Family planning
Key facts
- An estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception.
- Some family planning methods help prevent the transmission of HIV and other sexually transmitted infections.
- Family planning reduces the need for unsafe abortion.
- Family planning reinforces people’s rights to determine the number and spacing of their children.
Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through use of contraceptive methods and the treatment of infertility (this fact sheet focuses on contraception).
Benefits of family planning
Promotion of family planning – and ensuring access to preferred contraceptive methods for women and couples – is essential to securing the well-being and autonomy of women, while supporting the health and development of communities.
Preventing pregnancy-related health risks in women
A woman’s ability to choose if and when to become pregnant has a direct impact on her health and well-being. Family planning allows spacing of pregnancies and can delay pregnancies in young women at increased risk of health problems and death from early childbearing, and can prevent pregnancies among older women who also face increased risks. Family planning enables women who wish to limit the size of their families to do so. Evidence suggests that women who have more than four children are at increased risk of maternal mortality.
By reducing rates of unintended pregnancies, family planning also reduces the need for unsafe abortion.
Reducing infant mortality
Family planning can prevent closely spaced and ill-timed pregnancies and births, which contribute to some of the world’s highest infant mortality rates. Infants of mothers who die as a result of giving birth also have a greater risk of death and poor health.
Helping to prevent HIV/AIDS
Family planning reduces the risk of unintended pregnancies among women living with HIV, resulting in fewer infected babies and orphans. In addition, male and female condoms provide dual protection against unintended pregnancies and against STIs including HIV.
Empowering people and enhancing education
Family planning enables people to make informed choices about their sexual and reproductive health. Family planning represents an opportunity for women for enhanced education and participation in public life, including paid employment in non-family organizations. Additionally, having smaller families allows parents to invest more in each child. Children with fewer siblings tend to stay in school longer than those with many siblings.
Reducing adolescent pregnancies
Pregnant adolescents are more likely to have preterm or low birth-weight babies. Babies born to adolescents have higher rates of neonatal mortality. Many adolescent girls who become pregnant have to leave school. This has long-term implications for them as individuals, their families and communities.
Slowing population growth
Family planning is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts.
Contraceptive use
Contraceptive use has increased in many parts of the world, especially in Asia and Latin America, but continues to be low in sub-Saharan Africa. Globally, use of modern contraception has risen slightly, from 54% in 1990 to 57% in 2012. Regionally, the proportion of women aged 15–49 reporting use of a modern contraceptive method has risen minimally or plateaued between 2008 and 2012. In Africa it went from 23% to 24%, in Asia it has remained at 62%, and in Latin America and the Caribbean it rose slightly from 64% to 67%. There is with significant variation among countries in these regions.
Use of contraception by men makes up a relatively small subset of the above prevalence rates. The modern contraceptive methods for men are limited to male condoms and sterilization (vasectomy).
Global unmet need for contraception
An estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception. Reasons for this include:
- limited choice of methods;
- limited access to contraception, particularly among young people, poorer segments of populations, or unmarried people;
- fear or experience of side-effects;
- cultural or religious opposition;
- poor quality of available services;
- gender-based barriers.
The unmet need for contraception remains too high. This inequity is fueled by both a growing population, and a shortage of family planning services. In Africa, 53% of women of reproductive age have an unmet need for modern contraception. In Asia, and Latin America and the Caribbean – regions with relatively high contraceptive prevalence – the levels of unmet need are 21% and 22%, respectively.
