Compiled by Isabel Carter.
There are many ways of helping couples to space their families. The most suitable method depends on what is available, the needs of the couple and their beliefs about which methods are appropriate.
It is important first to understand how a baby is made. Each month a woman’s body produces an egg. This lives for just a few days if not fertilised. If it meets with a sperm released from the husband’s body during sexual intercourse, the egg may become fertilised. About half of all fertilised eggs fail to attach themselves to the womb. As with the unfertilised eggs, they pass out of the woman’s body during her monthly bleeding. If a fertilised egg does become firmly attached to the wall of the womb, in most cases it will then develop into a baby.
Some Christians do not feel that any artificial methods should be used to prevent fertilisations. Others do not feel happy with methods which prevent a fertilised egg from implanting in the womb. Others believe that since so many eggs are lost naturally, these methods are acceptable.
Each couple should have the opportunity to learn about the different methods and decide what will be right for them. Methods vary in how effective they are. Some will provide almost complete protection from pregnancy. Other methods are not so reliable but may be helpful in spacing births when more children are wanted.
Temporary methods
Pill The woman takes a pill every day which contains a hormone which prevents eggs from being produced and alters the lining of the womb. She must remember to take the pill at the same time each day. A few women find this method makes them feel unwell, but they can usually change to a different kind of pill. Some feel better because their periods become lighter and less painful.
Using this method, about 1 out of 100 women will become pregnant in any year.
Cap This is a small rubber cap which fits over the neck of the womb, preventing sperm from entering. Various sizes are available and women need to be fitted correctly. If used with spermicide cream this is quite a reliable method.
Using this method, about 10 out of 100 women will become pregnant in any year.
Condom This is made of fine rubber and fits over a man’s penis. It collects the sperm and prevents them from going inside the woman’s body. There is also a female condom which fits inside the vagina and works in the same way.
Using this method, about 7 out of 100 women will become pregnant in any year.
Foams or spermicides These are creams or foams which are placed inside the woman just before sexual intercourse. They damage the sperm, preventing them from reaching the egg.
Using this method, about 20 out of 100 women will become pregnant in any year.
Mini-pill This can be used during breast-feeding. It contains a hormone which makes eggs less likely to be produced and changes the lining of the womb to prevent implantation of the egg.
Using this method, about 2 out of 100 women will become pregnant in any year. (Fewer during full breastfeeding.)
Injections These contain hormones which prevent the woman from producing any eggs. This is a simple, safe and popular method. The effects of Depo-Provera last for three months but can make a few women feel unwell at first and it changes the monthly bleeding pattern. New injections, known as Mesigyna and Cyclofem, are needed each month but have few side effects and do not alter the monthly bleeding pattern.
Using this method, about 1 out of 100 women will become pregnant in any year.
Permanent methods
These methods are only for couples who are quite sure they will never want more children. They involve cutting the tubes which carry the eggs in a woman, or the sperm in a man. They have no effect on a couple’s sex life.
Vasectomy is the operation for men. It can be done quickly with a local anaesthetic.
Sterilisation of women involves surgery and, often, a general anaesthetic in hospital.
Both are simple operations. There will be some pain for a week and they must avoid heavy work for two weeks.
Using these methods, failures (further pregnancies) are extremely rare.
Natural methods
Breast feeding Breast feeding is best for a baby’s health. Women who breast feed at least six times daily and give no extra milk or food to the baby are unlikely to become pregnant. This is not reliable after the first six months, but it can help in child spacing. Remember that a woman can become pregnant before the return of her monthly bleeding.
Safe period or natural family planning This method relies on the couple’s understanding of the woman’s cycle. They agree to avoid sexual intercourse during the time when the woman could be fertile (one to two weeks each month). The woman learns to recognise when she is fertile and to keep careful records of her cycle. Illness may upset the cycle. Clear teaching is needed to understand and use this method as it is quite complicated to understand.
Using this method, about 10–20 out of 100 women will become pregnant in any year.
Abstinence This simply means that husband and wife agree to live apart or go without sexual intercourse for a time (for example, while breast feeding). In traditional societies, the wife will often remain with her family for up to two years following the birth of a child. However, this may lead to the husband having other women. boxed Understanding the times when a woman is most fertile may also help couples who have difficulty in conceiving children.
WITHDRAWAL (coitus interruptus) is sometimes included as a ‘natural’ method. With this method, the man prevents his sperm from being released inside the woman’s body by pulling out quickly. This is an unreliable method which is very unsatisfactory for both husband and wife.
It is not recommended.
Reversible, long-term methods
Implants These are small, matchstick-sized implants which are placed inside a woman’s arm. They release hormones very slowly and prevent the woman from producing any eggs. Their effects are long lasting – up to five years for Norplant (which has six implants) – but can cause side effects. A new type, called Norplant 2, only has two implants and lasts for three years with few side effects. The implants can be removed if the woman wants another child.
Using this method, about 1 out of 100 women will become pregnant in any year.
IUD (loop or coil) An IUD is a small piece of plastic, often carrying some copper, which is placed inside a woman’s womb and prevents a fertilised egg from implanting. An IUD can remain in the body for four or five years. This is a simple and popular method. The most effective is the Copper T380.
Using this method, about 1 out of 100 women will become pregnant in any year.