Benefits And Differences Of Contraceptive Methods

Family planning has widely been adopted whereby almost all couples in the developing world make use of the modern contraception method for healthy spacing, timing and limiting the birth size in order to achieve a desirable family size. Family planning is a way of saving the lives of women, children, newborns and teenage girls. It also decreases the number of unplanned pregnancies and abortions, it serves as a benefit for families and communities, it reduces the burden on natural resources and the environment (Irina Yacobson, 2012).

The use of family planning helps women to limit their pregnancies which has a great and direct impact on her health, well-being and also to the outcome of each pregnancy. Therefore, the purpose of family planning is to regulate and control the rate of child births by individuals, either married or unmarried (Anyanwu, 2013). The success of family planning has not been regular across or within the countries. In some country, the use of contraceptive has risen slowly or remained low over the years. Also, in some countries that the modern method is readily available, there are populations that still do not have access to these family planning services. In the developing countries, an estimated 222 million women would like to space or limit their pregnancies but are not using a contraceptive method. Also, South Asia has the highest number of women who wishes to avoid pregnancy but are not using any family planning method. Sub-Saharan Africa has the largest proportion of women who fall in this category (Irina Yacobson, 2012).

Population growth has been a major problem all over the world which makes many developed countries to approve and resort to family planning. The rapid population growth made the former President of Nigeria Babangida to state that each family should not have more than four children. For that reason, the mass media started campaigning awareness about the consequences of having more than four children. Family planning clinics were also created in government owned hospitals but this did not yield much useful result due to cultural and religious beliefs of the diverse and numerous ethnic groups that made up Nigeria (Anyanwu, 2013).

There are number of factors that contribute to the growth in population which some of the reasons for high fertility rates are high infant mortality rate, low age at marriage and unmet need for contraceptives. There are some roles such as education, age at marriage, religion, economic status and type of family plays an important role in adopting family planning (Hetal T Koringa, 2015).

Furthermore, other forms of achieving family planning apart from the use of contraceptive and the treatment of involuntary fertility are sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and management, and infertility management.

Benefits of Family Planning

Prevention of HIV and AIDS

Family planning suppresses the risk of getting unintended pregnancies amidst women living with HIV/AIDS which will result to fewer infected babies and orphans. Also, male and female condoms protect against HIV/AIDS and unintended pregnancies.

Empowering people and enhancing education

Family planning gives people the chance to make a choice on their sexual and reproductive health. Family planning stands as an opportunity for women to enhance in their education and also participate in public life which includes paid employment in non-family organizations, politics. Also it is an avenue for parents to invest more on their children when they have smaller family.

Well-being

Family planning gives room for a recovery period after child’s birth, promoting family planning and ensuring access to different contraceptive methods and also supporting the health and development of countries.

Reducing adolescent pregnancies

Pregnant adolescence have a higher risk of giving birth to preterm or low birth-weighted babies, causing the pregnant adolescence to leave school which has a long-term implication for them, their future, families and communities.

Healthy spacing of pregnancies

Ill-timed pregnancies and birth are strong contributing factors to infant mortality rates. For example, infants of mothers who die as a result of giving birth have a greater risk of death and poor health.

Family Planning Services

• Information and counseling by health workers about modern contraceptive methods
• Provision of the family planning methods or prescriptions
• Surgical procedures for example intra-uterine devices (IUD), Insertion or Sterilization.(Hannah, 2012)

Causes of Family Planning

The use of family planning is prompt by some factors in which helps or affects an individual one way or the other. In this session, we will be looking at some factors that prompt or cause the use of family planning in developing countries.

Women are no longer limiting themselves but are now looking beyond reproducing and playing domestic roles in order to produce and contribute positively to their society. In order for this to be achieved, there is a need to be involved in family planning.

Another reason that prompt the use of family planning is for women to control their fertility and the ability to subsidized the number of children they are giving birth to in order to regulate the population growth of a country that brings about a stable economy. Family planning also serves as a substitute for abortion.

Effect of Family Planning

• In this section, we will be looking at the outcome or contribution of family planning to women of child bearing age.
• It makes a child healthier in which the spacing in between the children will give the mother the benefit to breastfeed a child for a long period of time and also spend more time with each child.
• Family planning gives women the opportunity to be productive and to give back to their society.
• Family planning also helps teenagers of child bearing age to delay their first pregnancy because girls between ages 10-14 years are more likely to die of pregnancy-related causes than women between the ages of 20-24.
• Family planning also lowers the number of unplanned pregnancies and abortions.
• Family planning also reduces the burden on natural resources and the environment. The population level of a country have a great impact on the demand that is being placed on the country’s natural resources whereby smaller families protect the country’s natural resources and deny them from being overused and damaged.

