Course Code

Description NSTP 2
Pre-Requisites

Department: General Education Department Week 13

FAMILY PLANNING AND BIRTH CONTROL Module No. 11

LEARNING OUTCOMES

At the end of this module, the students are expected to;

1. Define family planning and contraceptive use

2. Describe the importance/benefits of family planning and contraceptive use
3. Understand the Medical Eligibility Criteria for Contraceptive Use
4. Describe the different family planning/contraceptive methods available
5. Discuss termination of pregnancy and its role in family planning

INTRODUCTION

Use of modern family planning methods, which include pills, condom, female
sterilization, male sterilization, intrauterine device (IUD), injection,
diaphragm/foam/jelly/cream, mucus/Billings/ovulation, LAM, temperature, and
standard days method, increased in most regions. Central Mindanao, Bicol, Central
Visayas, and Cordillera Administrative Region
registered the highest increases in the
percentage of women using modern methods
between 2001 and 2002. Meanwhile, the
National Capital Region had a significant decline
in modern contraceptive use.
Thirty-five percent or about one-third of married
women in the country are using modern
contraceptive methods, according to the 2004
Family Planning Survey (FPS). This proportion is
the same as that recorded in the 2002 FPS. One
out of 10 married women (14%) uses a
traditional method, while five out of 10 (51%)
are not using any contraceptive method at all.
Modern methods include female sterilization,
male sterilization, pill, IUD, injectable, condom,
mucus/Billings/ovulation methods, Standard
Days Method and Lactational Amenorrhea Method. Traditional methods include
calendar method, rhythm or periodic abstinence, and withdrawal.
The contraceptive prevalence rate (CPR) or the proportion of married women 15-49
years reporting current use of contraceptives drops to 47.0 percent in 2000 from the
49.3 percent recorded in 1999 (Figure 1). This is primarily caused by the decrease in
the use of traditional methods (16.9% to 14.7%), particularly withdrawal (6.7% to

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 4.8%). Meanwhile, the prevalence rate of modern methods leveled off in the last two
years (32.4% in 1999 and 32.3% in 2000).
Contraceptive use among married women in the Philippines has almost tripled over
the last 30 years, from 17 percent in 1973 to 49 percent in 2003 (Table 1).
Furthermore, two Filipino women in five who are not currently using a contraceptive
method declare having the intention to use one in the future (Table 2), according to
results just released by the 2003 National Demographic and Health Survey (NDHS).
The National Statistics Office (NSO) conducted the NDHS, a nationally representative
survey of 13,000 households, 14,000 women age 15-49- and 5,000-men age 15-54.

COURSE CONTENT

FAMILY PLANNING
“The practice of controlling the number of children one has and the intervals
between their births, particularly by means of contraception or voluntary
sterilization”
In the Philippines, the challenge of encouraging more couples to use contraceptives
is still imperative. However, this mission is no longer limited to the adoption of
contraception, but also includes the selection of appropriate methods that suit client
needs and the maintenance of effective use over time. It is in this light that an
analysis of contraceptive use dynamics focusing on the determinants of method
choice and discontinuation is useful to better guide policy and program directions.

The Philippines ranks as the fifteenth most populous country in the world and eighth
in the Asian region (DOH, 1996). Its population is expected to increase from 68.3
million in 1995 to 91.8 million by 2010, even if replacement fertility is attained by the
year 2010 (NSO et al., 1999:32). For more than three decades, the Philippine family
planning program has been implementing strategies aimed at managing the
population in relation to the developmental needs of the country. The emphasis
provision of family planning information and services is based on a policy of
noncoercion and respect for religious and moral convictions. Emphasis is placed on
the health benefits derived from practicing family planning. However, rapid increases
in contraceptive prevalence have heightened the awareness that method choice and
contraceptive discontinuation are important research and policy questions.

Family planning was first introduced in the Philippines by the private sector in the
early sixties. It was only through the Population Act of 1971 that family planning was
integrated into the government’s development plans. In general, the transition to
low fertility has been slow in the Philippines, particularly in comparison with
neighboring Asian countries.

