Did you know that half of pregnancies in the U.S. are not planned? And did you know that planned pregnancies are better for mothers' and infants' health? That's why the U.S. Office of Population Affairs and the Centers for Disease Control and Prevention recently released formal recommendations on family planning services.
I spoke with Susan B. Moskosky, acting director of the Office of Population Affairs, to learn more about quality family planning and why it matters.
Health professionals have been eagerly waiting for these new recommendations. Why should the general public be interested in recommendations for health providers?
Whether women and couples want to prevent pregnancy, are thinking about getting pregnant for the first time, or already have children, it's important to think about family planning. Knowing whether you want to have a child in the next few years can help you have a healthier pregnancy and birth. Problems such as early delivery or babies born at low birthweight can often be prevented. Let's prevent these conditions because they can lead to lifelong health problems.
The new recommendations define what high-quality family planning services are and how to best provide them for women, men, and adolescents. The recommendations are for all primary care providers - like your family doctor or nurse practitioner - not just for obstetrician/gynecologists. Our vision is that over time, every primary care provider will ask every patient of reproductive age about their goals for having or not having children and work with them to meet those goals.
Do the recommendations address services for women and couples who want to have children, as well as for those who want to prevent pregnancy?
Yes. For those who want to delay or prevent pregnancy altogether, the recommendations describe specifically how health providers can most effectively help their patients avoid pregnancy until they are ready to care for a(nother) child. For example, research shows that patients are more likely to choose more effective birth control when the most effective methods are discussed first. A woman who uses a more effective contraceptive method is less likely to have an unplanned pregnancy.
The recommendations also suggest that health providers — such as doctors, nurse practitioners, and physician assistants — talk about preconception health with their patients who might want to have children now or in the future. Women and men in their reproductive years (15–44) need to maintain their health and take care of health issues, both for their own wellbeing and for the wellbeing of any children they may have. Preconception health care includes health screenings, as well as counseling and education on topics like quitting smoking before pregnancy, achieving a healthy weight, and managing chronic conditions like diabetes that could affect a future pregnancy.
What else should a high-quality family planning visit include?
A family planning visit can include many different services, depending on the patient's individual needs. It could include contraceptive care, preconception health, pregnancy testing and counseling, screening and treatment for sexually transmitted infections (STIs), reproductive life planning, and basic infertility services. The new recommendations also include suggestions for related preventive services, such as breast and cervical cancer screening.
What is something else you'd like our readers to know?
We looked at both the research and ways to make family planning services more "client-friendly" in order to provide women and men with the highest standard of care. For example, research shows that pelvic exams are not generally needed for a woman to safely receive a prescription for hormonal birth control methods like the pill, patch, or ring. Of course, a pelvic exam is needed for certain types of birth control - in order to have an IUD inserted or a diaphragm fitted, for example. A pelvic exam may also be needed to address a medical issue. However, the recommendations emphasize removing unnecessary barriers to providing contraception safely to more women.
It seems women and men can also ask their family doctors about family planning.
Yes, we encourage patients to ask questions and start family planning conversations with their health providers. It will take all of us working together to improve on the number of pregnancies that are planned and spaced appropriately, in order to improve overall maternal and child health.
For more information about Providing Quality Family Planning (QFP) Services: Recommendations from the U.S. Office of Population Affairs and the Centers for Disease Control and Prevention, visit OPA's website. QFP training and resources for health care providers is available online. Follow @OPA1 on Twitter for QFP updates.