Various Method of Family Planning

Family planning methods are methods that are put in place by couples so as to avoid pregnancy, delay pregnancy, desirable spacing between children, gaining of strength by women after birth, controlling population, protecting natural resources of a country e.t.c. Women of child bearing age can choose any type of family planning method to help them plan their family and prevent any form of unplanned pregnancy. The family planning method used by women of child bearing age can have either a negative or positive influence on the couple’s sex lives.

There are different things various couples or women of child bearing age wants from a contraceptive method. Some women wants a method that will guarantee them of no chance of pregnancy, some wants the method that will quickly return back to fertility whenever they stop so as to get pregnant very fast, some do not want to always take pills, some do not want to put the burden on their partner alone, some will want a protection from STIs which will led them to the use of condoms. Also, some wants a form of fertility awareness because of their religious beliefs, some uses a certain method because of the fear of side effects, some women uses a method so as to hide it from their partner while some of them might be due to a medical condition that could affect the safe use of a particular method.

The effectiveness of a family planning method is an important factor of choosing a particular method.

• Type of Method
• Implants
• IUD
• Female Sterilization
• Vasectomy
• Injectables
• LAM
• Pills
• Male Condoms
• Female Condoms
• Fertility Awareness Methods
• Withdrawal
• Spermicides
• List of The Available Family Planning Method
• Hormonal contraceptive methods
• Oral contraceptive pills
• Injectable contraceptives
• Contraceptive implants
• Emergency contraceptives pills
• Intrauterine contraceptive devices (IUDs or IUCDs)
• Barrier methods
• Fertility awareness methods
• Breastfeeding
• Withdrawal method
• Female and male sterilization

Breakdown of the Methods Listed Above

Hormonal Contraceptive Method

This method includes oral contraceptive pills, injectables and implants. These methods work by preventing pregnancy whereby it stops the woman’s ovaries from releasing eggs. This method also include in it one or two female hormones that are similar to the hormones a woman produce naturally.

This method can be used by all women and it is highly effective in the prevention of pregnancy. Since the egg stops the hormones from releasing an egg, there is no way fertilization can take place that will lead to the occurrence of pregnancy. This method also makes the mucus thick in order to prevent sperm to enter into the uterus. The oral, injectable and implant methods have different side effect in which a woman needs to talk to a health care provider to help confirm if she has no health conditions that can make the methods not suitable for use, also to get full details about the methods in order to choose the one that she thinks is right for her. Out of these hormonal methods, there are short-acting and long acting. The short acting causes a repeating action to take place while the long acting hormone will not require any repetitive action because it last up to 3-5 years depending on the implants used. The short acting hormone will be very effective when used correctly by not missing the any pills but the log acting hormone is more effective because one it has been planted, it will keep on working till after 3-5 years. It is also good to note that none of the pregnancy method can harm a baby if it is accidentally taken b a pregnant woman.

Under the hormonal method, we have the Oral contraceptive pills such as;

Combined oral contraceptives (COCs)

The common contraceptive pills make use of two synthetic hormones which are estrogen and progestin. The method will only be effective if it is used appropriately. There are some side effects that accompany the method such as nausea and mild headache when taking it for the first time but it tends to go away after the first few months and it is also advisable for pregnant women to take it only when the child is 6months away because the estrogen in the pill can reduce the flow of breast milk.

Progestin-only pills (POPs)

This pill contains only the progestin hormone and it can also be called mini-pill. The pill is best recommended for breastfeeding women because the progestin will not reduce the breast milk and it works effectively in breastfeeding women than non-breastfeeding women. There are some side effects that come with the POP such as light bleeding and spotting but it is not harmful.

All oral contraceptives

When using the oral contraceptives, it is very easy to for women to return to fertility and it can be gotten at the pharmacies, clinics and community-based providers.

Injectable Contraceptives

These are contraceptives given by injection into a woman’s hand or buttocks that are directed to the muscle or under the skin where the fatty tissue is which depend solely on type of injectable. After the injection is given, the hormone is then released slowly into the bloodstream which requires that the woman repeat the injection process once in every 1, 2 or 3 months.

The injection is 100% effective only if the process is repeated in due time and it won’t be very effective if the women are late for the injection. The side effect that comes with this method is bleeding changes which can be irregular, heavy, or prolonged bleeding but taking several injections can stop the monthly bleeding altogether. To return to fertility after this method is often delayed which can take up to 4-10 months and it can be done by pharmacists, health workers, in a clinic or health outpost.

