Family Planning Counseling
Family Planning Counseling
Family Planning Counseling
PLANNING
COUNSELLING
What is in this session?
It is important to help women and their partners to gain increased control over their
reproductive health. One of the main ways you can do this is through counselling
on family planning methods during late pregnancy, the postpartum and the post-
abortion periods.
IMPORTANT
This session only provides an introductory overview on family planning
counselling. If necessary and where possible, you should refer women to see a
trained family planning provider and/or use family planning support materials,
such as the WHO ‘Decision-Making Tool for Family Planning Clients and
Providers’.
http://www.who.int/reproductivehealth/publications/family_planning/
9241593229/en/index.html
Waiting to become pregnant at least 24 months after birth can lead to health
benefits for the mother and baby.
Limiting the number of children in a family means more resources for each
child and more time for the parents to dedicate to each child.
Younger women (adolescents) can delay pregnancy until their bodies are
mature and they are ready in terms of their life course.
Older women (over 35) can prevent unwanted pregnancies that are often
risky for their health and can lead to complications for both mothers and
infants.
REMINDER
Exclusive breastfeeding means that the baby is not given any other food or drink,
not even water. She or he is only given breast milk. See Session 13 for more
information on breastfeeding.
Once the baby reaches six months, or receives complementary foods or the
mothers' periods have returned, she should use another family planning method.
Before this time she needs to start thinking about what method she will use after
LAM.
If she has no post-abortion complications or infection, she can safely use any
family planning method, and can start all methods immediately post-
abortion (except for the natural calendar method, when she should wait for 3
months).
If she thinks she could be at risk of getting STI/HIV, she should use a
condom in all sexual relations.
Male partner
The partner should be encouraged to take part in family planning counselling
sessions, especially if the chosen method involves his cooperation, for example,
condoms or natural methods. In some places research has shown that family
planning method use is more successful when partners choose and agree upon a
method together. First, ask the woman whether she would be happy for her partner
to be involved. In some cases women may feel more comfortable if their partners
are not present or if their partners are counselled on their own and/or by a male
counsellor.
Within the community, men also need to participate in discussions on the
importance and benefits of family planning and birth spacing. Men need to
understand their role in reproduction so that they can share the responsibility for
family planning and birth spacing. This can be done through outreach work or
through discussion with men when they accompany their wives or partners to the
health facility.
REMINDER
Adolescents or unmarried women should also be offered family planning
counselling. Sometimes this is difficult if the family or community disapproves of
adolescent sexual activity and pregnancy. Explore ways you can work with
adolescents, youth groups and schools to reach adolescents who may need support.
Consider the counselling context, specifically any cultural norms you identified
in Session 4 to help you locate any key gatekeepers in the community to help you
address this topic with adolescents.
When working with a pregnant adolescent, it is particularly important to discuss
birth spacing and support her in planning when she would be ready for a next
pregnancy.
Often people do not know if they or their partner has an STI as they may
have no symptoms.
If you are sexually active (and are not 100% sure that your partner is not
infected) then consistent and correct condom use is the only way to protect
fully against STIs/HIV.
Condoms can be used together with another method to ensure very effective
protection from pregnancy and STIs.
Remember that only condoms protect against both pregnancy and STIs/HIV.
a. you can ask if she knows about family planning, what she has heard
about it, and if she knows it is important;
b. explain that it is important to know that she can become pregnant soon
after giving birth if she is not exclusively breastfeeding;
c. you should also ask whether the woman or couple already have a
family planning method in mind – those people who receive the
method that they have planned for are much more likely to use it
successfully. You can then help them assess if this method suits their
situation and needs (e.g., Are you confident you could remember to
take a pill every day?), or it may also be helpful to discuss other
options in case there is a method that better suits his/her or their
needs.
When discussing her needs and situation, you can ask about:
h. popular beliefs about family planning and how these affect her
decision to choose a particular method;
j. her and her partner's HIV status or risk factors for HIV;
2. Help to prioritize solutions, narrow down options and make a good choice
You can then discuss various family planning methods based on the needs
and situation of the woman and her partner. Possible methods are listed in
the table below. Key method characteristics that can be discussed include:
Before giving out detailed information on method use, check if the woman is
eligible to use the method. Some women who have recently given birth or
who are breastfeeding may be unable to use certain methods
(see table below). You can also check if she is able to start using the family
planning method straight away. Some health conditions may prevent a
woman from using certain methods.
c. Side-effects: what the user can expect, and what to do about them
The best way to check whether a woman knows how to use the method is to ask
her to explain to you in her own words how to use the method. You could also ask
her to demonstrate the use of certain methods such as condoms or diaphragms, or
you could consider demonstrating their use to her first, asking for her to repeat
back the demonstration afterwards to ensure that she has fully understood.
Table
Starting family planning methods after childbirth.
Activity 1
variable
o joint decision-making
2. Get the person who will be observing you to review this session beforehand.
Remember to get permission from the woman or couple for the observer to
be present if you will be carrying out this activity in a real situation rather
than a role-play
3. Ask the observer to give you feedback on your strengths and weaknesses
during the counselling process using the points outlined above as a checklist.
You can also refer back to Session 9 Activity 2 for a more general observer's
checklist.
Our View
Because of expertise and knowledge and the respect person in the community have
for this knowledge, we can sometimes inadvertently push people towards decisions
that they are not ready to make or are not happy with. Skilled counsellors facilitate
the process while taking a ‘back seat’ when it comes to making a decision. In other
words they let the woman or couple reach their own decision. Your questioning
and listening skills will help you to make accurate assessments and know where to
provide guidance and where to take a step back, as people work through the
information.
What did I learn?