Family Planning

This page has information related to family planning methods.

Be sure to ask:

  1. Whether the caller is using any birth control or method of family planning? If so, what kind?
  2. If the caller is experiencing any any problems or complications related to taking birth control? (For example: development of a blood clot (thrombosis) when using the oral birth control pill? If so  refer to a health center

Problems and when to go to the health center (when using birth control):

  • Jaundice or yellowing of the skin
  • Severe lower abdominal pain
  • Severe, unexplained vaginal bleeding
  • Severe headaches or vision changes (migraine aura or blurry vision)
  • High blood pressure
  • Chest pain or difficulty breathing and heart palpitations
  • Swollen, warm and red area in the lower legs (may be a sign of a blood clot)

Conditions Requiring special assessment before initiating FP methods

  • High blood pressure
  • Smokes and is older than 35 years of age
  • Gets severe headaches regularly
  • Takes medication for TB, HIV or seizures (fits)
  • Has a serious heart condition
  • Has had a stroke, or blood clot in the legs or lungs
  • Has history of breast cancer
  • Has a serious liver condition or jaundice (yellowing of the skin or eyes)

** Family Planning Methods**

Type Hormonal Methods: Oral contraceptive pill, IUD, implants, injections Barrier Methods: Condoms (both male and female condoms) Natural Family Planning Methods: The breastfeeding method (LAM -lactational amenorrheic method)
How it works Prevents ovulation (the release of an egg from the ovary) May cause missed periods or a total absence of periods which is normal and is NOT a sign of fertility problems Provides a barrier that prevents sperm from entering the vagina and fertilizing an egg Breastfeeding exclusively and often (both day and night) for the first 6 months after birth will prevent menstruation and the release of an egg into the uterus. Is effective if the menses have not yet returned after delivery
How effective it is If used perfectly: 99% effective If used typically: 94% effective Used typically: 82% effective If done perfectly (for first 6 months, breastfeeding exclusively AND no menses): 97-98% effective
How to use Pill or mini-pill: take a pill every day (at the same time), if you miss a pill take the missed one as soon as possible. If you miss more than 2 days in a row, use condoms for 7 days and keep taking the pills to ensure they are effective. Injections: Go to health facility for infection every 2 months (for NET-EN) or 3 months (for DMPA). IUD: A specially trained provider inserts the implant/IUD into the upper arm or uterus respectively and it can stay in place preventing pregnancy for up to 5 years (implant) or 10 years (IUD) Male condom: Put a new condom onto erect penis before each sex act. Female condom: Before sex, insert a female condom into the vagina. Both: Make sure not to rip or tear condom when removing package and ensure condom is not expired. Do not use male and female condoms together or doubling the condoms as this can cause tearing. Discard condom in trash and make sure not to re-use condoms Breastfeeding the baby exclusively for the first 6 months after birth (not supplementing with formula) while the menses has not yet returned after pregnancy. Is only effective if the menses have not returned AND a woman is breastfeeding exclusively and often
Side Effects May cause irregular bleeding (as body adjusts), then lighter bleeding and less monthly cramping. Hormonal methods may cause spotting between periods and eventually cause no monthly bleeding (amenorrhea) this is normal and safe and not a sign of infertility! Implants may cause pain on insertion area after insertion which lessens over time. Slight weight gain is not unusual Very few side effects – people with a latex allergy should not use latex condoms as they can cause severe skin irritation and allergic reaction Exclusive breastfeeding can cause some breast and nipple soreness (see module on breastfeeding for how to manage symptoms)
Key Points Implants/injectable do not require a daily action. Still need to use condoms for protection against STIs and HIV (if at-risk for infection) Important to use correctly EVERY TIME you have sex. Only method that offers protection against pregnancy AND sexually transmitted infections and HIV Is only effective if you are breastfeeding exclusively AND your menses has not returned. Is only effective for the first 6 months after birth if you do not have your period then you must switch to another method

Natural Family Planning Methods

While natural family planning methods are typically less effective than other forms of family planning, they can still be helpful strategies for planning pregnancy if other options are not available.

Breastfeeding Method (Lactational amenorrhea method) Withdrawal Standard Days Method
What Is It? Exclusive breastfeeding for 6 months if menses have not returned. This suppresses ovulation and prevents the release of an egg into the vagina The man withdraws his penis from the woman’s vagina before he ejaculates Learning which days of a month you could get pregnant and using a condom or avoiding sex during these 12 days
Key Points In order to be effective: Baby must be exclusively breastfeed for the first 6 months of life. Must breastfeed often throughout the day and night. Cannot give the baby other foods or liquids to supplement. To prevent pregnancy, a woman must switch to a different method of family planning after 6 months or if their menses returns. Does not protect against STIs or HIV The man should withdraw when he feels he is close to ejaculation. This is one of the less effective methods. Does not protect against STIs or HIV Use cycle beads or calendar to count days of the cycle. The first day of monthly bleeding is Day 1. Days 8 thru 19 are the “fertile” days when sex should be avoided or condoms used. Works best for women with regular bleeding. If bleeding is irregular or becomes irregular another method should be used. Does not protect against STIs or HIV

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