Family planning/Contraception

Fact sheet
Updated July 2017

Key facts

214 million women of reproductive age in developing countries who want to avoid pregnancy
are not using a modern contraceptive method.

Some family planning methods, such as condoms, help prevent the transmission of HIV and
other sexually transmitted infections.

Family planning / contraception reduces the need for abortion, especially unsafe abortion.

Family planning reinforces peoples rights to determine the number and spacing of their
children.

By preventing unintended pregnancy, family planning /contraception prevents deaths of

mothers and 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 / contraception

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 womans 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. It prevents unintended
pregnancies, including those of older women who face increased risks related to pregnancy. Family
planning enables women who wish to limit the size of their families to do so. Evidence suggests that
women who have more than 4 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 worlds 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 to pursue additional education and participate 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.

Who provides family planning / contraceptives?

It is important that family planning is widely available and easily accessible through midwives and other
trained health workers to anyone who is sexually active, including adolescents. Midwives are trained to
provide (where authorised) locally available and culturally acceptable contraceptive methods. Other
trained health workers, for example community health workers, also provide counselling and some
family planning methods, for example pills and condoms. For methods such as sterilization, women and
men need to be referred to a clinician.

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 57.4% in 2015. Regionally, the proportion of women aged 1549 reporting use of a
modern contraceptive method has risen minimally or plateaued between 2008 and 2015. In Africa it
went from 23.6% to 28.5%, in Asia it has risen slightly from 60.9% to 61.8%, and in Latin America and the
Caribbean it has remained stable at 66.7%.
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

214 million women of reproductive age in developing countries who want to avoid pregnancy are not
using a modern contraceptive method. 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;

users and providers bias

gender-based barriers.

The unmet need for contraception remains too high. This inequity is fuelled by both a growing
population, and a shortage of family planning services. In Africa, 24.2% 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 10.2 % and 10.7%,
respectively (Trends in Contraception Worldwide 2015, UNDESA).

Contraceptive methods

Modern methods

Effectiveness
to prevent
Method Description How it works pregnancy Comments

>99% with
Prevents the
correct and
Combined oral Contains two release of eggs
consistent use
contraceptives hormones from the Reduces risk of
(COCs) or the (estrogen and ovaries endometrial and
pill progestogen) (ovulation) 92% as ovarian cancer
commonly
 Effectiveness
to prevent
Method Description How it works pregnancy Comments

used

Thickens 99% with

cervical correct and
mucous to consistent use Can be used
block sperm while
Progestogen- Contains only and egg from breastfeeding;
only pills progestogen meeting and 9097% as must be taken
(POPs) or "the hormone, not prevents commonly at the same
minipill" estrogen ovulation used time each day

Health-care
provider must
Small, flexible insert and
rods or Thickens remove; can be
capsules cervical used for 35
placed under mucous to years depending
the skin of the block sperm on implant;
upper arm; and egg from irregular vaginal
contains meeting and bleeding
progestogen prevents common but
Implants hormone only ovulation >99% not harmful

>99% with Delayed return

Thickens correct and to fertility
Injected into cervical consistent use (about 14
the muscle or mucous to months on the
under the skin block sperm average) after
every 2 or 3 and egg from use; irregular
Progestogen months, meeting and 97% as vaginal bleeding
only depending on prevents commonly common, but
injectables product ovulation used not harmful

>99% with
Monthly Injected Prevents the correct and Irregular vaginal
injectables or monthly into release of eggs consistent use bleeding
combined the muscle, from the common, but
 Effectiveness
to prevent
Method Description How it works pregnancy Comments

injectable contains ovaries not harmful

97% as
contraceptives estrogen and (ovulation)
commonly
(CIC) progestogen
used

The patch and

the CVR are
new and
research on
effectiveness
is limited.
Continuously Effectiveness The Patch and
releases 2 studies report the CVR provide
Combined hormones a that it may be a comparable
contraceptive progestin and more effective safety and
patch and an estrogen- Prevents the than the pharmacokinetic
combined directly release of eggs COCs, both as profile to COCs
contraceptive through the from the commonly with similar
vaginal ring skin (patch) or ovaries and consistent hormone
(CVR) from the ring. (ovulation) or correct use. formulations.

