• Sailtaaj Kunwar

Unplanned pregnancies, resulting in excessive abortions, expose women to serious health risks, including physical complications, emotional trauma, and long-term reproductive problems. Though abortion is necessary under certain conditions, over-reliance on it is harmful, and the need for family planning becomes very important.

Family planning enables women to take responsibility for their reproductive lives by preventing unplanned pregnancies, thereby avoiding multiple abortions. It also creates avenues for informed decision-making on child delivery, therefore guaranteeing improved health for the women and their families.

In Pokhara, the institutions that offer relatively affordable and accessible family planning services include Marie Stopes, FPAN, and Gandaki Hospital. They offer a lifeline to women and couples who strive to handle their reproductive choices responsibly. However, lack of awareness and access continues to force many women into multiple abortions, which can badly affect their health.

For example, health reports from local clinics show that women have had to go through three to four abortion surgeries within a very short period of two years due to a failure to use contraceptives or access family planning services. By facilitating family planning, we would reduce such incidents, protect women’s physical and mental health, and build healthier communities where women can thrive.

According to the Directorate of Health, The Family Planning Program in Gandaki Province showcases significant progress in contraceptive use and distribution. Data reveals that condoms are the most widely used method, with 222,146 individuals currently using them and an equal number of units distributed. Emergency contraceptive pills served 1,658 new users, while oral pills accounted for 792 new users and 9,559 cycles distributed. Injectables like Depo-Provera had 191 new users and 5,370 doses distributed, catering to 16,099 current users.

Long-term methods such as IUCDs and implants have also gained traction, with 17,094 and 43,859 users, respectively, and hundreds of units distributed. Notably, youth participation is evident, with individuals under 20 years adopting methods like condoms, pills, and implants. These figures highlight the importance of offering diverse and accessible contraceptive options to meet varying needs, reduce unintended pregnancies, and promote reproductive health in the region.

Despite the benefits of family planning, many women face resistance from their husbands, who usually perceive it negatively due to cultural beliefs, misconceptions, or patriarchal mindsets. Some men think that contraceptives are unnecessary or unnatural and feel that limiting the number of children contradicts traditional values that are tied to masculinity and family lineage.

Others are suspicious of modern contraceptive methods, thinking they may cause infertility or reduce intimacy in relationships. Such attitudes discourage women from seeking family planning services, leaving them vulnerable to unintended pregnancies and repeated abortions. However, following such stigmas not only endangers women’s health but also undermines the overall well-being of the family.

When family planning is rejected, women are often forced to endure repeated unwanted pregnancies or unsafe abortions, which result in severe physical, emotional, and financial strain. This, in turn, affects the entire household, hindering opportunities for better education, healthcare, and financial stability.

Breaking these stigmas is vital to healthier families and communities. It is important to educate men on the benefits of family planning, share responsibility in reproductive health, and foster open dialogue between couples to move toward a more equitable and healthy society.

Family planning has a wide range of options, from devices that may offer permanent to temporary solutions for individuals and couples desiring or not desiring to bear children. This allows each individual to choose those solutions which best fit their personal needs, medical needs, and family planning needs.

Permanent family planning devices are targeted at the individual or couple who is certain that they do not want any more children.

Tubal Ligation (Female Sterilization): Tubal ligation is a surgery where the fallopian tubes are blocked or sealed to stop eggs from reaching the uterus, preventing pregnancy. It is a one-time procedure that is very effective, with over 99% success. Once done, it cannot be reversed, so it’s for women who are sure they don’t want more children. This procedure does not affect hormones, so women can still have regular periods. It’s a good option for women who don’t want to use other methods anymore.

Vasectomy (Male Sterilization): A vasectomy is a small surgery where the tubes carrying sperm are cut or sealed to prevent sperm from mixing with semen. It’s quick, effective, and doesn’t affect sexual performance. Like tubal ligation, it is permanent and cannot be reversed easily. This method is ideal for men who are sure they don’t want more children. It’s a safer and simpler option for men compared to female sterilization.

