Family Planning

Family planning is a big part of life. You need to be 100% sure you want to have a baby, and if there are any doubts, its best to hold off until you are sure.

There are many different factors to consider such as; will both parents be part of the child’s life, are you responsible enough to take this on, are there any financial constraints, how will the baby be brought up, and so on. If you decide to go ahead with planning a family there are some things that need to happen first.

Get a Medical Checkup

It is important to find a clinician who specialises in pregnancy health and delivers babies and will help the prospective parents feel comfortable. Your GP can recommend someone that specialises in obstetrics and gynaecology.

It's important to research and meet with any professionals that may be involved with the pregnancy and delivery. It also needs to be considered where the birth will take place.Some options are in a hospital, in your home or in a birthing centre.

The Preconception Visit

Certain factors are associated with difficult pregnancy. Some may be treated or controlled. Be sure to have a preconception visit if the mother:

• has had only brief times between earlier pregnancies or just had a baby
• has a history of stillbirths or miscarriages, or babies born premature or low birth weight
• knows she is at personal risk of having a child with birth defects, mental retardation, or a genetic disorder
• is at risk for rubella (German measles) or other infectious diseases
• has heart or kidney disease, hypertension, or other chronic conditions such as lupus
• has or had a sexually transmitted infection, cytomegalovirus, streptococcal infections, or toxoplasmosis
• has psychological stress, such as family or financial problems
• was exposed to environmental hazards, such as X-rays or toxic chemicals
• smokes, drinks alcohol, or uses over-the-counter, prescription, or illegal drugs
• has a weight problem or a history of eating disorders
• is younger than 15, or older than 35

The clinician may ask questions about the prospective parents and their medical histories, along with their families medical histories. It is important to be honest about both families' medical histories. This preliminary screening may reveal possible risks for the pregnancy and for the health of the baby. This check-up may also include a physical exam, a pelvic exam, blood and urine tests.

Change Bad Habits

It's important to change unhealthy habits as soon as the planning of a pregnancy begins. The first 12 weeks of pregnancy are very important for foetal health and development. Many women do not even know that they are pregnant during this time.

• Don't smoke. The dangerous chemicals in cigarettes can cut off oxygen to the developing foetus. Smoking can also cause many complications from low birth weight to infant death.
• Don't drink alcohol. Even a little alcohol may harm a foetus — no matter what kind of alcohol it is. Beer and wine are just as dangerous as spirits and other hard liquor.
• Don't use drugs. Addictive, habit-forming, or trippy drugs such as heroin, cocaine, codeine, crystal meth, uppers, downers, marijuana, PCP, or LSD can cause serious problems for the foetus and for the baby when it is born. Many babies go through painful withdrawal in the first few days of life. Many babies die from it. If the baby does survive, the child may have difficulty paying attention, making decisions and remembering things.

It can be difficult to get pregnant if a man has a low sperm count. Some habits that can affect sperm badly include:

• drinking alcohol
• smoking cigarettes
• using anabolic steroids
• using illegal drugs, such as marijuana, cocaine, or heroin
• taking certain antibiotics, prescription drugs, or over-the-counter medicine
• using saunas, whirlpools, or hot tubs at more than 102ºF (40ºC)
• unhealthy diet

Stress, certain bacterial and viral infections, some medical conditions, and exposure to pesticides may also reduce sperm count or the quality of semen.

Eat Well and Exercise

A healthy diet is vital for a healthy pregnancy. It's the best thing that can be done for the baby’s health. It will also make the mother strong and ready for labour, delivery, and breastfeeding.
The mother should speak with her doctor if she is:

• vegetarian or has allergies to some foods
• vomiting frequently
• unable to take prenatal vitamins
• experiencing too much or too little weight gain

The mother will need about 100-300 more calories a day than usual. It's important to eat a balanced diet of carbohydrates, fat, protein, and fibre. It is important to drink enough water, but mothers need to avoid caffeine, sugary soft-drinks and sodas, and alcohol.

Most women need to take extra vitamins during pregnancy — even if they eat well. Pre-natal vitamins are often needed. The most important ones to take during pregnancy are calcium, iron, and folic acid — a type of vitamin B. Folic acid helps reduce the risk of very harmful brain and spine defects. It is possible to get too much of some vitamins and minerals. Too much Vitamin A, for example, can cause birth defects. The doctor will be able to work out a simple eating plan and advise of any minerals that may be needed.

Regular exercise can help strengthen a woman's body and prepare it for pregnancy. It will also help with sleeping. Benefits of exercise for the prospective mother include:

• feel more relaxed.
• have fewer backaches.
• feel healthier.
• blood will flow better.
• prevent varicose veins and haemorrhoids.
• bowel movements will be more regular.
• Pregnancy and delivery may be easier.