Contraceptive methods
Modern methods
| Method | Description | How it works | Effectiveness to prevent pregnancy | Comments | |
| Combined oral contraceptives (COCs) or “the pill” | Contains two hormones (estrogen and progestogen) | Prevents the release of eggs from the ovaries (ovulation) | >99% with correct and consistent use | Reduces risk of endometrial and ovarian cancer; should not be taken while breastfeeding | |
|
| 92% as commonly used | |
|
| Progestogen-only pills (POPs) or "the minipill" | Contains only progestogen hormone, not estrogen | Thickens cervical mucous to block sperm and egg from meeting and prevents ovulation | 99% with correct and consistent use | Can be used while breastfeeding; must be taken at the same time each day | |
| 90–97% as commonly used | |
|
|
|
| Implants | Small, flexible rods or capsules placed under the skin of the upper arm; contains progestogen hormone only | Same mechanism as POPs | >99% | Health-care provider must insert and remove; can be used for 3–5 years depending on implant; irregular vaginal bleeding common but not harmful | |
|
|
|
| Progestogen only injectables | Injected into the muscle every 2 or 3 months, depending on product | Same mechanism as POPs | >99% with correct and consistent use | Delayed return to fertility (1–4 months) after use; irregular vaginal bleeding common, but not harmful | |
|
| 97% as commonly used | |
| Monthly injectables or combined injectable contraceptives (CIC) | Injected monthly into the muscle, contains estrogen and progestogen | Same mechanism as COCs | >99% with correct and consistent use | Irregular vaginal bleeding common, but not harmful | |
|
| 97% as commonly used | |
| Intrauterine device (IUD): copper containing | Small flexible plastic device containing copper sleeves or wire that is inserted into the uterus | Copper component damages sperm and prevents it from meeting the egg | >99% | Longer and heavier periods during first months of use are common but not harmful; can also be used as emergency contraception | |
|
|
| Intrauterine device (IUD) levonorgestrel | A T-shaped plastic device inserted into the uterus that steadily releases small amounts of levonorgestrel each day | Suppresses the growth of the lining of uterus (endometrium) | >99% | Reduces menstrual cramps and symptoms of endometriosis; amenorrhea (no menstrual bleeding) in a group of users | |
|
|
|
| Male condoms | Sheaths or coverings that fit over a man's erect penis | Forms a barrier to prevent sperm and egg from meeting | 98% with correct and consistent use | Also protects against sexually transmitted infections, including HIV | |
|
| 85% as commonly used | |
| Female condoms | Sheaths, or linings, that fit loosely inside a woman's vagina, made of thin, transparent, soft plastic film | Forms a barrier to prevent sperm and egg from meeting | 90% with correct and consistent use | Also protects against sexually transmitted infections, including HIV | |
|
| 79% as commonly used | |
|
| Male sterilization (vasectomy) | Permanent contraception to block or cut the vas deferens tubes that carry sperm from the testicles | Keeps sperm out of ejaculated semen | >99% after 3 months semen evaluation | 3 months delay in taking effect while stored sperm is still present; does not affect male sexual performance; voluntary and informed choice is essential | |
|
| 97–98% with no semen evaluation | |
| Female sterilization (tubal ligation) | Permanent contraception to block or cut the fallopian tubes | Eggs are blocked from meeting sperm | >99% | Voluntary and informed choice is essential | |
|
|
|
|
|
|
|
| Lactational amenorrhea method (LAM) | Temporary contraception for new mothers whose monthly bleeding has not returned; requires exclusive breastfeeding day and night of an infant less than 6 months old | Prevents the release of eggs from the ovaries (ovulation) | 99% with correct and consistent use | A temporary family planning method based on the natural effect of breastfeeding on fertility | |
|
| 98% as commonly used | |
|
|
| Emergency contraception (levonorgestrel 1.5 mg) | Progestogen-only pills taken to prevent pregnancy up to 5 days after unprotected sex | Prevents ovulation | Reduces risk of pregnancy by 60–90% | Does not disrupt an already existing pregnancy | |
Traditional methods
| Method | Description | How it works | Effectiveness to prevent pregnancy | Comments | |
| Withdrawal (coitus interruptus) | Man withdraws his penis from his partner's vagina, and ejaculates outside the vagina, keeping semen away from her external genitalia | Tries to keep sperm out of the woman's body, preventing fertilization | 96% with correct and consistent use | One of the least effective methods, because proper timing of withdrawal is often difficult to determine | |
| 73% as commonly used | |
| Fertility awareness methods (natural family planning or periodic abstinence) | Calendar-based methods: monitoring fertile days in menstrual cycle; symptom-based methods: monitoring cervical mucus and body temperature | The couple prevents pregnancy by avoiding unprotected vaginal sex during most fertile days, usually by abstaining or by using condoms | 95-97% with correct and consistent use | Can be used to identify fertile days by both women who want to become pregnant and women who want to avoid pregnancy. Correct, consistent use requires partner cooperation. | |
| 75% as commonly used | |
WHO response
WHO is working to promote family planning by producing evidence-based guidelines on safety and service delivery of contraceptive methods, developing quality standards and providing pre-qualification of contraceptive commodities, and helping countries introduce, adapt and implement these tools to meet their needs. WHO is also developing new contraceptive methods, including male methods, to reduce the unmet need for contraception.
