Abstract
The safety or health benefit of family planning needs to be weighed against the risks associated with unintended pregnancy and birth. It is the responsibility of family planning providers to consider these relative benefits and to inform contraceptive users of them. The risks related to childbearing and contraception differ greatly, varying with age, parity, race, nutritional status, geographic area, amount and type of medical care, contraceptive method, and availability of legal abortion. The prevention of pregnancy in less developed countries has a larger public health impact than in developed nations. A significant proportion of maternity related mortality and morbidity could be reduced by increasing the interval between pregnancies and by limiting the number of births. Contraception is 5-10 times safer than childbearing in developing countries, but data on contraceptive risks are inadequate so it is difficult to weigh the risks and benefits of a specific contraceptive method for a specific population. The information presented on contraceptive methods has been drawn mainly from studies conducted in the more developed countries. More than 150 million women around the world are using oral contraceptives (OCs). Even in a developed country such as England, deaths caused by strokes associated with OC use are only 1/8 the number of deaths due to pregnancy. In less developed countries, the incidence of these diseases is even lower than in developed countries. For OC users in a developing country, the diagnosis of complications and adequate treatment are not always readily available and so mortality from these complications may be higher. Yet, there are many advantages in addition to the OC's contraceptive effect, such as reduced rates of iron deficiency anemia and benign breast disease. There appears to be an increased risk of spontaneous abortion and ectopic pregnancy among IUD users, but careful selection of women for IUD insertion can minimize these risks. Young women with no children particularly should be informed of the increased risks to health and fertility, but the public health impact may be limited in developing countries where most women who practice family planning have had several children. Considering the risk benefit ratio, the advantages of sterilization far outweigh any adverse effects and contribute significantly to the improvement and promotion of family health. Despite the known side effects of long-acting progestogens such as Depo-Provera, they have proven to be an important contraceptive method for many countries. They are particularly appropriate for women who have completed their desired family size and are awaiting permanent sterilization. The US Food and Drug Administration has not yet approved its use as a contraceptive in the US. Barrier methods cause no known illness, disease, or mortality, and they offer some protection against sexually transmitted diseases and are highly effective when used by motivated persons.
Original language | English (US) |
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Pages (from-to) | 20-22 |
Number of pages | 3 |
Journal | Draper Fund report |
Issue number | 12 |
State | Published - Aug 1 1983 |
Externally published | Yes |
ASJC Scopus subject areas
- General Medicine