condom: DisadvantagesAllery to latex (rare)Deteriorates quickly when storage conditions are poor.Causes some men difficulty in maintaining erection.

Long Acting and Permanent MethodsIntrauterine Device (IUD)ImplantsFemale sterilizationVasectomy

Intrauterine DeviceEffective for at least 12 yearsCopper ions decrease sperm motility and function

Intrauterine device: AdvantagesHighly effectiveVery safeReversible and economicalMay be safely used by lactating and immediate postpartum womenIntrauterine device: AdvantagesLong duration of useOnce inserted they are convenient and extremely easy to use.Allows privacy and control over her fertility.Does not interact with medicationsNo systemic side effectsIntrauterine device: DisadvantagesRequires pa pelvic exam to insert the IUD.Does not protect against STIsDevice may be expelledFemale SterilizationKnown as Bilateral Tubal Ligation (BTL)Safe and simple surgical procedure to tie and cut the 2 fallopian tubes located on both sides of the uterus.99.5% effective

Bilateral Tubal Ligation: AdvantagesVery effectivePermanentNothing to rememberNo supplies needed

Bilateral Tubal Ligation: AdvantagesNo interference with sexIncrease sexual enjoymentNo hormonal side effectsNo effect on breast milk

Bilateral Tubal Ligation: DisadvantagesRequires minor surgeryIrreversibleBilateral Tubal Ligation: DisadvantagesGreater risk for ectopic pregnancy if pregnancy happens (very rare)Does not protect against STIs, HIV/AIDSMale SterilizationAlso known as VasectomyProvides permanent contraceptionSafe, simple and quick surgical procedure

Male SterilizationInvolves tying and cutting a segment of the 2 vas which carries sperm99.9% very effective

Vasectomy: AdvantagesVery effectivePermanentNothing to remember

Vasectomy: AdvantagesNo interference with sexIncrease sexual enjoymentNo supplies neededNo known long-term side effects

Vasectomy: DisadvantagesRequire minor surgery by a specially trained health care providedIrreversible

Vasectomy: DisadvantagesNot immediately effective. at least 3 months after the procedureDoes not protect against STI, HIV/AIDS

Family Planning: Topics to discussFamily PlanningKey FactsPhilippine Family Planning ProgramBasic PrinciplesBenefitsTypesThank You for Listening!