“So when are you planning to start a family?” This may be a favourite question to ask a young couple, when they are newlyweds, or when they have been married for some time without having a child. And indeed it is a very important question which every couple needs to consider carefully, as the implications of having a family are undoubtedly far reaching. The family planning definition is to control the number of children you have, and the timing and intervals between their births, by means of using contraceptives or voluntary sterilization. Nowadays there are many options available and it may be a daunting prospect to try and determine what might work best in your particular situation. Or perhaps you have some doubts and questions as to the safety of certain methods, or about the whole subject of family planning in general.
This article will seek to lay some of those doubts and fears to rest as we discuss the most frequently asked questions, as well as some not so frequently asked questions, on the topic of family planning, as follows:
- Why is family planning important?
- What are the advantages of family planning?
- What are the disadvantages of family planning?
- What are some different types of family planning?
- What are some of the traditional methods of family planning?
- How does natural family planning work?
- What does sterilization involve?
- How effective are the different types of family planning?
- How does my health affect the family planning method I chose?
- What are the health benefits of oral contraceptives?
- What factors should I consider when choosing a contraceptive method?
- If I get pregnant while using a hormonal contraceptive, will it harm my baby?
- How long will I take to get pregnant after I stop using the pill or injection?
- How will we know when we are ready to start a family?
1. Why is family planning important?
It is important for every sexually active adult to consider family planning, or birth control issues. This is not only for the purpose of preventing unwanted pregnancies, but also to plan the timing of conception for wanted pregnancies. In this way, every baby can be wanted and planned for. The spacing between siblings is also important and can be regulated through appropriate planning. In bygone eras birth control options were severely limited, and couples could expect to keep on conceiving children throughout their fertile years, possibly up to twelve or even fifteen pregnancies! However, now that there have been such advances in this area, the importance of family planning is that it gives couples the opportunity to exercise their responsibility and choices in this significant area of their life.
What are the advantages of family planning?
When you plan your family carefully, taking into consideration how many children you would like and how far apart you would like them to be, there are definite advantages. Firstly, there are health benefits for both mother and child. If children are spaced at least two or more years apart, this gives the mother’s body time to recover before going through another pregnancy, and she is better able to care for each individual child in their early months. Secondly, there are economic benefits when you can plan to have only as many children as you know you will be able to provide for adequately. Thirdly, through wise family planning you can have your children while you are still in your twenties or early thirties, thereby reducing the health risks involved in having a pregnancy after the age of thirty-five. It is also not recommended to get pregnant before the age of twenty.
What are the disadvantages of family planning?
Depending on what method of family planning you use, there may be a few disadvantages to take into consideration where so called side effects are concerned. This is especially true when using hormonal birth control such as the contraceptive pills or injections, implants, patches or vaginal rings. Although many women use these methods happily with no ill effects at all, for some women there may be some noticeable complications or adverse reactions. The most common of these may include weight gain, dizziness, nausea and headaches. In more serious cases, which rarely occur, there may be strokes, blood clots or ectopic pregnancies. After reading that, you may be thinking that the best option is the natural family planning method (more on that later). It is true that this method gives no side effects, but bear in mind that it is only about 75% effective, so you would have at least a 25% chance of having an “unplanned” pregnancy.
What are some different types of family planning?
There is a wide variety of family planning options available. These can be broadly divided into the following categories:
- Barrier methods: As the name suggests, this method basically involves creating a barrier to prevent the sperm from reaching the egg. This can be done by using male or female condoms, spermicidal substances, diaphragms, cervical caps or sponges.
- Hormonal methods: Hormonal birth control includes the use of oral contraceptives (the pill) or injections, as well as vaginal rings and patches. These may include two hormones, namely estrogen and progestin, or only progestin.
- Intrauterine devices: These are generally referred to as IUD’s. This method involves placing a birth control device into the woman’s uterus. One option is the Copper T (ParaGard) which does not contain hormones and can last for ten years or more. Another option is the LNG-IUS (Mirena) which releases a synthetic female hormone and lasts up to five years.
- Natural methods: This method is sometimes called the rhythm method, and it involves the woman taking careful note and monitoring her menstrual cycle, and refraining from having sexual intercourse on the days of the month when she would be most likely to conceive.
- Permanent methods: If you feel that your family is complete and you would like a permanent option to prevent any further pregnancies, then you may need to consider having sterilization surgery. For women this would mean having a tubal ligation, and for men, a vasectomy.
