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home : health : health Friday, November 24, 2017

7/9/2014 1:51:00 PM Email this articlePrint this article 
Family Planning: An Essential Component of Life Planning

By Shoua Vang

Family planning is about making choices and asking questions. Do you want to be a parent? Do you want a career? A college education? At an early age, it is important for people to envision what kind of a life they want. Having a child is an important life event, but when and IF a pregnancy occurs will profoundly affect every other aspect of life. "The best preparation for parenthood might be a full life prior to parenthood that involves the establishment of a secure and nurturing relationship between parents, desired educational attainment, career development, and life experiences," according to Wendy Hellerstedt, an Associate Professor who studies unintended pregnancy at the University of Minnesota's School of Public Health.

Family planning is thus about more than birth control use--it is ensuring that individuals and couples create a pregnancy when and if they want to do so. "It is an essential part of life planning," Hellerstedt said.

Family planning services include: counseling; preconception care; screening and laboratory tests; and education about, and access to, all FDA-approved methods of contraception. For many people, childbearing is unplanned because pregnancies "just happen." In 2008, 45% of all pregnancies in Minnesota were unintended. While women often adapt well to an unintended pregnancy, there is evidence that women with unintended pregnancies, compared to women with intended pregnancies, are at higher risk for abortions. If they desire to continue an unintended pregnancy, they are also at higher risk for infant complications and health problems. Family planning allows individuals and families to optimize the health of the mother and infant as well as prepare for the tremendous life changes that occur during pregnancy and after the birth of a child.

Family Planning that Meets the Needs of Individuals and Couples

For some individuals, there are external and internal barriers to family planning. Some of the external barriers, like cost and access to services, and internal barriers, like lack of knowledge, may be easily addressed. However, some internal barriers require self-reflection and thoughtfulness--they include conflicts between cultural norms and personal desires, indecision, and confusing priorities.

In the last year, the cost of family planning services has become less of a barrier because of the Affordable Care Act (ACA). The ACA requires that most health insurance plans (including Medicaid) cover all FDA-approved contraceptive methods and education and counseling for all women, as prescribed by a health-care provider. These services must be completely covered without a co-pay, coinsurance, or deductible. Individuals can find more information about contraceptive coverage by reviewing their plan's policy or asking their employer's benefits administrator.

In addition to cost, women and teens often don't know where to go for family planning counseling and services. Finding a provider may seem like a daunting task, but there are many available, especially to people in urban areas. Family planning services can be provided by a primary doctor, public health nurse, or other health-care providers. If someone does not have a primary health-care provider, clinics like Planned Parenthood, Clinic 555 (Ramesy County, http://www.co.ramsey.mn.us/ph/hs/birth_control.htm), or Red Door Services (Hennepin County, http://www.reddoorclinic.org/) can also provide those services. Family planning is also an important topic for men. Hellerstedt explains, "Men become parents and men are interested in the timing of their transition to fatherhood. Family planning clinics welcome men and health-care providers would be delighted, I am sure, to have more men ask them about family planning."

The easiest family planning barrier to overcome may be knowledge. Health-care providers and educators want to help people understand their family planning options and they know how to convey information in an understandable and accurate way. "There are also many opportunities for people to educate themselves before they speak with a family planning provider. There are some great websites available for people (see For More Information)," said Hellerstedt.

According to Hellerstedt, many of the barriers to effective family planning are internal. "Sometimes people face cultural barriers to taking control of their reproductive lives. For example, some individuals live in cultures that have myths about some family planning methods that are not supported by the scientific literature. It is not uncommon to hear that people are afraid of some contraceptives because they incorrectly believe they will cause sterility--an inability to have children" she said. There are also barriers to thoughtful planning decisions that go beyond misinformation. "We recently completed a research project with low-income youth in Alabama that showed that some adolescents see having a child as a marker of being a 'real man' or a 'real woman.'" Hellerstedt reflected. "If we value children, they should not be brought into the world to serve the needs of parents. Parents should be able to meet their own psychological and emotional needs before they become parents. Parenting means guiding a child to development, not using a child to further one's own development," she said. Families may also push individuals to become parents; people may want to parent in order to strengthen a romantic relationship; or they may feel that becoming a parent ("having someone to love me") will help them have happier lives. It is important for people to reflect on WHY they want to become parents.

Family Planning Methods

Birth control includes "natural" methods (e.g., withdrawal, fertility awareness methods), barrier methods (e.g., condoms, diaphragms), and hormonal methods (e.g., birth control pills, IUDs, implants, patch, and injections). The most effective family planning method is one that you and your partner are most comfortable with.

An area of family planning that is receiving attention is Long-Acting Reversible Contraception (LARC). These hormonal methods for women are known to be safe and very effective. Contraceptive methods often fail because people forget to do something.--they don't take a pill on time or don't use a condom. With LARC, you have a method, like an IUD or an implant, that does not depend on the user remembering to do something or visiting a provider frequently. These methods are safe, have low discontinuation rates, are more than 99% effective, and most important, they are reversible. Individuals can live their lives and when they are ready, discontinue the LARC and start a family.


• Centers for Disease Control and Prevention, http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm

• Planned Parenthood, http://www.plannedparenthood.org/health-topics/birth-control-4211.htm

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