Plan now, baby later | Philstar.com
At a recent conference, former NEDA secretary Cielito Habito mentioned that while most Asian countries are experiencing population decline, the Philippines is experiencing the opposite. Unfortunately, even as our population continues to grow, the health and nutritional status of our people continues to deteriorate.
With that in mind, we’ve dedicated an Okay, Doc edition of #PamilyaTalk to one of the pleas close to my heart: family planning. And because this lively discussion focused primarily on the medical aspects of family planning, I thought it best to dig a little deeper into the issue in this week’s Broad Cast.
For more information on how to plan a safer, happier, and much more secure family, watch this edition of Okay, Doc with Tita Jing and Dr Sharon Mendoza and Dr Frances Monette Bragais here on #PamilyaTalk!
What is Family Planning?
The Ministry of Health defines family planning as “having the number of children you want and when you want to have them using safe and effective modern methods. Good birth spacing is having children 3 to 5 years apart, which is best for the health of the mother, her child and the family.
Therefore, in a nutshell, family planning is synonymous with responsible parenthood. It takes into account the well-being of the entire family, including the willingness of parents to provide for the financial, physical, emotional and other developmental needs of each family member.
Why is family planning necessary?
Too many people, too small a world
According to the Commission on Population and Development, an average of 4,177 babies are born in the Philippines every day. This equates to 174 babies born every hour or three babies every minute. And this is in addition to the total population of 109 million Filipinos reported by the Philippine Statistics Authority in 2021.
What does it mean? The Philippines currently accounts for 1% of daily population growth worldwide.
In fact, according to World Population Prospects 2022, a United Nations report, “More than half of the projected increase in world population through 2050 will be concentrated in just eight countries: the Democratic Republic of the Congo, Egypt, Ethiopia, India, Nigeria, Pakistan, the Philippines and the United Republic of Tanzania.
For such a small country, this is the impact we are expected to have over the next few years. And unfortunately, not for the better.
At this point, the world is already facing food insecurity, water scarcity, and climate change, among many other global issues that threaten our survival as a species. But it’s not too late to change that. With good family planning, the Philippines doesn’t have to put so much pressure on the limited and rapidly dwindling resources of our small planet.
Family planning is the sensible and responsible way to move forward as a nation. To do otherwise is unwise.
But while national and global sustainability may seem too abstract to justify the need for family planning for some, then let’s look at it on a more personal level.
Closer to home
It all comes down to responsible parenting.
Although every child is a blessing, having more children than you can provide ends up being a curse for them. When parents have more children than they can adequately feed, clothe, educate and care for, it diminishes the quality of life for the whole family.
Besides depriving children of their right to be fully nourished, nurtured, protected and loved, it also puts extra pressure on parents who have to work twice to pay the bills and put food on the table. They become too busy making a living that they end up missing out on life.
Therefore, responsible parents are the most loving parents. They ensure that their offspring, whether large, few or even unique, have the best chance of thriving. They also make sure they have the time, resources and presence to give to their spouse and children.
In addition, multiple pregnancies and births can put a mother’s life at risk. Maternal and infant mortality and morbidity tend to increase in proportion to the increase in population. Appropriate birth spacing greatly reduces the risk of losing the baby and/or tragically leaving other children orphaned.
What does family planning involve?
Mutual commitment. The most crucial ingredient in family planning is full cooperation. Both spouses need to be there for the long haul. Family planning should not be the responsibility of one or the other.
Doctor’s advice. Under the regular guidance of a doctor, a couple can determine which methods will work best for them.
An open mind. This way, a couple will understand that family planning is unnecessarily controversial. This is because it is neither anti-religion nor pro-promiscuity.
There are methods that will not violate a couple’s religious beliefs. Numerous studies have shown that awareness, adequate education and the availability of safe and reliable contraceptive methods do not encourage sexual experimentation, especially among young people. Instead, the incidence of unwanted pregnancies and sexually transmitted diseases is lower.
Which methods work best?
