Raising a child requires a significant amount of time, financial resources and energy. The primarily purpose of family planning is to help couple delay their childbirth until they are financially ready. The childbirth can be delayed by using various fami

Using family planning method is the practice of planning and controlling the number of children in a family, and the intervals between them by using various contraceptives. Both men and women have different options regarding the selection of contraceptives depending upon whether they want the contraceptive to be temporary or permanent according to their needs. Temporary contraceptives can be used when couples are not yet ready to have a child, and can stop using them once they are ready.  But permanent measures make them permanently sterile. Both permanent as well as temporary measures must be used only after proper counseling with trained health service providers.  Here are some tools for family planning as discussed with Dr. Radha Shah, who is a Gynecologist at Suvekshya Hospital, in Sitapaila, Kathmandu.

Female Temporary Contraceptive Methods:

  1. Pills (Combined Oral Contraceptives): Using birth control pills is a temporary female hormonal birth control method which is very effective at preventing pregnancy.  It contains estrogen and progestin hormones, which are similar to the estrogen and progesterone hormones normally produced in the ovaries. Pill stops the development and release of the egg in the ovary. The pill should be taken every day at the same time within the first 5 days of menstrual period. If the Pill is taken at the same time every day, it’s more than 99% effective when used correctly.

Advantages:

  • No complicated usage procedures, which means that there is no need to visit the doctor before each use.
  • Easily available in the market & cost effective
  • 98-99% effectiveness (if correctly used)
  • Usually menstrual cycle remains regular
  • Abdominal pain and menstrual blood loss may decrease

Disadvantages:

  • The pills have to be consumed every day at the same time, if even one dose is missed, the effectiveness is decreased
  • Some women may feel nauseous, have headaches, get dizziness and may increase pimples and colasma on the face during the first 1-2 months of use
  • Some women should not take pills if they have specific health conditions, such as diabetes, liver disease, cardiovascular disease, etc.
  • It does not provide protection from STDs including HIV/AIDS
  1. Injectable Contraceptive: Injectable contraceptive is also a temporary hormonal contraceptive for women. It is an injection given by a trained health service provider to a woman and its effectiveness lasts for three months. These shots must be taken within a week of menstrual period. Depo provera injectons prevent ovaries from producing eggs, thereby preventing fertilization.

Advantages:

  • Effective for 3 months after injection, and  no need to worry about daily use
  • 98-99% effectiveness
  • May increase breast milk in breast feeding women

 

Disadvantages:

  • For the injection, health clinics must be visited every 3 months
  • Does not provide protection form STDs including HIV/AIDS
  • Menstrual irregularities including amenorrhea
  • May delay in return of fertility to about 6-9 months
  1. Implants: Implants are small rods that are inserted under the skin of the upper arm of the woman. These are temporary female hormonal contraception that prevents ovaries from releasing eggs. Implants are so small that once inserted are not visible from the outside and thus helps in maintaining privacy.

Advantages:

  • Effective for up to 5-7 years once implanted, and no need to worry about daily use
  • 97-98% effectiveness
  • Fertility quickly returns after taking them out
  • May help prevent against pelvic infections

Disadvantages:

  • Insertion and removal requires minor surgery by a trained professionals so women have to go to health institutions every time they want an implant
  • Menstrual cycle can be affected including amenorrhea, irregular bleeding and excessive bleeding
  • Does not provide protection form STDs including HIV/AIDS
  1. Intra-Uterine Contraceptive Devices (IUCD): An intra-uterine contraceptive device is a small contraceptive device, which contains copper and is inserted into the uterine cavity through cervix by trained health professional. It prevents pregnancy by destroying the embryos or preventing excess sperm from reaching the fallopian tubes. This device can be removed when couples have the desire to have a child.

Advantages:

  • No hormonal imbalance
  • Effective for long duration (1-12 years)
  • Once removed, there is a quick return to fertility
  • 98-99% effectiveness

Disadvantages:

  • Need professional help to insert and remove the device in the uterus
  • Excessive blood flow may occur in some cases with abdominal pain during period
  • May cause genital tract infection in those at risk of STIs
  • Does not provide protection form STDs including HIV/AIDS

Male Temporary Contraceptive Methods:

  1. Condoms: Condoms are the only temporary contraceptive method used for family planning by men. They are made of thin synthetic rubber (latex). Condoms stop male sperms from reaching the genital tract in female. Besides preventing pregnancy, condoms also provide protection against various Sexually Transmitted Diseases (STDs) including HIV/AIDS.  Female condoms are also available and they too serve the same functions and features as that of a male condom. But female condoms are not very popular in  the context of Nepal.

    Advantages
  • Effectively helps prevent transmission of sexually transmitted diseases including HIV/AIDS
  • Has no hormonal effects
  • 85-97% effective if correctly used every time
  • Easily available in the market & inexpensive
  • Can be used without any professional consultation

Disadvantages:

  • High user failure (about 3-15%)
  • Has to be used during every sexual intercourse
  • May take time getting used to it
  • Some men as well as women may have latex allergies due to which they may have the itching or burning sensation
  • Storage conditions with high temperature may damage the condoms, or may decrease effectiveness

 

Permanent Sterilization

  1. Vasectomy: Vasectomy is a procedure in which the two vas deferens that carry sperm from the two testicles to the penis are surgically obliterated so that sperms cannot reach the genital tract of the woman during sexual intercourse. Couples who intend on not having any more children, go for vasectomy.  It is the safest and easiest form of surgical sterilization. It is a simple and fast procedure which takes less than thirty minutes to complete. Couples must go for this procedure only after proper counseling from the doctors.

Advantages:

  • More than 99% effective
  • Permanent measure of birth control for men, and there is no need to worry about any temporary birth control measures
  • Operation is performed externally and does not take very long time and is easy
  • No long term side effects

Disadvantages:

  • Minor complications may occur during operation, such as infection, excessive bleeding, etc.
  • Temporary measures must be taken for the first 3 months or for the first 20 ejaculations after the operation, whichever comes first.
  • The vas deferens tubes that are cut may sometimes on rare occasions, less than 1%, reattach,  resulting in pregnancy
  1. Minilap tubal ligation: It is a procedure where a small hole is cut in the abdominal wall and both the fallopian tubes are tied together by trained physicians. This is the permanent method of birth control for female.

    Advantages
  • No need to worry about any temporary birth control measures
  • Minor operation performed by trained physicians
  • No long term effects

    Disadvantages
  • Complications may occur during operation, such as infection, excessive bleeding, etc.
  • Occasional bladder and bowl injury