 Every day, 1,600 women and more than 10,000 newborns die from
preventable complications during pregnancy and childbirth.
 Almost 99% of these maternal and 90% of neonatal deaths occur in the
developing countries.
 18.5 million women experience an unsafe abortion each year in developing
countries and 13% of all maternal deaths are as a results of unsafe abortion
 • Family planning plays a major role in reducing maternal and newborn
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 morbidity and mortality as well as unsafe abortions.

BENEFIT OF FAMILY PLANNING

• Preventing pregnancy-related health risks in women
• Reducing infant mortality
• Slowing population growth (WHO)
• Helping to prevent HIV/AIDS
• Empowering people and enhancing education
• Reducing adolescent pregnancies

CONTRACEPTIVE METHODS
Methods of contraception include oral contraceptive pills, implants, injectables,
patches, vaginal rings, Intra uterine devices, condoms, male and female sterilization,
lactational amenorrhea methods, withdrawal and fertility awareness-based
methods. These methods have different mechanisms of action and effectiveness in
preventing unintended pregnancy.

1. Combined oral contraceptives

 Contains two hormones (estrogen and progestogen
 Prevents the release of eggs from the ovaries (ovulation)
 >99% with correct and consistent use
 Reduces risk of endometrial and ovarian cancer

2. Progestogen-only pills
 Thickens cervical mucous to block sperm and egg from meeting and
prevents ovulation
• 99% with correct and consistent use
• Can be used while breastfeeding; must be taken at the same time each
day

3. Implants
 Small, flexible rods or capsules placed under the skin of the upper arm;
contains progestogen hormone only
 progesterone only pill
 Health-care provider must insert and remove; can be used for 3–5 years
depending on implant
 irregular vaginal bleeding common but not harmful

4. Progestogen only injectables

 Injected into the muscle every 2 or 3 months, depending on product
 >99% with correct and consistent use
 Delayed return to fertility (about 1–4 months on the average) after use
 irregular vaginal bleeding common, but not harmful

5. Intrauterine device (IUD): copper containing

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  Small flexible plastic device containing copper sleeves or wire that is
inserted into the uterus
 Copper component damages sperm and prevents it from meeting the egg
 Longer and heavier periods during first months of use are common but
not harmful
 can also be used as emergency contraception
 >99% effective

6. Intrauterine device (IUD) levonorgestrel

• A T-shaped plastic device inserted into the uterus that steadily releases
small amounts of levonorgestrel each day
• Suppresses the growth of the lining of uterus (endometrium)
• Decreases amount of blood lost with menstruation over time
• Reduces menstrual cramps and symptoms of endometriosis
• >99% effective and can be used for 3 to 5 years

7. Emergency contraception (levonorgestrel 1.5 mg)

• Progestogen-only pills taken to prevent pregnancy up to 5 days
after unprotected sex
• Prevents ovulation
• Does not disrupt an already existing pregnancy (CDC)

8. Combined contraceptive patch and combined contraceptive vaginal ring

(CVR)
• Continuously releases 2 hormones – a progestin and an estrogen- directly
through the skin (patch) or from the ring.
• Prevents the release of eggs from the ovaries (ovulation)
• Effectiveness studies report that it may be more effective than the COCs,
both as commonly and consistent or correct use

9. Male condoms
• Sheaths or coverings that fit over a man's erect penis
• Forms a barrier to prevent sperm and egg from meeting
• 98% with correct and consistent use
• Also protects against sexually transmitted infections, including HIV

10. Female condoms

• Sheaths, or linings, that fit loosely inside a woman's vagina, made of thin,
transparent, soft plastic film
• Works like male condoms
• 90% with correct and consistent use

11. Male sterilization (vasectomy)

 Permanent contraception to block or cut the vas deferens tubes that carry
sperm from the testicles
 Keeps sperm out of ejaculated semen
 >99% efective after 3 months semen evaluation
 does not affect male sexual performance

