Choosing the Right Family Planning Method After Having Children

By Dr. Okechukwu Amako, MBBS (Ibadan)
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Sex is both for procreation and pleasure. However, every sexual intercourse for pleasure between a couple can equally result in pregnancy and procreation without a family planning method. Considering the health of the woman and the financial capacity of the couple, there's a limit to the number of children any couple can have and raise in the best possible way. This is made possible through the adoption of a family planning method by a couple while they are still having children so they have control over when their meeting can lead to a pregnancy.

We have talked about the importance of family planning in one of our previous health tips. But how about couples who are done with having children--about 3 or 4 they can comfortably raise. What is the best family planning method for them? Depending on the age of the woman when she completed her family size, she will likely still be ovulating and seeing her menses until she approaches between 50 and 55 years of age. Therefore, it is advisable she adopts a long-lasting family planning method. This means she may need only 2 to 4 replacements before menopause when contraception will no longer be necessary.

However, family planning involves both the husband and the wife. For couples who have completed their family size, the following are family planning methods they can choose from. These are divided into the reversible and permanent methods:

The reversible methods

These are family planning methods that can easily be stopped if the couple changes their mind and decides to have another child in the case of losing their child for instance.

1. The man can faithfully adhere to using a condom whenever he wants to have sex with his wife; combined with a spermicidal cream, this is effective in preventing pregnancy with a very small failure rate. Although, many men complain about the reduced pleasure that comes along with using condom, and some also react to the latex material of the condom. However, there are better condoms now with improved pleasure sensitivity.

2. Reversible family planning methods for the woman include:

-hormonal implants such as Jadelle (2 plastic-like rods) which are inserted into the skin of the inner part of the upper left arm. The Jadelle hormonal implant lasts for 5 years before needing a replacement, meaning the woman who is through with giving birth will need to change it 3 times before menopause.

-another method is the intrauterine contraceptive devices (IUCD) such as Mirena which are inserted into the woman's womb. IUCDs last for about 10 years before needing a replacement so the woman will likely not need a replacement or may just need one replacement before hitting menopause.

Some of the common side effects of both the hormonal implants and IUCDs include heavy or prolonged menstrual bleeding, spotting between periods, absence of menses for many months, weight gain and acne (pimples on the face). The IUCD may also perforate the wall of the womb or be expelled out of the womb, although this is not common. So, couples on any of these methods should report to their gynaecologist once they notice any of these side effects.

The Permanent Methods

These family planning methods are either totally irreversible once done or can be reversed but with very limited success in terms of leading to a pregnancy. They include:

1. Vasectomy, a surgical procedure in which the structure that carries sperm from the man's testes to the prostate gland is obstructed or cut to prevent this sperm transport.

So, the man can have normal erection and have sex; but his ejaculate will be fluid from the prostate gland containing no sperm cells.

2. Bilateral tubal ligation or occlusion is the equivalent in the woman. Here, the woman's two fallopian tubes that carry ovulated eggs from the ovaries to the womb are either tied, clipped with special clips or surgically cut to both prevent egg transport and stop the sperm from meeting any ovulated egg for fertilisation.

The woman will still see her menses as usual.

Couples who are through with having children can always consult their gynaecologists for a detailed counselling on each of these long-lasting family planning methods before making their choice.

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Published Friday, April 14th 2017

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