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Family planning/birth control is voluntary control of the number of children conceived through contraception.

It involves techniques used to prevent the birth of a child such as prevention of conception or fertilization.

There are many methods of contraception, some of which are reversible while others are irreversible.

Despite the wide availability of contraceptives, still there are cases of unplanned pregnancies.

What should you consider when choosing a Contraception Method?

Let us start by looking at the characteristics of an ideal family planning method

What are the characteristics of an Ideal Method?

The method should be:

  • 1.Highly effective
  • 2.Have minimal or no side effects at all
  • 3.Affordable / Cheap
  • 4. Rapidly available in case one wants to conceive
  • 5.Easily available
  • 6.Acceptable to one’s culture and religion
  • 7. Not interfere with one’s sexuality
  • 8.Easy to use by non-healthcare personnel.

Classification of contraceptives

These methods of family planning can be classified into various categories based on how they work. That is;

  1. Hormonal Contraceptives - (Oral Contraceptive Pills, Injectables, Implants
  2. Intrauterine Devices.
  3. Barrier methods (condoms, diaphragms, etc.)
  4. Natural methods (safe days, EBF, etc.)
  5. Coitus interruptus (Withdrawal method)
  6. Emergency contraception
  7. Sterilization (Vasectomy and female sterilization)

Hormonal Contraceptive Methods

These are family planning methods that use hormones to prevent pregnancy.

Hormonal contraceptives include the pill and the Depo Provera injection.

There are two types of family planning pills available:

  1. combined oral contraceptive pill
  2. progestogen-only contraceptive pill

These combined oral contraceptive pills are taken one each day of the month. For maximum efficacy and reduced chances of failing, one is supposed to take the tablet daily.

They are more than 99% effective at preventing pregnancy if you take it correctly.

Hormonal contraceptives also are available in the form of injectables such as Depo Provera.

With Depo, You get an injection every three months. If you get your injections on time, Depo Provera is more than 99% effective but typically it is 97% effective.

Long-Acting Contraceptive methods

Long-acting reversible contraception or in short LAC is a contraceptive that lasts for a long duration of time when compared to other methods.

There are two common types of long-acting contraceptive methods:

  • The intrauterine device (IUD) that lasts for three or five years
  • The implant that lasts for three or five years. The most common implants are Implanon which lasts for three years and Jadelle that lasts for five years

These long-acting contraceptive methods are also known as “fit and forget” contraception because once it has been inserted in, you don’t need to remember it every day of every month.

LARCs are the most effective types of contraception. They are more than 99% effective at preventing pregnancy.

Barrier Methods of contraception

Barrier methods of contraception work by preventing the entry of sperm into the vagina. The two common barrier methods are:

  • Male condoms
  • Female  condoms

These latex condoms protect against sexually transmitted infections (STIs) as well as unplanned pregnancy.

Emergency contraception pills (e-pills)

These emergency contraceptive pills are a kind of preventive emergency contraceptive method that is approved to be taken within three days after unprotected sex. It has an effectiveness of about 98% when used correctly. 

If you weigh more than 70kg, the ECP is less effective and a copper IUD is recommended. If you weigh more than 70kg and you choose to take ECP, you should ask if taking a double dose is the right option for you.

The copper IUD can be inserted up to five days after unprotected sexual intercourse and is more than 99% effective at preventing pregnancy.

This emergency contraception can be used to prevent unplanned pregnancy if:

  • One has not used any protection
  • The normal contraception fails e.g. condom splits
  • One has missed more than one contraceptive pill
  • Has missed the Depo Provera injection
  • One has been forced to have sex without contraception.

The ECP as your regular method of contraception is less effective than if you were using a LARC or hormonal method. 

All these methods are effective for the prevention of pregnancy even though all methods may fail.

Apart from abstinence and male sterilization, no other method is 100% effective.

Of all the methods, there is no one method that will suit everybody. Different individuals have different preferences and body responses to the methods chosen.

This table gives you an overview of each contraceptive method and failure rates respectively.

Contraceptive method

Failure rates

Progesterone only pill

0.1-1

Depo Provera

0.1-3

Implanon

0

Copper-bearing IUCD

1-2

Levonorgestrel-Releasing IUD

0.5

Male condoms

2-5

Female diaphragm

1-15

Persona

6

Natural family planning

2-3

Vasectomy

0.02

Female sterilization

0.13