Contraceptive Implants

These are small plastic rods that look like a matchstick and are placed under the skin on the inside of a woman’s upper arm. They are 100% effective and can protect a woman from pregnancy for 3-5 years depending on the type of implant. Women find this method very easy because it does not require any further action after implant except when it will be removed. The side effect includes vaginal spotting and bleeding, stopping of monthly flow.

Emergency Ocntraceptive Pills (ECPS)

These are also referred to as morning after pill and are taken after unprotected sex which contains either progestin alone or both progestin and estrogen. It works like other hormonal method by preventing ovulation but are not 100% effective as most regular methods. The side effect includes headaches, nausea or vomiting after taking the contraceptive which goes away within several days.

Intrauterine Contraceptive Devices (IUDS Or IUCDS)

This is a small, often T-shaped plastic device, wrapped in copper or contains a progestin hormone. It is being inserted by a specially trained health care provider into the uterus. A plastic string is tied to the end of the IUD and it is being hung down through the cervix into the vagina. A woman can check the place of the IUD by feeling the strings inside the vagina. The string is used to remove or replace the IUD from the vagina whenever the woman wants by the health care provider.

IUDs are nearly 100% effective and also last long. They can protect a woman from pregnancy for 5-12 years depending on the type of IUD. The woman will become fertile once the IUD is removed and can become pregnant immediately. It can be used by women of all ages because it does not cause infertility. Women with high risk of STIs such as gonorrhea and Chlamydia should not use IUD because the process of inserting the IUD can push the gonorrhea and Chlamydia higher into the reproductive tract which can cause a more serious health problem. Under the IUD, we have examples such as copper-bearing IUD and hormonal IUD.

Copper-bearing IUD

This creates an environment in the uterus by destroying the sperm and stops them from fertilizing an egg. It is effective for up to 12 years and the common side effect include heavier and longer monthly bleeding that can come with increased cramping. The side effect might go away after the first 3 to 6 months of IUD use.

Hormonal IUD

This method releases slowly a small amount of progestin hormone. It thickens the vaginal mucus and makes it hard for the sperm to enter into the uterus from the vagina. It is highly effective and can be used for up to 5 years. It changes bleeding pattern and makes it irregular.

Barrier Methods

These are method that involves using male and female condom to delay pregnancy and it is the only contraceptive that provides protection from STIs and HIV. The types are diaphragm and cervical caps which are not readily available in many countries. These devices works by forming a mechanical barrier between the sperm and an egg. Also, spermicides are chemical substances that are placed in the vagina such as gel, foam, film or a tablet and it works by killing or disabling sperm. It effectiveness depends on the consistent use.

Male condom

It is a covering usually made of thin latex that unrolls over a man’s erect penis which prevents sperm from entering into the vagina. It is effective when used correctly and keep the small orgasm that causes some STIs/HIV from affecting the partner.

Female condoms

This is a lubricated pouch made of thin, soft plastic that fits loosely inside a woman’s vagina that prevents sperm from entering into the vagina. It is effective when used correctly and block the transmission of STIs/HIV.

Spermicides

These are chemical substances that are inserted deeply into the vagina shortly before sex to kill or disable sperm. They are available as foaming tablets, vagina suppositories, foam, melting film, jelly, cream and are used alone as well as with diaphragms cervical caps and condoms. They are one of the least effective contraceptive methods even when used correctly.

Fertility Awareness Methods

This is a method that involves the male and female understanding their reproductive system. When using this method, the couples must identify the days the woman is fertile and abstaining from unprotected sex on those days. This type of method has no side effect and do not require any procedures, devices or hormones. There are two types of fertility awareness method which are standard days method and calendar-based method.

Breastfeeding(Lactation Amenorrhea Method)

In this method, breastfeeding is used to delay pregnancy. In this method, only breast milk is given to the child in order to delay fertility up to 6 months and it helps the uterus of the mother contract and return to its pre-pregnancy state. This method is effective when used correctly.

Withdrawal

This method involves the withdrawal of penis from the vagina during sex so that sperm will be released outside the vagina. This method is the least effective of every other method because if the man does not withdraw before ejaculating, his partner may become pregnant.

Female and Male Sterilization

This is a permanent method of family planning that goes through minor surgery in which the surgery does not require hospitalization in most cases.

Female sterilization

This method is also called ligation and it is a surgical procedure in which a very small incision is made in a woman’s abdomen and her fallopian tube are cut and blocked so that eggs will not be able to move through the tubes to meet the sperm. This method has no side effect apart from the mild pain and swelling from the surgery which will go away after some days.

Male sterilization

This method is also called vasectomy and it is a surgical procedure whereby a tiny hole is made in the scrotum which is the sac that holds the testicles and the tubes that carry a man sperm to his penis are cut and blocked. Vasectomy is not effective immediately but takes up to 3 months before the semen will be cleared completely of sperm.

