Family planning

 

 

 

 

The difference between family planning and contraception

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Contraception, or birth control, are the methods you can use to avoid unintended pregnancy.

Family planning is the process where you are preparing for pregnancy, by either starting to think about or are trying to have a baby.

Contraception

 

There are many forms of contraception to consider. These are also known as birth control and aim to reduce your risk pregnancy.

No method of contraception is 100% effective. If you have unprotected sex (even once), then you are at risk of getting pregnant.

Regardless of the type of contraception you choose, using condoms means you also benefit by reducing your risk of getting a sexually transmitted infection (if either you or your partner are having sex with other people).

 

Choosing the right contraception

 

When selecting the most suitable method of contraception, there are certain factors you should consider.

Your general health

  • Lifestyle
  • Relationships
  • Risk of getting a sexually transmissible infection (STI)
  • Ease of use
  • Cost
  • Possible side effects
  • Effectiveness against pregnancy
  • Plans for future pregnancy

Before choosing any contraception, it is important you have access to accurate information on your options. If you are in a relationship, then ideally you should discuss your options with your partner.

You and your doctor can discuss the benefits and disadvantages of each type of contraception so you select the contraception that best meets your current and future needs.

 

Types of contraception

 

Whatever contraception you select, it is important to remember that not one is 100% effective and most do not protect against sexually transmissible infections.

Contraception options include:

  • Oral pills – typically a daily pill.
  • Long Acting Reversible Contraception (LARCs) – these forms of contraception can last from three to ten years.
  • Barrier methods – use each time you have sex.
  • Natural methods
  • Emergency contraception
  • Sterilisation

 

Oral contraceptive pill

 

Oral contraceptive pills need to be taken every day to be effective.

Combined oral contraceptives (COCs)

The combined oral contraceptive is commonly referred to as the ‘pill’ or the ‘combined pill’.

This contains two hormones, oestrogen and progestogen, which are similar to the hormones produced by your ovaries.

You take one pill around the same time every day. Each pack of pills covers a 28-day timeframe and include both hormone and sugar pills.

The sugar pills are taken during your period, however they can be skipped.

Progestogen-only pills (POPs)

The progestogen-only pill is commonly referred as the ‘mini-pill’ and contains the hormone progestogen. It can be taken while you are breast-feeding.

You take one pill around the same time every day. Each pack of pills covers a 28-day timeframe and does not contain any sugar pills.

 

LARCS – Long Acting Reversible Contraception

 

There are three LARCS commonly used and these include implants, an IUD or a contraceptive injection.

Not all doctors at our practice administer LARCs so it may be necessary for your regular GP to refer you to one of them to carry out the procedure. Our reception staff can help you with bookings.

 

Contraceptive implants

 

The contraceptive implant, Implanon NXT®, is a small thin flexible rod inserted just under the skin on the inside of your arm. It is 4 cm long, made of plastic and works for three years.

Inserting and removing the implant is carried out via a small cut to your skin, once the area has been numbed with a local anaesthetic. This may leave a small scar.

Once in place you will be able to feel the implant but not see it. If you can’t feel the implant at any time, then use another form of contraception (such as condoms) until you have checked its status with your doctor.

 

IUD

 

An intrauterine device (IUD) is a small contraceptive device that is inserted into the uterus.

  • There are two types of IUDs available in Australia:
    Copper IUD – this is designed to stay in place for up to 10 years.
  • Hormonal IUD Mirena™ – this can stay in place for 5 years.

The IUD is placed inside your uterus through the cervix. You don’t need to worry re feeling this as all components of the IUD is put well up into the vagina.

Prior to having an IUD fitted, your doctor will:

  • Take swabs to ensure you don’t have a pelvic infection
  • Conduct a PAP test
  • Conduct a pregnancy test if required

 

Contraceptive injection (DMPA)

 

DMPA (Depot medroxyprogesterone acetate) is a contraceptive injection and is delivered by your doctor every 12 weeks.

 

Barrier methods

 

It is not necessary to see your doctor for a prescription for barrier contraception, as these are generally available from pharmacies or online.
There are three main types of barrier contraception:

  • Diaphragm
  • Male condoms
  • Female condoms

 

Diaphragm

 

A diaphragm is a shallow, cup-shaped device made of silicone. This is used in conjunction with a lubricant gel and placed inside the vagina to cover the cervix, which is the opening to the uterus. It acts as a barrier to prevent sperm from passing through the cervix into the uterus.

To be effective, the diaphragm must stay in place for at least 6 hours after sex but no longer than 24 hours.

