Family Planning Facts
Family planning is the privilege and responsibility of the married couple to decide with love when to have children and how many children to have.
The ideal method of family planning should be effective, have no long-term or short-term side effects, be morally and aesthetically acceptable, be easily available, have reasonable cost, and not cause any damage to natural fertility.
A complete method of family planning can be used to achieve pregnancy as well as to avoid pregnancy.
Effectiveness to avoid pregnancy can be measured as “method effectiveness” (how well a method works when it is used exactly as directed, with no mistakes), or “use effectiveness” (how well a method works when it is used under “real life” circumstances, including human errors).
For obvious reasons, “use effectiveness” is more variable for most methods and depends on the motivation and diligence of the users.
The following charts give comparative information about commonly used methods of family planning, including possible side effects, method effectiveness, use effectiveness, continuation rate for users at one year, long-term effects on fertility, the responsibility for use, and cost.
The information given is based on currently available scientific studies. Cost may vary.
Methods of Family Planning
Natural Methods
| Methods | Creighton Model FertilityCare System | Ovulation Method - Billings | Symptothermal Method |
| Possible side effects | None | None | None |
| Effectiveness to achieve pregnancy (normal fertility) | Approximately 75% per cycle | Approximately 67% per cycle | Not available |
| Effectiveness to avoid pregnancy (method/use) | 99.5%/96.8% | 97%/93-98% | 98-99.5%/96-97% |
| Continuation rate at one year | 79% | 65% | 69% |
| Harmful to fertility | No | No | No |
| Responsible for use | Man & woman | Man & woman | Man & woman |
| Total cost first year (may vary) | $200 (8 sessions) | $35 (4 sessions) | $45 (4 sessions) |
| Total cost 10 years | $300 | $135 | $145 |
| References | Repro Med 1998; 43:495-502 | Pope Paul VI Institute Press, 1995 | Advances in Contraception 1993; 9:269-83 |
Barrier Methods *
| Methods | Condoms | Diaphragm | Sponge |
| Possible side effects | Irritation or allergic reactions | Irritation or allergic reaction, risk for urinary tract infection | Allergic reaction, Rare: risk to toxic shock syndrome |
| Effectiveness to achieve pregnancy (normal fertility) | Not applicable | Not applicable | Not applicable |
| Effectiveness to avoid pregnancy (method/use) | 97% | 94% | 80-91% |
| Continuation rate at one year | 63% | 58% | 52% |
| Harmful to fertility | No | No | No |
| Responsible for use | Man | Woman | Woman |
| Total cost first year (may vary) | $30-60 | $120-150 | $75-150 |
| Total cost 10 years | $300-600 | $450-750 | $750-1500 |
| References | Irvington Publishers 1994 | Irvington Publishers 1994 | Irvington Publishers 1994 |
Vaginal Spermicides *
| Methods | Creams, Gels, Suppositories |
| Possible side effects | Irritation or allergic reactions |
| Effectiveness to achieve pregnancy (normal fertility) | Not applicable |
| Effectiveness to avoid pregnancy (method/use) | 94/79% |
| Continuation rate at one year | 43% |
| Harmful to fertility | No |
| Responsible for use | Woman |
| Total cost first year (may vary) | $30-60 |
| Total cost 10 years | $300-600 |
| References | Irvington Publishers 1994 |
Sterilization Surgeries *
| Methods | Tubal Ligation | Vasectomy |
| Possible side effects | Associated with increased rates of hysterectomy, ectopic pregnancy, painful periods | Associated with two-fold increase in the rate of prostate cancer |
| Effectiveness to achieve pregnancy (normal fertility) | Not applicable | Not applicable |
| Effectiveness to avoid pregnancy (method/use) | 99.8%/99.6% | 99.9%/99.8% |
| Continuation rate at one year | 100% | 100% |
| Harmful to fertility | Yes | Yes |
| Responsible for use | Woman | Man |
| Total cost first year (may vary) | $2,300 | $1,000 |
| Total cost 10 years | Same | Same |
| References | Obstetrics and Gynecology 1993; 83(1):118-21 | JAMA 1993; 269:873-77 |
Intrauterine Device **
| Method | Intrauterine Device |
| Possible side effects | |
| Effectiveness to achieve pregnancy (normal fertility) | Not applicable |
| Effectiveness to avoid pregnancy (method/use) | 98/97% |
| Continuation rate at one year | 80% |
| Harmful to fertility | Can be |
| Responsible for use | Woman |
| Total cost first year (may vary) | $400 |
| Total cost 10 years | $800 |
Hormonal Methods ***
| Methods | Oral Contraceptives (birth control pill) | Norplant (surgical insertion every 5 years) | Depo-Provera (injection every 3 months) |
| Possible side effects | Breast tenderness, breast cyst, weight gain, headaches, nausea & vomiting, irregular bleeding. May delay return of normal fertility. Rare; increased risk to breast cancers, liver tumors, elevated blood pressure, heart attack, phlebitis, stroke | Local infection & bruising upon insertion is possible, irregular menses, acne, weight gain, headaches, breast pain | Delays return of fertility by an average 9 months after last shot. Irregular menses, acne, weight gain, headaches, breast pain |
| Effectiveness to achieve pregnancy (normal fertility) | Not applicable | Not applicable | Not applicable |
| Effectiveness to avoid pregnancy (method/use) | 99.6%/94% | 99.9%/99.9% | 99.7%/99.7% |
| Continuation rate at one year | 72% | 85% | 70% |
| Harmful to fertility | May delay | Unclear | Delays |
| Responsible for use | Woman | Woman | Woman |
| Total cost first year (may vary) | $240 | $600 | $240 |
| Total cost 10 years | $2,400 | $1,900 | $2,400 |
| References | Contemporary Obstetrics & Gynecology 1988; 19:315-26 | Contraception 1990; 41:169-77 | Contraception 1974; 10:181-202 |
* Acts as contraception: prevents conception (see definition of conception below)
** Acts as both contraceptive (prevents conception) and abortifacient (ends human life after conception has occurred)
*** Acts as contraceptive; may also act as abortifacient
Conception: the union of sperm and egg; the beginning of human life.
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