Some women with certain health problems may not be able to increase their physical activity, especially once they are pregnant. Gentle swimming is recommended as it takes pressure off the joints.

Contraception After the Birth

Contraception after the birth is important. Methods involving hormones should not be used, as this will alter the mother’s milk. Condoms are the best contraceptive option as they are not intrusive into the mother and baby’s health, and they only need to be used when sex is going to occur, rather than the Pill which needs to be remembered every day- which is hard to do with a new born! Some people believe breast-feeding is contraceptive, but this is false. It is still possible to fall pregnant again whilst breast-feeding a baby.

 

Different Types of Contraception

Condoms

What- The male condom is a sheath worn over the penis during intercourse. It prevents pregnancy by acting as a barrier and preventing the man's semen from entering the woman's vagina (or also for anal intercourse between men and women and men and men), so sperm can't reach a woman's "egg".

Use of condoms allows males to have an active part in preventing pregnancy. Condoms also lessen the chance of males and females contracting a sexually transmitted infections, including HIV. They act as a barrier to some organisms that carry sexually transmitted infections, so these organisms cannot pass from one partner to another. Condoms are usually made out of latex, which offers the best protection against pregnancy and STIs, although, for people allergic to latex, there are polyurethane condoms available. Condoms may be lubricated or unlubricated, some contain spermicides already and some do not. It is best to use condoms without spermicide. To make sure you are using them properly you must check the use by date, use a new one each time you have sex, and ensure you are putting it on and taking it off the right way. To reduce the chance of breakage condoms should be used with a water-based lubricant. There are dozens of sizes, styles, shapes, and features of condoms to choose from.

Pros- Protects against sexually transmitted infections, condoms are cheap, easily available, don’t need a prescription, are effective when used properly, easy to use(how to use a condom), no side effects, only need to use them when having sex, many different sizes, styles, shapes and features, always hygienic as they are only used once

Cons- Some condoms can interrupt sex, can break if not used properly, can only be used once

The Pill

What- Birth control pills, also known as "The Pill," are a type of contraception in the form of small tablets that are swallowed each day. Most pills contain two type of synthetic (man-made) female hormones, progestin and estrogen, and are called the "combination oral contraceptive". The hormones estrogen and progesterone are normally produced by the ovaries. The estrogen and progestin prevent pregnancy by suppressing your pituitary gland, which stops the development and release of the egg in the ovary, called ovulation. The progestin also helps to prevent the sperm from reaching the egg and changes the lining of the uterus. One type of pill contains only one hormone, progestin, and is called either the "progestin-only pill," or the "mini-Pill." It works by suppressing ovulation and helping to prevent the male's sperm from reaching the egg. Doctors will advise which Pill is most suitable.

Pros- Doesn’t interrupt sex, lighter periods, decrease in menstrual cramps, less chance of becoming iron deficient, can improve acne

Cons- Doesn’t protect against STIs, need to visit a doctor, need a prescription, can be expensive, need to take it every day at the same time, can decrease in effectiveness if taken incorrectly, effectiveness decreases when taken with antibiotics, or when suffering with vomiting or diarrhoea, possible weight gain, mood swings

Hormonal Injections

What- Depo-Provera contains a man-made form of the hormone progesterone, which is called depot medroxyprogesterone acetate (DMPA). The Depo-Provera injection gives 3 months safe guard against pregnancy. The injected DMPA suppresses your pituitary gland, which in turn stops the ovaries from releasing eggs. The injections also change the lining of the uterus and the mucus in the cervix. By changing your cervical mucus, the hormones make it more difficult for sperm to reach the egg. You need one injection every 3 months to be protected against pregnancy.

Pros- Don’t have to remember to use it day to day, doesn’t interrupt “the mood”, lighter or no periods, decrease in menstrual cramps, less chance of anaemia (iron deficiency), is highly effective.

Cons- Doesn’t protect against STIs, possible weight gain, have to visit the doctor every three months, irregular periods, headaches, possible bone mineral loss, possible depression, can be expensive, can cause skin problems, can take a year or more for periods to return to normal.

Hormonal Implants

What- Hormonal implants are tiny rods the size of a matchstick and contain hormones that are inserted under the skin. Hormonal implants are a type of contraception that lasts for 3 to 5 years. The rod is inserted on the inside of the upper arm, with local anaesthesia. The procedure takes five minutes and is performed at a health care provider’s office. The rods slowly release levonorgestrel or etonogestrel that suppresses the pituitary gland and stops her ovaries producing eggs.

Pros- Don’t have to remember to use it day to day, doesn’t interrupt sex, lighter or no periods, decrease in menstrual cramps, less chance of anemia (iron deficiency), is highly effective.