What are some of the traditional methods of family planning?
By now you may be wondering, what on earth did they do in the olden days before all these modern methods were discovered? Surely family planning is an age-old concern, and our forefathers and mothers must have had their own ideas and methods. By 1873 condoms and diaphragms had become available, but before that the main methods of family planning were abstinence, withdrawal (coitus interruptus), or infanticide (killing babies at birth). Attempted and failed abortions were also prevalent and posed a serious health risk to mothers. Prolonged breastfeeding was a method in some cases whereby the mother was able to prevent or stall falling pregnant again while she was still breastfeeding. The natural method, also known as the calendar method or the rhythm method would have been the most widely used traditional attempt at family planning.
How does natural family planning work?
Although natural family planning was used in the past, these days with all the research that has taken place, we have much more knowledge and technology at our disposal to make this a more viable and effective method than it was for our predecessors. Natural family planning (NFP) refers to any method of contraception in which pregnancy is prevented by not having sexual intercourse on the particular days when the woman is fertile and conception is most likely. A careful study is made of the woman’s menstruation and ovulation patterns in order to determine when she may or may not fall pregnant. Although this can be done at home, it is best to enlist the help of your doctor or clinician. There are six variations of the natural family planning method, as follows:
- Symptothermal: This method requires the woman to take her basal body temperature every morning with a special thermometer called a basal thermometer which is highly accurate, up to a few hundredths of a degree. A slight increase in temperature will indicate the end of a fertile period, as well as other bodily functions which need to be carefully observed, such as the cervical position, mucus consistency and moods.
- Calendar-Rhythm: This is the most traditional method and works best with women who have very regular menstrual cycles. It is based on the assumptions that ovulation occurs fourteen days before menstruation begins, that the ovulated egg can live for up to twenty four hours, and that sperm can live for up to three days. Using these three assumptions, one can count fourteen days from the first day of the menstrual period to determine when ovulation should next take place, and then avoid having intercourse around that time.
- Standard Days Method: The Standard Days Method (SDM) is similar to the calendar-rhythm method in that it involves counting off the days of the cycle and works best for those who have a very regular cycle of between 26 and 32 days long. A ring of color-coded beads (CycleBeads) is used, with the different colors indicating which the fertile and infertile days are.
- Ovulation-Mucus: When using this method, a woman needs to observe and record her natural fertility signs as indicated by the different kinds of mucus secreted by the cervix. With practise and the help of a certified natural family planning instructor, a woman can soon learn to recognise her most fertile days when sexual intercourse should be avoided if she does not want to become pregnant.
- Fertility Computers: A fertility computer or a fertility monitor is a little handheld device which can be used to predict a woman’s fertility. There are different types of devices; some which measure the basal temperature, and some which measure the hormones present in the urine. The device will then indicate whether or not a pregnancy may be likely to result on that particular day.
- Lactational Amenorrhea Method: This method, also referred to as LAM is when breastfeeding is used to prevent pregnancy. The reason this works is that while a mother is breastfeeding, hormones are generated in her body which suppress ovulation, temporarily causing the reproductive system to remain inactive. This is especially true within the first six months after a baby is born, if the mother is fully breastfeeding and not giving the baby anything else besides breast milk.
What does sterilization involve?
Perhaps you already have one or two children and you feel your family is complete. You may have been using one or other method of contraception, and now you are considering a more permanent family planning solution. Basically there are two options, one for men and one for women, which involve minor surgery and will result in permanent sterilization.
- Tubal Ligation: For females, this kind of surgery involves cutting, clipping or cauterizing the fallopian tubes which are attached to the uterus. It is 99% effective and does not stop a woman’s menstrual cycle from occurring.
- Vasectomy: For males, having a vasectomy means that the vas deference (or tubes) from each testicle are cut and sealed, thus preventing sperm from mixing with the semen which is ejaculated. It is considered 99% effective and does not in any way affect the man’s sexuality.
How effective are the different types of family planning?
Different types of family planning would have different rates of effectiveness, with some being more reliable and effective than others. Besides the actual method used, the commitment of the user also plays a vital role in its effectiveness. If it is consistently and properly used, a better result can be expected. According to various studies and statistics, the following is a general guideline as to the effectiveness of the different types of family planning:
- Surgical sterilization: 99% effective
- Hormonal implants, IUD’s, and hormonal injections: 97% effective
- The pill and the ring: 92% effective
- Condoms, diaphragms, sponges: From 68% – 85% effective
- Natural Family Planning: 75% effective
How does my health affect the family planning method I chose?
