Traditionally the focus of family planning services has been on women. This can be seen from a large number of methods available for women compared to men. Women’s reproductive health is presumed to be her sole responsibility. This presumption has a major effect on women’s reproductive health.

Following ICPD -1994 – Cairo there was a paradigm shift in thinking about population and development. For the first time, the reproductive health approach in the plan of action was adopted. The fourth world conference on women in Beijing in the year 1995 formally recognized the role of men in promoting gender equality and better reproductive health for men & women.

The ICPD Program of action specifically

Special efforts should be made to emphasize Men’s shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behavior, including family planning, prenatal, and maternal-child health; prevention of sexually transmitted diseases, including HIV prevention; prevention of unwanted and high-risk pregnancies, shared control and contribution to family income, children’s education, health and nutrition; and recognition and promotion of the equal value of children of both sexes. Male responsibility in family life must be included in the education of children from the earliest ages. Special emphasis should be placed on the prevention of violence against women and children (United Nations, 1995:197)

The same was also reaffirmed at the 1995 World Conference on women in Beijing.

Shared responsibility between men and women in matters related to reproductive and sexual behavior is essential to improving women’s health(United Nations, 1995:180).

Here I will limit my discussion to family planning measures. Family planning and women's health are closely related. Family Planning practices help individuals or couples to attain certain objectives like 1. To avoid unwanted Births 2. To bring about wanted births 3. To regulate the intervals between pregnancies 4. To control the time at which births occur in relation to the ages of the parent 5. To determine family size 6. To prevent sexually transmitted diseases and 7. To prevent unsafe abortion. A couple must have a shared decision with regard to its family size and both partners actively communicate regarding this while arriving at a decision. Ideally, they must talk to a family planning counselor for making an informed decision which will enable them to make an informed choice.

Usually, Family Planning methods are broadly divided into two main categories 1. Temporary or Spacing methods and 2. Permanent or Terminal methods. No contraceptive is ideal and hence a basket of choice is available. The best contraceptive suitable for the couple can be chosen after proper counseling by a family planning service provider or the family doctor. Temporary or spacing methods are used by the couple to delay the first pregnancy and to space the duration between two pregnancies. The commonly available spacing methods are Barrier Methods like male and female condoms, diaphragm, vaginal sponge, etc. The other methods commonly used are Intrauterine devices or popularly called Copper T which are inserted into the uterus by trained personnel. Hormonal Contraceptives are also available as Mala N; Mala D. Injectable Hormones are available which protect for a longer duration. However, the choice of contraception lies in the accessibility, affordability, and medical condition of the client. The effectiveness and failure rate of each method varies. Hence it is always advisable to choose a method by the couple after talking to their family doctor.

The methods mentioned here are all reversible meaning once they are discontinued the couple can plan for pregnancy again.

There is also emergency contraception available for unprotected sex commonly called Morning after pill and this pill has to be taken within 72 hours of unprotected intercourse. This should not be used as a regular method of contraception. The post conception method, Abortion meaning termination of pregnancy is not only bad for women’s health but also carries a lot of risk to her life. It’s here the support of a male partner is essential. Recurrent abortions as a method of contraception should never be encouraged. There is always a risk of abortion being conducted by an unsafe, untrained hand endangering women’s life. There are strict guidelines for medical termination of pregnancy which should be adhered to.

Once the couple achieves the desired family size (no. of children they wish to have) there are permanent methods available. Though the available methods are said to be reversible it needs a lot of medical intervention. Hence the couple should make a shared decision while adopting permanent methods. The available methods are female sterilization and male sterilization. Compared to female sterilization, male sterilization is an easy procedure. It’s called Non-Scalpel Vasectomy. Its 100 percent is effective if properly performed. Certain precautions need to be taken after the procedure as the male is completely not sterile immediately. So the client is advised to use condoms for three months post-operative or till his sperm count becomes nil. This method should be popularised as it is a non -invasive procedure in the sense abdomen need not be opened, simple, with no side effects, faster and less expensive. The present trend of overemphasis on female sterilization should be reversed. The Myths Associated with Male Sterilisation should also be busted and more awareness should be brought in at the community level.

Summarising family planning should not be the sole responsibility of the female partner, the male partner should equally share the responsibility and adopt a safe sexual behavior promoting his and partner’s reproductive and sexual health.

Note:This is an informative article, for Family Planning services please consult your Doctor.

References-

1. Parks Text Book Preventive and social medicine 25th edition

2. United Nations (1995) Program of action of the 1994 International Conference on population and Development.

3. Report on the fourth world conference on women, Beijing.