Family Planning & Contraception

Family planning is one of the most important issues facing couples. While this usually begins with the question, "How many children do you want to have?" the conversation should not stop there. Many different factors influence decisions about family planning, many choices of contraceptives are available, and sometimes unexpected issues must be faced.

Family Planning

• Family planning is the purposeful act of deciding when to have children and then using birth control to make it happen at the right time. Before deciding how many children to have there are other questions to explore, starting with "do I want to have children." Deciding when to have children can be complicated. Career goals or other life plans and financial stability must be considered. Emotional and personal issues need to be added to the equation, including the questions: Are you ready for the lifestyle changes that will be required? Are you prepared to devote the time necessary to raising a child? Are both partners in agreement about all of these issues? Will we need daycare or will one of us stay at home? What is our approach to discipline? Remind yourself that this is a major commitment and be sure that expectations are realistic.

Contraception

• Contraception is the deliberate prevention of pregnancy. This can be accomplished by many methods but they have different rates of effectiveness and ways of working. Of course, the most effective contraception is abstinence. According to Planned Parenthood's effectiveness chart, intrauterine devices have an effectiveness of 99% and oral contraceptives, the patch or ring are 92% to 98% effective. The patch, ring, and oral contraceptives all contain hormones that prevent an egg from being released. Barrier techniques such as a condom or diaphragm are 75% to 85% effective. A condom is the only form of contraception that also protects against sexually transmitted diseases.

Fertility Awareness

• This method can be used to prevent pregnancy or plan for when a woman has the highest chance of becoming pregnant. The goal is to know when a woman is fertile by identifying when ovulation has taken place because an egg can only be fertilized for one day after ovulation. Certain physical changes indicate ovulation and these can be monitored with urine tests that measure luteinizing hormone, by taking the basal body temperature, or by charting menstrual periods to determine which days in the cycle are the most fertile.

Planning for Pregnancy

• If you've decided it is time to get pregnant then there are some steps you can take to improve the health of your baby. Take extra vitamins and be careful to get enough folic acid, which should be taken before conception and during pregnancy to protect against neural tube defects in the baby. Stop smoking, drinking alcohol, or taking drugs unless they are prescription medications and you've talked to your physician about any threat they may pose to the fetus. Smoking can cause miscarriage, premature birth and low birth weight and alcohol during pregnancy can lead to fetal alcohol syndrome. Men should also limit alcohol, smoking, steroids, or saunas and hot tubs as all of these have an effect on sperm count.

Complications

• While you can't always plan for complications, sometimes it helps to be aware of potential risks. Remember that age is a significant factor that affects a woman's ability to get pregnant and the baby's health. Some couples finally make the decision to begin a family only to discover there are health issues that make it difficult to conceive. If you are aware of any genetic traits that run in the family and that cause concern, be sure to talk with your doctor to find out what your chances are of carrying the gene or to obtain genetic testing.