Theoretical Framework

The existence of family planning program presumes that individual’s fertility expectations are not yet consistent with the objectives of the program which leads to some individuals not cooperating (Liao, 1994).

For the various method of family planning, it is important to know that there is no one best measure. The unmet need for family planning is measured in two ways in which the first one is stated as women of child bearing age who wants no more children and are not pregnant do not make use of any form of contraception. The second measure is the percentages of currently married women, who want no more children, who want a minimum family size, not breastfeeding and are still not using any form of family planning (CF & AR, 1984).

Furthermore, having a better theoretical understanding about the process in contraceptive behavior will help in increasing contraceptive prevalence. Yet, many health providers are not providing education that will intervene that contraceptive use are not based on any explicit guiding theory or principles (I., 2012). According to (Terzioglu, 2010), family planning method used by women of reproductive age can have negative or positive influences on the sex lives of couples. Therefore, couples should be aware of the effect of the family planning method they use on their sex lives to be able to improve the quality.

Particular emphasis and priority should be given to methods that coincide with the Women’s perceived needs and priorities, including among others, methods that are under the user’s control and that also protect against STD's, post-ovulatory methods, and safe male Methods that enable men to share responsibility for fertility regulation and disease prevention (World Health Organization, 1993) as cited in (FAMILY PLANNING ISSUES AND CHALLENGES, 1993).

Furthermore, the view that having too many children can lead to health failure, Davis (2003) explained that family planning is important in the aspect of health and welfare of mothers and children but does not control population which leads to (UNPFA 2001) motion that family planning improves maternal and infant health which reduce the exposure to health risk and low outcome of abortion cited in (Anyanwu, Family Planning in Nigeria: a Myth or Reality? Implications for Education, 2013).

Empirical Framework

Morgan (2002) who conducted a study in Western Nigeria on traditional contraceptive techniques, In his study on family planning attitudes and practices in rural Eastern Nigeria, Ukaegbu (2003) revealed that attitudes toward family planning and marital relations were less positive among men than among women. For example, a smaller proportion of men (42%) than women (50%) had ever used contraceptives, and women were more likely than men to have ever used a traditional method or a modern method (50-60% of wives used traditional methods like abstinence, prolonged lactation and rhythm/safe period but the use of modern contraceptive method were very low).

The result also showed that although the majority of respondents reported knowing of a contraceptive method (76%), only 28% were currently using one, and fewer than half (47%) reported ever having used one. This goes to prove that family planning is not a very popular practice and basically regarded as a female affair. This may be as a result of the belief that having a large family strains a couple’s relationship as accented to by 55% of the female respondents against 40% of the males. Ukaegbu concluded that among the chief predictors of contraceptive use for all respondents combined were education, religion, approval of family planning, media exposure, spousal communication and approval and agreement that female education should be encouraged.

Using education as a variable to determine the knowledge, attitude and practice of family planning in Ibadan, Adeleye and Adeleye (2003) sampled 200 women from the outpatient clinic of University College Hospital (UCH) Ibadan. Ninety-six per cent of their samples were married, 93 per cent were aged 15-44 years and 68 per cent illiterate. They found that abstinence was the common method used mainly by the illiterates (80%) and 20% literate respondents. Besides, the knowledge and practice of modern family planning method were generally low (38%). They concluded that education was positively related to the knowledge and practice of contraception as surveyed in (Anyanwu, Family Planning in Nigeria: a Myth or Reality? Implications for Education, 2013).

Another report presented a review of literature on male attitudes and behaviors concerning family planning and male initiatives in Africa. The results indicated that men often have positive attitudes toward family planning, but women believe that their husband disapproves of family planning. The report further noted that spousal communication was positively associated with family planning method use (Toure, 1996). However, another study conducted by Ezeh (1993) in Ghana showed that spousal influence, rather than being mutual or reciprocal, is an exclusive right of the husband. According to the Demographic and Health Surveys, many married women who want to avoid pregnancy are not using contraception because their husband objects. Nearly one in ten married women with unmet need cited husband’s disapproval as the principal reason for non use of contraception (Drennan, 1998) as stated in (Korra, 2002).

Summary

This session represents a review of the available literature along subject matter of the seminar which is family planning and its various methods. The central theme of this research work is family planning and the various method of family planning. In addressing these themes, this session undertook a review of literature on individual segments of the central theme and also the combinations of the segments as basis for developing the researcher’s ideas on the general concept of this research work. The review of literature is aimed at providing detailed account of earlier studies in order to identify the gap that is in existence in the literature which this research work attempts to study.