Family Planning for Individuals or Couples
Choosing when and how many children to have
What is family planning?
Family planning is defined as the voluntary decision by individuals or couples as to the desired size of a family and the timing of those births, essentially ensuring children are born because they are wanted at a certain time.
Family planning exists to serve three critical goals:
- Help people avoid unintended births
- Reduce the transmission of STDs
- Decrease the chance of infertility in men or women
Types of Family Planning
The types of family planning can be broken down into several categories:
- Barrier methods
- Intrauterine Devices (IUDs)
- Sterilisation
- Natural Methods
- Emergency Contraception
Barrier Method
The purpose of the barrier method is to basically stop a man’s sperm from fertilising a woman’s eggs. This type of family planning is only effective when you have sexual intercourse and is achieved through the use of one or more of the following:
For a Man – Male condoms – acts as a barrier to STD’s as well
For a Woman – Diaphragms, Female condoms, vaginal contraceptive sponges or spermicidal foam.
It is important to mention that out of all the barrier methods, the male condom when used correctly, is still 98% effective when preventing pregnancies. The only other method that is more effective at 100%, is abstinence from sexual intercourse.
Intrauterine Devices (IUD)
An IUD is a small device made of plastic and/or copper that is inserted into the uterus by a trained health professional to prevent pregnancy. They come in two forms, non-hormonal IUD’s and hormonal IUD’s.
Non-hormonal IUD’s is a plastic device with copper wire wrapped around the frame, releasing small amounts of copper into the uterus once inserted, immediately effective when the procedure is completed. It can last anywhere between 5-10 years depending on the type and is an ongoing form of contraception until menopause starts.
On occasion there may be times when the IUD may be ineffective due to:
- The IUD device falling out (you need to check for the strings on a regular basis)
- The IUD being placed into the uterus incorrectly
- The IUD device being left in longer then the recommended period of time (i.e. greater than 5 – 10 years depending on the type of the device)
Side effects of using the copper IUD can include the following:
- When the IUD is inserted the woman might feel period type cramping, this will often settle after a couple of days. If it doesn’t make an appointment with your doctor to review.
- Your period will change. Within the first three months it is common for spotting to occur, this will nearly settle over time. Again if it doesn’t make an appointment with your doctor to discuss your concerns.
- For most women, periods will be 50% heavier.
The other type of IUD is a hormonal IUD. Shaped like a “T” similar to the non-hormonal IUD, the hormonal IUD contains a synthetic version of the hormone progesterone, the same that is found in the ovaries. It can last up to 5 years but must be removed by the age of 55 years old.
The hormonal IUD like its counterpart physically stops the sperm fertilising the egg but also additionally thickens the fluid around the cervix, as well as the walls of the uterus. Stopping the sperm from travelling towards the woman’s eggs with effectiveness of the device only beginning after 7 days from the insertion of the device.
On occasion the IUD may be ineffective due to:
- The IUD device falling out (you need to check for the strings on a regular basis)
- The IUD being placed into the uterus incorrectly
- The IUD device being left in longer then the recommended period of time (i.e. greater than 5 years)
That being said, the advantages of the hormonal IUD are:
- Once inserted you only have to check the strings once a month
- You can use it while breast feeding
- No medications stop it working
- Most users have very limited bleeding (periods), with some cases none at all
- Period pains are less
- Once removed your fertility quickly returns to what is normal for yourself
- It is an option for those women that have trouble with taking Oestrogen
Side effects of using the hormonal IUD can include the following:
- When the IUD is inserted the woman might feel period type cramping, this will often settle after a couple of days. If it doesn’t make an appointment with your doctor to review.
- Your period will change. Within the first 3-6 months it is common for spotting to occur, by the 6th month most women will only have light bleeding or no bleeding at all (this is completely normal).
- Headaches – nearly always settle with time
- Changes to your skin – nearly always settle with time
- Your breasts may feel tender or sore – nearly always settle with time
- Mood changes may occur – nearly always settle with time
Again if are concerned, make an appointment with your doctor to discuss your concerns.
This service is not only limited to normal consults, patients can now access chronic disease management and mental health item numbers as well.
Sterilisation
The next barrier in family planning is sterilisation. Sterilisation is a more permanent method and is achieved through a procedure performed by a health professional on a male or female.
Male Sterilisation
The procedure for a male sterilisation is called a vasectomy, it is usually done under local or general anaesthetic. A vasectomy is where the doctor cuts and seals the vas deferens (the tube that carry’s the sperm). After three months it is advised that you get your semen tested to ensure there is no sperm present, before resuming sexual intercourse. Before having this procedure you need to be sure that you do not want any more children. While it is possible for a doctor to complete a vasectomy reversal, there is no guarantee that it will be successful.
Female Sterilisation
The procedure for female sterilisation is called a tubal ligation. A tubal ligation is where the doctor under general anaesthetic, uses a laparoscope to either clip, tie or cut the fallopian tubes. In some cases the doctor may elect to complete a laparotomy (which involves making a larger cut on the abdomen) in which case you may be required to stay in for longer.
Like the male sterilisation procedure, you must be sure that you do not want any more kids. While the reversal off a tubal ligation is possible, statistics show that it is only 50% effective once the reversal is completed.
Natural Methods
Natural family planning is where the woman determines her fertile days (i.e. when in her menstrual cycle she is most fertile) and abstaining from having sexual intercourse on those days. Working out when you are most fertile can be done by:
- Observing changes in your basal body temperature (BBT) and/or cervical mucous
- Using the calendar method where you chart your menstrual cycle on a calendar
- Using the sympo-thermal method involving combination of these three methods
It is important to mention, whatever method you choose you need to know what a woman’s fertile day is. This is defined as the time of ovulation (release of the egg from the ovaries). After ovulation the egg survives 24 hours but as the male sperm can last as long as 5-7 days in the female reproductive system. Women are considered to be fertile 5 days before and 2 days after ovulation.
Emergency Contraception
The final form of family planning in is the emergency contraception. Emergency contraception comes in three forms:
- The Levonorgestrel emergency contraceptive pill (must be taken within 72hrs of the unprotected sex)
- The Ulipristal acetate emergency contraceptive pill (must be taken within 120hrs of the unprotected sex)
- The copper IUD (has to be inserted within 5 days of the unprotected sex)
The pills (commonly known as the morning after pill) is generally taken orally and its purpose is to stop or delay the release of the egg in a woman until the male sperm is no longer effective.
Family Planning Services offered by Vitalia Healthcare include:
- Implanon Insertion and Removal
- IUD removal
- Sexual Transmitted Disease advice
- Organising Sexual Transmitted Disease testing
- Family planning advice
