Family Planning in the 21st century

This article was exclusively written for The European Sting by Ms. Fatima Farooq, a 4th year medical student from Pakistan. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Family planning is a way of thinking and living that is adopted voluntarily upon the bases of knowledge, attitude, and responsible decisions by couples and individuals to limit or space the number of children through the use of contraceptive methods. It deals with reproductive health of the mother, having adequate birth spacing, avoiding undesired pregnancies and abortions, preventing sexually transmitted diseases, and improving the quality of life of mother, fetus, and family as a whole. 

According to 2017 estimates, 214 million women of reproductive age in developing regions have an unmet need for contraception. Reasons for this include:

• limited access to contraception 
• a fear or experience of side-effects
• cultural or religious opposition
• poor quality of available services
• gender-based barriers

It is important that family planning is widely available and easily accessible through trained health workers to anyone who is sexually active, including adolescents. There are many cadres of health care workers who are trained to provide (where authorised) locally available and culturally acceptable contraceptive methods including doctors and midwives. Other trained health workers, for example community health workers, also provide counselling and some family planning methods, for example pills and condoms. For methods such as sterilization, women and men need to be referred to a clinician.

WHO has developed recommendations on which types of health workers can safely and effectively provide specific family planning methods. WHO based these recommendations on the evidence that a wide variety of providers can safely and effectively provide contraception. Contraception in the simplest terms is the prevention of pregnancy and contraceptive methods, by definition, are the preventive methods to help women avoid unwanted pregnancies. There are different methods of contraception available. These include:

• Spacing methods of contraception include IUCDs (Intrauterine Contraceptive Devices), OCPs (Oral Contraceptive Pills), Condoms, Lactational amenorrhea method, etc.
• Permanent methods of contraception viz. vasectomy and tubal ligation are generally available at primary health centre level or above. They are provided by MBBS doctors or gynaecologists who have been trained to provide the services. 

Comprehensive sexuality education is learning that begins during early childhood, and continues throughout life, concerning the physical, emotional, mental and social aspects of reproductive and sexual health and rights, inclusive of sexuality and relationships. Comprehensive sexuality education builds on and promotes an understanding of universal human rights, including the rights of women and girls, and the rights of all people to access health, education, and information equally and without discrimination.³ As a foundation for exercising reproductive rights, comprehensive sexuality education includes information about access to family planning services, the right to choose whether or not to have children, and the right to decide freely on the number, timing and spacing of these children. These services can be delivered by trained medical students to adolescents by conducting interviews and activities related to family planning in educational institutions, neighbourhoods, etc.

References

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510098/  [Authors: Rabbanie Tariq Wani, Imrose Rashid, Sheikh Sahila Nabi, and Hibba Dar]
• https://www.fpnsw.org.au/advocacy/comprehensive-sexuality-education  
• https://www.who.int/health-topics/contraception#tab=tab_1  

About the author

Ms. Fatima Farooq is an IFMSA member and a 4th year medical student from Pakistan.