Cons- Doesn’t protect against STIs, possible weight gain, irregular periods, headaches, possible scalp hair loss or excessive hair growth, possible depression, is expensive to implant and expensive to remove, can cause acne, involves minor surgery

Female Condom

What- The female condom is a lubricated polyurethane sheath worn by the female inside of her vagina during sex. The female condom acts as a barrier to sperm and many sexually transmitted diseases by completely lining the vagina. The female condom has a ring at each end. One ring, at the closed end of the sheath, lies inside the vagina. The other ring, at the open end of the sheath, lies outside the vagina after the female condom has been inserted. The female condom provides protection against pregnancy and some protection against STDs.

Pros- It is cheap, don’t need a prescription

Cons- It isn’t very effective, isn’t readily stocked in many shops, difficult to use, can be uncomfortable and noisy when used, it can move easily, is much more intrusive to use than the male condom, more expensive than the male condom

Spermicides

What- There are different forms of spermicides, including vaginal creams, foams, films, and suppositories. Spermicides work by forming a chemical barrier that either kills sperm or paralyses them. So the sperm can’t pass through your cervix to fertilize the egg. Spermicides can be used alone as a form of contraception, but is highly recommended to be used with another type of contraception.

Pros- It is cheap, doesn’t need a prescription

Cons- Is not very effective, doesn’t protect against STIs, can cause urinary tract infections, have to wait for 10-15mins after insertion before engaging in sexual intercourse, only lasts for an hour, using it frequently and having regular sex can increase the chances of contracting HIV. The ISO condom committee members are recommending not to use spermicides, and some effort has been made towards banning them altogether.

Diaphragms

What- The diaphragm is a soft, rubber dome with a flexible rim. It forms a barrier to stop sperm from reaching the cervix, so pregnancy doesn’t occur. It is always used with spermicidal cream or gel, which has a label that says it is to be used with the diaphragm. The dome covers your cervix, so that the spermicidal gel on the dome is near your cervix.

Pros- Can be inserted up to two hours before intercourse, reasonably cheap

Cons- Doesn’t protect against STIs, need a visit to the doctor and a prescription, not effective if used improperly, can be difficult to use, needs to be replaced every two years, or if the woman has had any weight fluctuation or has had a baby, increased possibility of developing a urinary tract infection.

Cervical Cap

What- The cervical cap is a soft, rubber, dome-shaped cup with a firm rounded rim. The rim fits tightly around the base of your cervix. The cap forms a physical barrier to stop sperm from reaching the uterus. Spermicidal gel is always used with the cervical cap to kill or paralyse sperm.

Pros- Can be inserted several hours before having sex, relatively cheap, can be left in for up to 48 hours.

Cons- Doesn’t protect against STIs, need to see a doctor to be fitted, a prescription is needed, difficult to use correctly, can move during sex, some women experience odours when using it, can cause changes in the cells of the cervix, so increased pap smears are recommended

Emergency Contraception (Morning-after Pill)

What- Emergency contraception is a treatment to prevent pregnancy in women who have had unprotected sex. This method is sometimes called the "Morning After Pill," but it can actually be used within 4 days of unprotected sex. Emergency contraception is more effective the sooner it is taken after unprotected intercourse. It uses a high dose of birth control pills to give a strong, rapid burst of hormones. This breaks the hormonal cycle needed to get pregnant. Laws differ from country to country, so if it is required, seek medical advice. It is to be used as a once-off emergency treatment, if the condom is used improperly or breaks, diaphragm or cervical cap is moved and any time unprotected sex occurs.

Pros- May help prevent pregnancy if unprotected sex occurs or if the contraceptive used was not utilised properly,

Cons- It doesn’t protect against STIs, not always effective, can cause nausea, vomiting, dizziness, breast tenderness, headaches, cannot be used as a regular contraceptive, can be expensive.

Intra-Uterine Devices

What- An intra-uterine device is a special device that fits inside of the uterus. There are various types of IUDs. One type contains the hormone  levonorgestrel. The hormone is continuously released into the uterus. Another type is a copper IUD. The copper IUD has copper wire coiled around the stem and arms of the device. Both are about 1 1/4 inches tall. Each IUD has a string attached to the end, so the woman can check that the IUD is in place and so it is easier for your health care provider to remove it. The IUD is inserted into your uterus through your vagina and protects against pregnancy. The IUD is a good form of contraception if you are not at risk of getting a sexually transmitted disease. It is best for women who are in a steady relationship with one partner. An IUD prevents pregnancy by stopping sperm from reaching an egg that your ovaries have released. An IUD also changes the lining of the uterus so an egg does not implant in the lining if it has been fertilized. Therefore, the egg has no place to grow.

Pros- It is quite effective, the newest IUDs can stay in for   5-10 years

Cons- The IUD does not protect against STIs, it is expensive, need to undergo exams, lab tests and insertion before use, need a doctor to insert and remove it, possible cramps, may have spotting or bleeding between periods, increased risk of pelvic inflammatory disease during the first six weeks after insertion.