Diaphragms can be used approximately 6 weeks after giving birth.

Before using a diaphragm, you may wish to consult with your doctor or practice nurse to check the sizing and that you are inserting it correctly.

 

Male condoms

 

The male condom is a thin pouch that is usually made of latex or polyurethane. This is placed over an erect penis and prevents the semen from entering the vagina.

If used correctly, condoms are an effective method of preventing pregnancy and sexually transmissible infections. Condoms can only be used once and then must be thrown into a bin and not down the toilet.

Always check the expiry date before use.

Condoms can be purchased from supermarkets, pharmacies and petrol stations.

 

Female condoms

 

The female condom is a soft pouch made of latex or polyurethane, which has two flexible rings at each end and is inserted into the vagina prior to sex. It prevents the semen from entering the vagina.

If used correctly, condoms are an effective method of preventing pregnancy and sexually transmissible infections. Female condoms can only be used once and then must be thrown into a bin and not down the toilet.

Always check the expiry date before use.

Female condoms can be difficult to get and are expensive. Some pharmacies stock them and they are available online.

 

Emergency contraception

 

The emergency contraceptive pill which is often called the ‘morning after pill’ can be effective up to five days after having unprotected sex but is more effective the earlier you take it.

It can prevent pregnancy if you’ve had unprotected sex, forgotten to take your prescribed contraceptive pill or a condom broke or came off the penis during sex.

You don’t need a prescription for the emergency contraceptive pill if you get it from a pharmacy.

You should make an appointment to see your doctor if you have concerns about having contracted a sexually transmissible infection, or your next period does not arrive at the normal time.

 

Natural contraceptive methods

 

Some natural contraceptive methods, like the calendar method or rhythm method, rely on you identifying your most fertile days and abstaining from sexual intercourse or using a barrier method during these times.

The withdrawal method, or coitus interruptus, is another natural contraception however is also one of the least effective.

 

Contraception and breastfeeding

 

Breastfeeding is reasonably effective in preventing pregnancy however it is reliant on the following factors:

  • Your baby is 6 months old or younger
  • You haven’t had a period since your baby was born
  • Your baby has no other food or drink besides your breastmilk.

It is best to consult with your doctor before relying on breastfeeding as contraception.

 

Contraception and menopause

 

There is no test that can diagnose whether you are in menopause and generally your doctor will rely on your symptoms and date of last period.

Menopause can be disguised if you are taking the combined contraceptive pill, as this will likely have affected your periods.

Menopause is when your periods stop permanently and means you are no longer fertile. It is generally diagnosed using the following parameters:

  • If you are over 50 and have not had a period for more than 12 months
  • if you are under 50 and have not had a period for more than 2 years

 

These rules do not apply if you are taking hormonal contraception.

Contraception to prevent pregnancy should be used:

  • If you are aged under 50, for 2 years after you have had your last period
  • If you are aged between 50 and 55, for 1 year after you have had your last period

After the age of 55, women can stop using contraception as the chances of getting pregnant (naturally) is extremely rare.

A barrier method of contraception (such as condoms) should be used to avoid contracting a sexually transmissible infection.

 

Permanent sterilisation

 

Permanent contraception are methods of sterilisation that permanently prevent pregnancy. The procedure for men is a vasectomy and for women it is tubal ligation.

 

Medical termination of pregnancy

 

Medical termination of pregnancy, also known as medical abortions, are available in appropriate circumstances.

If you are considering a medical termination make an appointment to see your doctor to discuss your options.

You can learn more about medical termination of pregnancy here.

Family planning

As you consider having a baby, whether you are actively trying or even just thinking about it, it is never too early to prepare for the healthiest pregnancy possible.

Your doctor can help with your pre-conception health care. These are the actions you can take before and between pregnancies, to ensure you are at your healthiest so you can increase your chances of having a healthy baby.

Some of the things your doctor may do:

  • Discuss your health history and any medical conditions you have that may affect your pregnancy, such as diabetes, STIs and high blood pressure.
  • Discuss any prior pregnancy problems.
  • Review the suitability of any medications you are taking, both prescribed and over the counter, as well as herbal remedies or vitamin supplements.
  • Recommend vaccinations or blood tests.
  • Look at lifestyle behaviours which could impact the health of you or your baby, such as smoking, alcohol or drug intake.
  • Ask about your home circumstances and anything which might impact your physical wellbeing, such as stress or abuse.
  • Assess your weight; if you are overweight, being obese or underweight it can put you at higher risk of complications during pregnancy.