Family planning options for pregnancy prevention

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In this handout, we are going to look at all family planning options categorized into the following 8 sections.
 

1. Surgical methods for sterilization (permanent birth control)
2. Long term, but not permanent
3. Hormonal methods
4. Barrier methods
5. Other methods that are non-hormonal and non-barrier 
6. Natural Family Planning
7. Lactation Amenorrhea Method
8. Combination options

 
Note: I do not use brand names in this handout. There are different brands of all the contraceptive products mentioned. I do not endorse any brand.
 
SURGICAL PROCEDURES (all permanent)
Surgical procedures are for sterilization. Reversal can be done with some methods, but may not be successful. Sterilization is a good method for couples or individuals who are positive they are done having children. 

• Male
  • Vasectomy
• Female
  • Salpingectomy – removal of the uterine tubes
  • Tubal ligation – having your “tubes tied”
  • Tubal implants – putting a barrier in the uterine tubes to block access to the egg

 
LONG TERM, BUT NOT PERMANENT

• IUDs (intrauterine devices)  
  • hormonal  
  • non-hormonal  
• the implant that goes in your arm (hormonal)

 
HORMONAL METHODS, SHORT TERM OR LONG TERM
These are hormonal methods that you can use month to month and stop easily if you want to. You can also use these options for years.

• the pill – there are many brands of “the pill” and they come with different doses
  • the combination pill (progestin and estrogen)
  • the mini-pill (progestin only)
• the patch
• the ring
• the shot

 
BARRIER METHODS

• Devices to block the cervix
  • Diaphragm
  • cervical cap
  • shield
  • sponge 
• Female condoms
• Male condoms

Note that male condoms are the only birth control option that also protects against STIs (sexually transmitted infections). Also, the effectiveness of condoms is based on pregnancy prevention. The rate of effectiveness against specific STIs will be different.
 
METHODS THAT ARE NON-HORMONAL AND NON-BARRIER

• Spermicides
• Withdrawal AKA the pull-out method

 
NATURAL FAMILY PLANNING
Natural Family Planning methods are unique because they can be used to avoid pregnancy or try to conceive. If you are using NFP to avoid pregnancy, you will monitor for ovulation and then choose to abstain from sex during your fertile days. There are no devices or hormones or barriers. For couples that have a religious objection to contraception, natural family planning is often not considered to be in violation of that belief because it’s not actually a contraceptive.

• Cervical mucous methods – Creighton Model, Billings Ovulation Method
• Sympto-thermal methods – monitoring for signs of ovulation such as basal body temperature and cervical mucous
• Sympto-hormonal methods – this is using ovulation testing kits monthly to confirm ovulation
• The calendar method also known as the rhythm method – avoiding sex on your fertile days based on your average cycle length and expected day of ovulation

 
LACTATIONAL AMENORRHEA METHOD 
Breastfeeding exclusively and on demand provides natural pregnancy prevention for the first 6 months after birth. This is 98% effective.
 
COMBINATION OPTIONS
Sterilizations are highly effective. There is no need to combine any other method with that. You can combine any hormonal method or IUD with any barrier device. For example: She can be on the pill and he can use a condom. Another option is to combine natural methods with barrier devices. You can use natural family planning to monitor ovulation and use condoms or withdrawal on your fertile days. 
 


OPTION TO NOT USE ANY PREGNANCY PREVENTION
There is also the option to choose not to use any method of pregnancy prevention. For people who are religious, it’s 100% fine to leave the timing and number of children up to God. Some people have religious convictions against contraception. Others feel that no one can be born who isn’t meant to exist. You can leave things up to what is meant to be. Or you can use any of the methods mentioned above. Choose the family planning options that are right for you in this season of your life.
 
 
Important Note: All sterilizations, IUDs, and hormonal methods come with potentially serious health risks. Be informed on potential side effects and risk factors before beginning any method. Talk to your gynecologist about any risk factors you may have and which options are good for your individual health.

Maternal-infant Wellness Education
with Leanna Mae

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