Introduction to Family Planning

What is Family Planning?

Family planning is the voluntary planning and action taken by individuals to prevent, delay or achieve a pregnancy. Family planning services include counseling and education, preconception care, screening and laboratory tests, and all FDA approved methods of contraception.

Why is family planning part of the health department?

The Centers for Disease Control characterizes family planning as one of the top 10 public health achievements of the 20th century. In 1800, women had an average of 7 children; today women average 2.1 children. A woman is fertile for an average of 35 years of her life; if she has two children, she will spend about 30 years of her life avoiding pregnancy. Family planning information and services help individuals maintain their overall health and improve family and community health by supporting men and women to have children when their health, financial conditions, and personal situations are optimal. Access to family planning services is an important factor in planning for healthy pregnancies.

Healthy People 2020

Healthy People 2020 is a national 10-year agenda for improving the health of all Americans. Its purpose is to identify nationwide health improvement priorities, and provide measurable objectives and goals that are applicable at the national, State, and local levels. Healthy People 2020 identifies Family Planning as a key area to improve the health of Americans, with the following goal: Improve pregnancy planning and spacing, and prevent unintended pregnancy.

What is unintended pregnancy?

An unintended pregnancy is one that is unwanted or mistimed at the time of conception. It does not mean an unwanted birth or an unloved child. It does mean that there is less opportunity for the parents to prepare physically and financially, take advantage of pre-pregnancy risk identification and management, and initiate needed changes in diet, exercise, smoking and drinking that help ensure a healthy pregnancy.

Why is unintended pregnancy a problem?

Research indicates approximately half of all pregnancies are unintended at the time of conception. For some, unintended pregnancies result in healthy children in happy families. For others there are negative health effects from late or inadequate prenatal care, low birth weight, fetal exposure to alcohol, tobacco smoke and other toxins, and maternal depression. Unintended pregnancies are also associated with economic hardship, marital dissolution, poor child health and development, spouse abuse, and child abuse and neglect. Almost half of all unintended pregnancies end with an induced abortion.

How can we reduce the incidence of unintended pregnancy?

A woman's ability to avoid an unintended pregnancy is related to her level of risk for pregnancy, her choice of methods, the strength of her motivation to avoid pregnancy and her pattern of contraceptive use. These factors, in turn, are often associated with a woman's demographic and socioeconomic background, characteristics of her sexual partnerships, and her experiences with and attitudes toward pregnancy and contraception.

While slightly more than half of unintended pregnancies occur among women who were not using any method of contraception in the month they conceived; more than four in 10 occur among women who were using a contraceptive method the month they conceived. Issues related to inconsistent or incorrect use of method were the primary reason they conceived.

Research indicates that the most effective family planning method is the one the client is the most comfortable with. Client understanding of various methods and comfort with the one they choose is best accomplished with non-directive counseling and education from a family planning provider they trust. Family planning providers aim at increasing the percentage of clients who use their chosen method consistently and correctly. Recent studies also have shown that when comparing the effectiveness of all family planning methods, Long Acting Reversible Contraceptives (LARCS) are the most effective with less than 1 pregnancy per 100 women in 1 year. LARCS include contraceptive implants and intrauterine devices. LARCS are more effective than other methods such as the Pill because user error is eliminated.

Cost benefit of Publicly Funded Family Planning Services

The Guttmacher Institute estimated the costs necessary to pay for maternity and infant care costs for unplanned births among Medicaid-eligible women. Their cost-benefit analysis indicated that for every $1.00 spent to provide services in publicly funded family planning clinics, a savings of $4.02 was realized in averted Medicaid birth costs.