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  voluntary and informed choice is essential

12. Female sterilization (tubal ligation)

 Permanent contraception to block or cut the fallopian tubes
 Eggs are blocked from meeting sperm
 >99 % effective and informed choice is essential

OTHER METHODS
• Lactational amenorrhea method (LAM)
• Standard Days Method or SDM (95%) (26-32 cycle)
• Basal Body Temperature (BBT) Method
• Calendar method or rhythm method (91%)
• Withdrawal (coitus interruptus) (96%)
• Diaphragm or cervical cap 12% failure rate
• Spermicides 28% failure rate

HORMONAL VS NON-HORMONAL
CONTRACEPTIVES
Let’s start with what they have in common:

 Both rank among the most effective forms of birth control methods.
 Both are long lasting birth control options.
 Both are safe and can be used by the majority of women, including many
women who have medical conditions that rule out other birth control
options.
 While the upfront cost of an IUD may seem more expensive, both IUD
options are less expensive in the long term when you compare them to other
forms of birth control.
 Both are easy to get started on, taking less than a minute to insert and can
usually be inserted right after deciding on it with your OBGYN.
 Both are very convenient. Once it’s in, it’s in, usually with not much follow-up
necessary. You don’t have to remember to take a pill once a day, or make an
appointment for a regular contraceptive injection, or bring along your barrier-
plus-spermicide. All you have to do is, well, nothing. It’s just there.
 Neither prevent sexually transmitted diseases ( STDs), only against pregnancy.
A condom is necessary to lower the chances of STD transmission.
Here’s where they differ:
Hormones:
This is the most obvious difference. Hormonal IUDs work by releasing a small amount
of levonorgestrel (a form of progestin) locally to the uterus each day preventing
pregnancy. Non-hormonal IUDs contain a copper coil filament whose chemical
release is contraceptive. This can be an advantage to women who can’t use
hormonal birth control. According to the Association of Reproductive Health
Professionals, “lack of hormones makes IUDs appropriate for smokers older than age
35, postpartum women who are breastfeeding, and others with contraindications to

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estrogen or progestin.”
Menstruation
Women who opt for the hormonal IUD often have irregular bleeding for the first
three to six months after insertion. After that initial adjustment period, most
hormonal IUD users have either very light periods or don’t menstruate at all. For
some women this is ideal, while others may prefer to get a regular period.
Non hormonal IUD users have a higher rate of dysmenorrhea than the non-hormonal
IUD, and may prolong the period up to 8-10 days (as opposed to the average 5 days)
for some women. However, usually after six months of usage, period bleeding
returns to normal.
Longevity
While both IUDs are long lasting, non-hormonal IUDs can be used for longer. The
non-hormonal option is usually viable for at least twelve years, if not twenty.
Hormonal IUDs can be used for 3-6 years depending on the brand.

Non-Hormonal/Barrier Hormonal
• Condoms • Pill
• Diaphragm • Patch
• Cervical Cap • Injection
• Spermicide • Ring
• Copper IUD • Progesterone IUD
• Abstinence1 • Implantable device
• Period abstinence/fertility
awareness1 Advantages
• “Withdrawal”, coitus interruptus Not event dependent
Additional health benefits
Advantages Menstrual symptoms
No hormones Acne
Fewer or no medical contraindications* Lower cancer risk
Can prevent STD Less blood loss

Disadvantages Disadvantages
Event based use Require use as prescribed
Some need a doctor’s visit Some medical contraindications

Although population growth in the 20th and 21st centuries has rocketed, it can be
slowed, stopped and reversed. Under the United Nations’ most optimistic scenario, a
sustainable reduction in global population could happen within decades.
We need to take many actions to reduce the impact of those of us already here -
especially the richest of us who have the largest environmental impact - including
through reducing consumption to sustainable levels, and systemic economic changes

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 to ensure global justice within the environmental limits of our planet.
One of the most effective steps we can take to achieve both goals – reducing our
environmental impact and ending population growth – is to choose smaller family
size, and empower those who can't make that choice freely to do so.
Population growth can be slowed, stopped and reversed through actions which
enhance global justice and improve people's lives.