Longer and
Small flexible heavier periods
plastic device Copper during first
containing component months of use
copper damages are common but
Intrauterine sleeves or sperm and not harmful; can
device (IUD): wire that is prevents it also be used as
copper inserted into from meeting emergency
containing the uterus the egg >99% contraception

A T-shaped Decreases
plastic device Suppresses the amount of
Intrauterine inserted into growth of the blood lost with
device (IUD) the uterus lining of uterus menstruation
levonorgestrel that steadily (endometrium) >99% over time;
releases small Reduces
 Effectiveness
to prevent
Method Description How it works pregnancy Comments

amounts of menstrual
levonorgestrel cramps and
each day symptoms of
endometriosis;
amenorrhea (no
menstrual
bleeding) in a
group of users

98% with
correct and
Sheaths or Forms a consistent use Also protects
coverings that barrier to against sexually
fit over a prevent sperm 85% as transmitted
Male man's erect and egg from commonly infections,
condoms penis meeting used including HIV

Sheaths, or 90% with

linings, that fit correct and
loosely inside consistent use
a woman's
vagina, made Forms a Also protects
of thin, barrier to against sexually
transparent, prevent sperm 79% as transmitted
Female soft plastic and egg from commonly infections,
condoms film meeting used including HIV

Permanent >99% after 3

contraception months 3 months delay
to block or cut semen in taking effect
the vas evaluation while stored
deferens sperm is still
tubes that Keeps sperm present; does
Male carry sperm out of 9798% with not affect male
sterilization from the ejaculated no semen sexual
(vasectomy) testicles semen evaluation performance;
voluntary and
 Effectiveness
to prevent
Method Description How it works pregnancy Comments

informed choice
is essential

Permanent
contraception
Female to block or cut Eggs are Voluntary and
sterilization the fallopian blocked from informed choice
(tubal ligation) tubes meeting sperm >99% is essential

Temporary 99% with

contraception correct and
for new consistent use
mothers
whose
monthly
bleeding has
not returned;
requires
exclusive or A temporary
full family planning
breastfeeding Prevents the method based
day and night release of eggs on the natural
Lactational of an infant from the 98% as effect of
amenorrhea less than 6 ovaries commonly breastfeeding
method (LAM) months old (ovulation) used on fertility

If all 100
Emergency women used
contraception Pills taken to progestin-only
pills (ulipristal prevent emergency
acetate 30 mg pregnancy up contraception, Does not disrupt
or to 5 days after one would an already
levonorgestrel unprotected Delays likely become existing
1.5 mg) sex ovulation pregnant. pregnancy

Standard Days Women track Prevents 95% with Can be used to

 Effectiveness
to prevent
Method Description How it works pregnancy Comments

Method or their fertile pregnancy by consistent and identify fertile

SDM periods avoiding correct use. days by both
(usually days unprotected women who
8 to 19 of vaginal sex want to become
each 26 to 32 during most pregnant and
day cycle) fertile days. women who
using cycle want to avoid
beads or pregnancy.
other aids Correct,
consistent use
requires partner
cooperation.

88% with
common use
(Arevalo et al
2002)

99% effective If the BBT has

Woman takes with correct risen and has
her body and consistent stayed higher
temperature use. for 3 full days,
at the same ovulation has
time each 75% with occurred and
morning Prevents typical use of the fertile
before getting pregnancy by FABM period has
out of bed avoiding (Trussell, passed. Sex can
observing for unprotected 2009) resume on the
Basal Body an increase of vaginal sex 4th day until her
Temperature 0.2 to 0.5 during fertile next monthly
(BBT) Method degrees C. days bleeding.

TwoDay Women track Prevents 96% with Difficult to use if

Method their fertile pregnancy by correct and a woman has a
periods by avoiding consistent vaginal infection
 Effectiveness
to prevent
Method Description How it works pregnancy Comments

observing unprotected use. or another

presence of vaginal sex condition that
cervical during most changes cervical
mucus (if any fertile days, mucus.
type color or Unprotected
consistency) 86% with coitus may be
typical or resumed after 2
common use. consecutive dry
(Arevalo, days (or without
2004) secretions)

Women track 98% with

their fertile correct and
periods by consistent
observing use.
changes in the May have to be
cervical Reported 98% used with
mucus (clear with typical caution after an
texture) , use (Manhart abortion,
body Prevents et al, 2013) around
temperature pregnancy by menarche or
(slight avoiding menopause, and
increase) and unprotected in conditions
Sympto- consistency of vaginal sex which may
thermal the cervix during most increase body
Method (softening). fertile temperature.

Traditional methods

Traditional
Methods
Traditional
Methods
Women 91% with
monitor their correct
pattern of The couple and
menstrual cycle prevents consistent
over 6 months, pregnancy by use.
subtracts 18 avoiding
from shortest unprotected May need to delay
cycle length vaginal sex or use with caution
(estimated 1st during the 1st when using drugs
fertile day) and and last (such as anxiolytics,
subtracts 11 estimated antidepressants,
Calendar from longest fertile days, by NSAIDS, or certain
method or cycle length abstaining or 75% with antibiotics) which
rhythm (estimated last using a common may affect timing of
method fertile day) condom. use ovulation.

96% with
Man withdraws
correct
his penis from One of the least
and
his partner's effective methods,
consistent
vagina, and because proper
use
ejaculates timing of
outside the Tries to keep withdrawal is often
73% as
vagina, keeping sperm out of difficult to
commonly
semen away the woman's determine, leading
used
Withdrawal from her body, to the risk of
(Trussell,
(coitus external preventing ejaculating while
2009)
interruptus) genitalia fertilization inside the vagina.

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.