Another factor which may influence the effectiveness of the family planning method you chose is the condition of your health at that time. For example, if you are using a contraceptive pill and you need to take antibiotics, it is important that your doctor knows you are on the pill. Certain types of antibiotic can prevent the pill from working properly. It is best to use other birth control precautions (such as condoms) while taking antibiotics and for a week after finishing the course. If you are a smoker and you are taking a contraceptive pill, you may have an increased risk of developing blood clots.
What are the health benefits of oral contraceptives?
When used effectively, oral contraceptives (ie. the pill) may in fact have some beneficial effects on your health. Certain types of birth control pills may help to clear up acne, as well as regulating the menstrual period. For women who have suffered from heavy and painful periods, the pill can be an absolute blessing, as periods now become lighter, with hardly any cramps or other premenstrual symptoms. According to some studies, regular use of oral contraceptives can reduce the risk of ovarian cysts.
What factors should I consider when choosing a contraceptive method?
Probably the first factor you should take into consideration when deciding what kind of contraceptive method to use is your lifestyle. If you have an extremely active or erratic lifestyle, then you may not want to be tied down to taking your pill at a specific and regular time every day. Similarly, the natural method of carefully observing your body signs and taking regular temperatures may become too burdensome to maintain in a busy lifestyle. Think about how important it is to you whether or not you may have an unplanned pregnancy. Look into the side effects you may experience, and how long you want to use contraception before starting your family. The financial costs may also be a consideration, and whether or not your health insurance would cover your doctor’s appointments.
If I get pregnant while using a hormonal contraceptive, will it harm my baby?
If you are using a hormonal contraceptive such as the pill, you may well be wondering what would happen if you were to fall pregnant despite your precautions. For the pill as well as the patch and vaginal ring, there would be no harm to the baby, as long as you discontinue use as soon as the pregnancy is discovered. If you are using a three-month contraceptive injection, such as Depo-Provera, and you should happen to become pregnant one or two months after having the injection, there may be some effects to the baby. These may include a low birth weight and other health concerns. Before receiving this injection it is important to have a pregnancy test to confirm that you are not pregnant.
How long will I take to get pregnant after I stop using the pill or injection?
When you decide to stop using the pill, you should first complete the cycle that you are currently using. It may take from one to three months for your body to resume its own hormonal cycle and to begin ovulating and menstruating normally. You may wish to ask your doctor or clinician for a pre-pregnancy check up and a course of prenatal vitamins.
If you have been taking a three-month contraceptive injection (Depo-Provera) it can stay in your system for anything from six to eighteen months after your last shot. This may mean that you have irregular ovulation and menstruation, but it may still be possible to conceive within that time. If you want to fall pregnant within the next year, you may consider going off the injection and using a shorter acting method of birth control in the meantime such as the pill, the diaphragm, condoms or spermicides.
How will we know when we are ready to start a family?
Coming back to the question we started out with: “So when are you planning to start a family?” This may not be a simple question to answer, depending on your circumstances and your thoughts and feelings. As a young (or not so young) married couple you may be feeling all kinds of pressure from conflicting directions. Perhaps prospective grandparents are giving not so subtle hints about their longings for a grandchild. And then of course there’s the ticking of the biological clock which reminds you that you’re not getting any younger… Maybe your career is doing so well that you just can’t imagine taking time off for a family. And what about the costs involved?
Before taking the momentous decision to start a family, you need to weigh up all these factors and more. Ask yourself whether both you and your spouse are ready for the full-time commitment that a child requires and deserves, not only physically and financially, but also emotionally and spiritually. Have you thought about whether there are twins in either of your families, and you might end up with two babies instead of one? If there is any genetic condition in your family which may be passed down, you would need to get some professional advice on the possible implications of this should you start a family.
Even when you have decided that “now is the time” and you are both excited and eager to forge ahead, bear in mind that it may just take longer than you expected to fall pregnant. Be patient and be prepared for the long haul. Read up all you can and get the knowledge and information you need to be as prepared as possible. Then one day, when and if you do find yourself holding a precious little bundle of life in your arms, enjoy every minute of it, and remember to be thankful and savour the immense privilege of parenthood.