EDUCATING GIRLS
Where women and girls have economic empowerment, education and freedom, they
choose to have smaller families. Greater freedom usually leads to greater uptake of
family planning and ending child marriage pushes back the age at which women have
their first child which often reduces family size.
For instance, African women with no education have, on average, 5.4 children;
women who have completed secondary school have 2.7 and those who have a
college education have 2.2. When family sizes are smaller, that also empowers
women to gain education, take work and improve their economic opportunities.

REMOVING BARRIERS TO CONTRACEPTION

Currently, more than 200 million women who want to avoid pregnancy are not using
modern contraception. There are a variety of reasons for this, including lack of access
to contraceptives, concerns about the side-effects of contraception and social
pressure not to use it.
These women mostly live in some of the world’s least developed countries, where
population is set to rise by 3bn by 2100. Overseas aid support for family planning is
essential – both ensuring levels are high enough and that delivery of service is
effective.

END NOTE
• Family planning / contraception reduces the need for abortion, especially
unsafe abortion.
• Some family planning methods, such as condoms, help prevent the
transmission of HIV and other sexually transmitted infections.
• Family planning reinforces people’s rights to determine the number and
spacing of their children.
• By preventing unintended pregnancy, family planning /contraception
prevents deaths of mothers and children

FOCUS QUESTIONS

1. What is Family Planning?

2. What is Birth Control?
3. What are the different contraceptives?

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LEARNING ACTIVITIES

Individual Activity.
FAMILY TREE

Create you own version of a

“Family Tree” and describe
your family setting.
(300 minimum words)

*Photos should be included

* With Full Names

ASSESSMENT

Answer the following questions;

1. What does your name mean? Why did you want to name me this?
2. What is the story of how my name was chosen?
3. Does anyone else in our family (past or present) have my name? If so, who?
4. What are some other interesting or important names in our family?

ASSIGNMENT

1. What is abstinence and what is its relation to our topic for this week?
2. How can we prevent pre-marital sex?
3. When a 16-year-old girl got pregnant who is responsible? The girl or the parent?

RELATED READINGS / REFERENCES

http://www.ss.cacmp.org/userfiles/23/my%20files/family%20tree
%20project%20(2nd-3rd).pdf?id=2160

https://www.who.int/news-room/fact-sheets/detail/family-planning-
contraception

https://www.slideshare.net/psbedson/family-planning-and-contraceptive

https://dhsprogram.com/pubs/pdf/FA35/FA35.pdf

https://populationmatters.org/solutions?
gclid=CjwKCAjwjLD4BRAiEiwAg5NBFifcG_EAnpg-
eOiGpCjzNHEG9YtIesYvHOUofDjj0ILdxs17xcpWNxoCwM4QAvD_BwE

https://psa.gov.ph/tags/family-planning#:~:text=Thirty%2Dfive
%20percent%20or%20about,Family%20Planning%20Survey%20(FPS).&text=One
%20out%20of%2010%20married,any%20contraceptive%20method%20at%20all.

https://www.miamiobgyns.com/blog/hormonal-nonhormonal-iud-one-right/

Sergio J. Lee (2015. National Service Training Program-Civic

Welfare Training Service I, Literacy Training Service I, 2nd
edition 2007

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 Prepared by: Approved by: Noted by:

_______________________ ______________________________ Rito A. Camigla Jr., EdD.

Faculty Program Chair VP for Academic & Student Affairs

PLAGIARISM DECLARATION

I hereby certify that the module ____________________ submitted to Trimex

Colleges is entirely my original work, except where otherwise indicated. I am aware of
the College's rules on plagiarism, including those on disciplinary action that may result
from plagiarism. Any use, in any form whatsoever, of the works of any other author shall
be properly recognized and cited at their point of use.

Signature :

Author’s Name : __________________

Faculty

Date of submission :

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