Traditional or natural methods for couples
According to obstetrician, gynecologist and sonographer Dr. Sharon Mendoza, the answer will vary from person to person, especially depending on their views and the unique response of their body. It’s also important to keep in mind that, like most things, there’s no 100% guarantee. Birth control methods are only effective up to 99% of the time.
Those with religious restrictions against contraceptive devices can opt for traditional methods of birth control. These include timing and pacing methods that require sexual abstinence when a woman is fertile. This is done by tracking the menstrual cycle via pen and paper or even a mobile app. He is effective only when the woman’s menstrual cycle is regular. If her periods are not predictable, these natural methods may fail.
The withdrawal method can also be practiced, however, it is only about 70% effective. This means that this method can lead to pregnancy 3 out of 10 times.
New moms can choose to use the Lactational Amenorrhea Method or LAM. However, this only applies to those who have breastfed directly without feeding the baby substitutes such as water or formula. Doing so, especially during the first six months of childbirth, sends signals to the brain that prevent the body from releasing a viable egg. Thus, the woman remains infertile for the entire duration. But as soon as her periods start again, she will need additional methods of contraception.
According to Dr. Mendoza, the pills must be taken regularly to be up to 99% effective. But with the hundreds of brands available, it may take some trial and error to find the best brand for each individual. Common complaints against the pill include weight gain or loss and stomach upset may cause the user to try other formulations until the right hormonal component for their system can be found.
Instead of pills, women can opt for longer-lasting injectables. Some last for a month while others last up to three months.
An intrauterine device or IUD is another option. This small T-shaped device is inserted by a healthcare professional into a woman’s uterus. It then releases copper which prevents pregnancy for up to 12 years.
The subcutaneous implant which, as its name suggests, is a small device inserted into the arm just under the skin. Dr. Mendoza emphasizes the importance of having it administered by a properly trained and certified health care provider (eg OB GYNE, family physician, midwife). Although bruising may occur after implantation, this side effect should not last longer than a week. The implant is effective for up to three years.
Then there’s tubal ligation, a major surgery that involves cutting, tying, or blocking the fallopian tubes. Ligation prevents the egg from moving from the ovaries to the uterus. It also prevents sperm from reaching the egg, but does not affect a woman’s menstrual cycle. This procedure is reversible.
Urologist Dr. Frances Monette Bragais stresses that women shouldn’t be tasked with preventing pregnancy on their own. Especially not when there are equally effective and less invasive male contraceptives.
Besides the withdrawal method, men can simply use a condom. For maximum effectiveness, she recommends using them well before their expiration date. Dr. Bragais also warned against exposing the wrapped condom to heat and against using oil-based lubricants, both of which can degrade the latex and render the condom useless.
A vasectomy is a long-term, reversible option that is now less invasive than ever. This involves cutting the vas deferens, a small tube in the scrotum that serves as a passageway for sperm to flow into semen.
It is a minimally invasive outpatient procedure that typically takes 30 minutes and requires only local anesthesia. The incision is so small that it only requires a small bandage and no stitches.
Patients can be on their feet a few minutes after the procedure. Any discomfort can be corrected by applying a cold compress to the area. But the patient will need to use other forms of contraception for the next three months to ensure that any semen remaining in the vas deferens has been evacuated. A semen analysis can easily confirm this.
Dr. Bragais assures that vasectomies are easier and safer to perform on men than tubal ligation on women. The latter is more invasive because it deals with the inside of the body. And since vasectomies are reversible and don’t affect men’s testosterone levels, Dr. Bragais says the fear of losing sexual pleasure, libido, virility and future fertility are all misconceptions. In fact, the procedure can be done safely by older and older men.
Responsible Parenting: It Takes Two
Whether a couple opts for more traditional or more modern, gender-specific contraception, family planning requires the commitment of both partners to achieve the desired number of children.
In the long run, the sacrifices and inconveniences of family planning are well worth achieving the right family size that you can support, and even spoil, within your means.
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