Family planning clinics provide clinical, informational, educational, social, and referral services to women and men throughout Alaska. Agencies receiving state or federal funds for family planning offer services at reduced or no cost, depending on the clients' income and family size. Clinics offer many acceptable and effective family planning methods. Contraceptive methods approved by the Food & Drug Administration are provided. A thorough health history and interview followed by physical examination and laboratory screening for breast and cervical cancers and sexually transmitted infections are routinely offered to assess each client's health status. This care improves overall health and contributes to healthy pregnancies.

Health educators, family planning clinic staff, and public health nurses provide health promotion messages in the community. Abstinence from sexual intercourse is a key message to adolescents and unmarried individuals to help them reduce their risk of unintended pregnancy and sexually transmitted infections.

Why is family planning important to you as an individual?

Family Planning services can help you decide if, or when, to have children. You can take better care of your health and have more control over your own life. Planning for a child will help you avoid the social, health, and financial problems you face if an unplanned pregnancy happens. Planned pregnancies spaced 2 or more years apart result in healthier babies and fewer medical problems for the woman.

There are many birth control methods and techniques available today. No one method is best for everyone at every stage of life. You can choose a birth control method to match your personal needs. Thinking about what method will be best for you, here are some questions to ask yourself:

You can use this website to find information to help you start thinking about your choices. You won't find all the answers to your questions here. Before you decide on a birth control method, talk with your health care provider or visit your local family planning clinic or public health center.

Birth Control Methods and Choices

ABSTINENCE

Abstinence means not having sex. At any point in your life you may decide not to have sex. Not having sex at all is the only 100% effective way to avoid pregnancy and sexually transmitted infections. If you change your mind, you may want to choose another birth control method to keep from getting pregnant. The decision to have sex is your personal decision and responsibility each and every time.

NATURAL FAMILY PLANNING OR FERTILITY AWARENESS METHODS

"Natural" family planning (NFP), fertility awareness methods (FAM), and rhythm method, are all methods that do not use any medications. There are slight differences between these three methods. It should be noted that the rhythm method, which tracks calendar dates and involves guessing when the fertile time occurs, is no longer promoted. Rhythm does not make use of the scientific advances that have occurred in identifying the signs of fertility.

"Natural" family planning (NFP) and fertility awareness methods (FAM) help identify the times during the menstrual cycle when pregnancy is most likely to occur. The fertile times are identified by checking some or all of daily body changes. Some of these are: basal body temperature (your resting temperature), cervical mucus consistency, and position of the cervix in the vagina. Once you have learned to keep track of these signs that can identify when an egg is likely to be released from the ovary (the "fertile" days), you can avoid having sex on the days around that time.

NFP or FAM can be very effective but only if the woman or couple is careful to learn the correct methods to identify and keep track of the menstrual cycle changes. Some couples use birth control methods such as barriers if they have intercourse during the "fertile" days. Other couples prefer to completely abstain from sexual intercourse on the "fertile" days.

COMBINED HORMONAL METHODS

Birth control methods containing both estrogen and progesterone are called combined hormonal contraceptives. A prescription is needed to obtain these methods. They come in many brands, doses, and forms. Examples of the different kinds of combined hormonal birth control methods are: Birth control pills, the "patch", and the vaginal ring. They all work in the same way to prevent pregnancy:

• They suppress ovulation, that is, the woman's body does not release an egg;
• They thicken cervical mucous, which makes it more difficult for the sperm to reach the egg, should one be released, and;
• They alter the lining of the uterus so that a fertilized egg (zygote) cannot implant.

Current medical science suggests that ovulation suppression is the most important action; however, the other actions also may play a role.

All combined hormonal methods are very effective when used correctly. They are also very safe to use for most women and serious side effects are rare.

PROGESTIN-ONLY CONTRACEPTIVES

Birth control methods containing only one hormone - progestin (the man-made form of progesterone) - come in many brands, doses and forms. Examples of progestin-only contraceptives are: the 3-month "shot" and "mini-pills". All progestin-only contraceptives work the same way to prevent pregnancy. They primarily work by preventing the release of an egg from the woman's ovary. They also make the cervix stay closed up tight by thickening the cervical mucus. These actions prevent an egg from being fertilized by a sperm. There may be other ways that these methods work to prevent pregnancy that are not listed here.

All the progestin-only contraceptive methods are very effective when used correctly. They are very safe to use for most women and serious side effects are very rare. A prescription from your health care provider is needed for these methods.

BARRIER METHODS

Barrier contraceptive methods all work by blocking the entrance to the uterus so an egg cannot unite with a sperm. All barrier methods work well if used correctly and consistently, but the user must take the initiative to use the method each time she or he has sex.

Barrier methods are extremely safe for the user, having few or no serious side effects. Two barrier methods that women can wear internally require a prescription to obtain. These are the diaphragm and the cervical cap.

Most other barrier methods are available for purchase without a prescription at a drugstore, grocery store, or health clinic. These include: male condom, female condom, spermicidal foam or film, spermicidal gel or cream.

INTRAUTERINE CONTRACEPTION

An intrauterine contraceptive is a small, plastic device that is placed into a woman's uterus by a trained health care provider. There are only two such products used in the United States, the IUD and the IUS. The intrauterine device, (IUD) contains copper. The copper slowly dissolves over a period of years and causes conditions inside the uterus sperm cannot tolerate. Thus, the sperm are unable to reach the woman's egg to fertilize it. An IUS (intrauterine system) is a specific type of intrauterine contraceptive with progestin (synthetic progesterone) in it, which is slowly released from the device. This may sometimes stop eggs from being released from the ovaries. Progestin also causes the lining of the uterus to become thinner and it causes blocking of the cervix to keep sperm from entering. So, with either device, the primary action is to prevent fertilization. Should the primary action fail, a secondary action could occur: the changes in the uterine lining would prevent any fertilized egg from implanting and growing in the uterus.

Intrauterine contraception provides extremely effective birth control. For many women it is a safe and easy method to use. However, since it will be in place for at least 5 years, it is important to carefully evaluate your health and pregnancy plans in order to get the most out of the intrauterine methods.

STERILIZATION

Sterilization is a surgical method of birth control and it is permanent. Because sterilization is permanent, you will want to be absolutely sure you don't ever want to have a child, or any more children, before you take this step. A part of the reproductive system is blocked by the surgical procedure. Sperm and eggs are still created but fertilization cannot occur because their paths are blocked. There are two methods of sterilization for women: tubal ligation, often referred to as "having your tubes tied", and "Essure", which is essentially "plugging" the tubes. The sterilization for a man is called a vasectomy.

Sterilization of men is most often done in a clinic and only takes about an hour. For women, sterilization is done as an out-patient surgical procedure.

EMERGENCY CONTRACEPTION

Emergency contraception (EC) is a relatively new method in the United States, although it has been used in Europe and Asia for more than 30 years. EC is usually a dose of progestin (man-made progesterone) used after unprotected intercourse, that is, sex without using birth control. EC is the only birth control method that can prevent a pregnancy from occurring after intercourse. Progestin is the same hormone used in ordinary birth control pills.

Emergency contraception is not a replacement for the birth control methods discussed above. If a couple's resolve to abstain from sex fails, if a condom breaks, or if a woman is raped, EC can be used to reduce the chances of a pregnancy. All of the other methods of birth control are more effective than EC for regular use.

It is important to determine if you are pregnant before using EC, since this method will not work if you are already pregnant.