Regardless of whether you have kids or not, you’ve probably heard the term family planning. While it’s often used as a euphemism for contraception, the term encompasses so much more. According to the World Health Organization, family planning allows people to try to attain their desired number of children, if any, and to determine the ideal spacing of their pregnancies.1 Whether it’s done purposefully or subconsciously, family planning has helped countless women and families, regardless of their situation or their desire to have children.
So how did the concept of family planning originate, and how can it benefit women and families today? Here we take a look at what family planning really means.
Family planning: A quick history
While you might assume family planning is a newer idea, it began centuries ago. In medieval civilizations of the Western Sudan, physicians advised women to space the births of their children by intervals of three years rather than over a shorter time span.2 Throughout the years, countless undefined methods of planning have advised when and how to birth children.
The more contemporary interpretation of family planning is fairly aligned with 2006 recommendations from the U.S. Centers for Disease Control (CDC) to improve preconception care.3 Their report focused on reducing adverse pregnancy outcomes by encouraging individuals to make a “reproductive life plan” or decide “whether or when they want to have children and how they will maintain their reproductive health.” Today, family planning also includes modern routes to parenthood, such as adoption, surrogacy, intrauterine insemination and sperm donation.
The philosophy behind family planning methods
As family planning as a concept has evolved, it has grown to include other health factors. In a world where fertility myths and misinformation abound, family planning elevates healthcare and educational services such as counseling, examinations and screenings, and sexually transmitted infection (STI) prevention, which inform and educate individuals who may or may not want to become parents.
Ultimately, the goal of family planning is to meet the reproductive health needs of women — and the method has proven successful. According to the United Nations, “the number of women with a demand for family planning has increased markedly over the past two decades, from 900 million in 2000 to nearly 1.1 billion in 2020.”4
Family planning and contraception options
One of the largest components of family planning is contraception, though the methods differ. Contraception is used by women for myriad reasons. If you are considering contraception, speak to your healthcare provider to determine the best option for you; your doctor will be able to discuss the pros and cons of each, including effectiveness.
It’s important to note that effectiveness is measured by typical use and perfect use.5 Typical use provides room for user error — for example, forgetting to take a pill or incorrectly using a condom — and method failure, so the failure rate is usually higher. Perfect use looks at a method’s effectiveness if used exactly as intended.5 For example, if you’re taking your birth control pill every day at the same time, that would be considered a step towards “perfect use.” For some methods, such as birth control pills, fertility awareness or condoms, this distinction is critical for effectiveness. For other methods, such as IUDs, implants or sterilization, perfect use and typical use are largely the same.5
Here are a few common contraception methods, with information available publicly from The American College of Obstetricians and Gynecologists (ACOG):
Birth control pills
Birth control pills are a common and convenient method, with a 1% chance of pregnancy if taken at the same time every day, or with perfect use.5 This is an example of how typical use vs perfect use can impact effectiveness; perfect use is >99% effective, whereas typical use drops to 91%.6 If you feel like taking a pill consistently and reliably isn’t realistic for your lifestyle, consider speaking to your doctor about other options.
An intrauterine device (IUD) is an easily reversible contraceptive method generally claiming to have a 0.02-0.8% chance of pregnancy, according to the ACOG.6 Hormonal IUDs are generally approved for up to three to seven years of use, and copper IUDs are generally approved for up to 10 years of use, according to the ACOG.6 Once an IUD is placed into the uterus by a healthcare provider, no further action is needed to prevent pregnancy.
An implant, a plastic rod about the size of a matchstick, is placed under the skin of the upper arm, where it releases the hormone progestin, which blocks ovulation and therefore pregnancy. Implants are approved for up to three years of use and are highly effective, generally claiming to have a 0.05% chance of pregnancy.6 Once an implant is placed by a healthcare provider, no further action is needed to prevent pregnancy beyond that percentage of chance.
Fertility awareness involves tracking your menstrual cycle and symptoms to avoid intercourse on your most fertile days. This natural method generally claims to have a 24% chance of pregnancy,6 but it’s also one of the most flexible — you can transition quickly from preventing pregnancy to trying to conceive.
Sterilization or vasectomy
With only a 0.15-0.5% chance of pregnancy,6 sterilization is one of the most effective methods. Tubal ligation involves blocking, tying or cutting the fallopian tubes, which transport the egg from the ovaries to the uterus. Alternatively, male sterilization, or vasectomy, is one of the few contraceptive methods available to men and is typically done at an outpatient surgical center. The typical failure rate is just 0.15%.7 Both procedures are considered permanent birth control solutions.
Having the resources and knowledge to choose which method works best for you and your body is a key pillar to family planning, so much so that September 26th has been dubbed World Contraception Day, an annual worldwide family planning campaign centered around improving awareness of contraception in younger demographics. If you’re considering contraception, speak to your healthcare provider to discuss and decide on the best option for you.
Family planning education and care
Another key component to family planning is education and access to healthcare services. You might have learned the basics of your body in high school health class, but that can leave a lot of gaps when it comes to getting pregnant. What factors might affect your fertility? How long could it take to get pregnant? Schools, healthcare providers, government entities, educators and others may offer additional resources to fill in those gaps so women can make well-informed decisions about their reproductive health.
The benefits of family planning
Family planning has had an enormous impact on both a global and personal scale. Most notably, family planning initiatives have massively lowered the rates of adolescent pregnancies. Compared to other age groups, women ages 15-19 years old have experienced the largest relative decrease in birth rates since 1990.8 Though some areas of the world still have unmet needs, educational programs and contraception access initiatives continue to make progress.
Even if children are decidedly not in your future, family planning is still vital, whether you’re seeking a contraceptive method that works for you or tracking your period. After all, family planning proposes that the choice to be child-free should be available to anyone who wants it.
If you are looking to build your family, the best time to get pregnant varies from person to person, and there is no one-size-fits-all solution. Whether you’re trying to conceive your first child or thinking into the future to a second (or third!), family planning can play a vital role in helping ensure you understand there are resources available to help..
- “Contraception,” (n.d.), World Health Organization, https://www.who.int/health-topics/contraception#tab=tab_1
- McKissack, P., McKissack, F., (1995), “The royal kingdoms of Ghana, Mali, and Songhay : life in medieval Africa,” https://archive.org/details/royalkingdomsofg00patr/page/104/mode/2up
- “Recommendations to Improve Preconception Health and Health Care — United States,” (April 21, 2006), Morbidity and Mortality Weekly Report, https://www.cdc.gov/mmwr/pdf/rr/rr5506.pdf
- United Nations Department of Economic and Social Affairs, Population Division, (2020), “World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning,” https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Sep/unpd_2020_worldfamilyplanning_highlights.pdf
- “Birth Control Effectiveness & the Pearl Index Explained,” (March 2020), Natural Cycles, https://www.naturalcycles.com/cyclematters/birth-control-effectiveness-explained
- “Effectiveness of Birth Control Methods,” (October 2021), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods
- “Birth Control Methods,” (n.d.), Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, https://www.cdc.gov/reproductivehealth/contraception/index.htm
- United Nations Department of Economic and Social Affairs, Population Division, (2020), “World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning,” https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_hi_worldfamilyplanning2020_highlights.pdf