Temporary family planning devices, on the other hand, are reversible and allow individuals to delay or space out pregnancies. Common methods include intrauterine devices (IUDs), such as copper T or hormonal IUDs, which are inserted into the uterus and can last for several years. Other options include oral contraceptive pills, contraceptive patches, implants, and injectables, which rely on hormones to prevent ovulation. Barrier methods like condoms and diaphragms provide additional temporary solutions while also protecting against sexually transmitted infections. These devices provide flexibility and control, allowing couples to plan their family size without making permanent decisions.

Intrauterine Devices (IUDs): An IUD is a small T-shaped device placed inside the uterus by a doctor. There are two types: copper IUDs, which use copper to stop sperm, and hormonal IUDs, which release hormones to prevent pregnancy. IUDs last from 3 to 10 years, depending on the type. They are over 99% effective and require little maintenance. Once removed, a woman’s ability to get pregnant returns right away.

Oral Contraceptive Pills (Birth Control Pills): Birth control pills are taken daily to stop ovulation and prevent pregnancy. They are simple to use but must be taken every day at the same time to be effective. If used correctly, they are 91% effective. They also help with period regulation and can improve skin conditions. However, they may cause side effects like nausea, and they don’t protect against sexually transmitted infections.

Contraceptive Implants: Implants are small rods placed under the skin of the arm by a doctor. They release hormones to stop pregnancy and can last for up to 3 years. They are more than 99% effective. After removal, fertility returns quickly. Some women might experience irregular bleeding, but they are a good choice for long-term contraception without daily effort.

Injectable Contraceptives: These are hormone shots given every 3 months to prevent pregnancy. They are more than 94% effective but require a visit to the doctor for regular injections. After stopping the shots, fertility may take a few months to return. Some women experience side effects like weight gain or changes in periods, but it’s a good option for those who prefer not to take pills.

Barrier Methods (Condoms and Diaphragms): Barrier methods, like condoms and diaphragms, work by blocking sperm from reaching the egg. Condoms are easy to use and also protect against sexually transmitted infections (STIs). Diaphragms are used with a special gel and need to be fitted by a doctor. These methods are about 85% effective when used correctly. They are great for temporary contraception and are easy to use without long-term commitment.

It is important to consult a healthcare provider before choosing a family planning method because they will be able to determine the safest and most effective option based on your individual health, medical history, and lifestyle. A healthcare provider ensures that the method you choose is suitable for your body and addresses any potential health risks or concerns.

They can explain how each method works, its benefits and side effects, and may even advise on what might work best for you. Regular consultations also allow for follow-up care, ensuring the effectiveness of the chosen method in your case and dealing with any issues that arise. This professional advice will lead you to an informed and confident decision about your reproductive health.

Data from the Fiscal Year 2080/81, provided by the Directorate of Health, Gandaki Province, underscores the critical role of family planning programs in addressing unplanned pregnancies and reducing health risks. Government facilities recorded 45 new female users and 2 male users, while non-government facilities added 2 new female users. Currently, 14,922 women and 17,607 men rely on family planning services.

Postnatal family planning adoption shows that within 48 hours of delivery, 5 women opted for IUCDs, 7 for implants, and 52 underwent tubectomies. For cases beyond 48 hours but within one year of delivery, 98 women chose injectables, 12 adopted Sangini Press, and 10 began using oral pills. These figures highlight the impact of accessible family planning services in mitigating unplanned pregnancies and promoting reproductive health in the region.

Gandaki Hospital in Pokhara offers comprehensive family planning services, providing both permanent and temporary contraception options to meet the diverse needs of individuals and couples. The hospital provides permanent family planning methods such as tubal ligation and vasectomy, which are highly effective and suitable for those who do not wish to have more children. For temporary methods, the hospital offers a wide range of options, including intrauterine devices (IUDs), oral contraceptive pills, contraceptive injections, and implants.

Gandaki Hospital is equipped with trained healthcare professionals who offer personalized counseling to help individuals make informed decisions based on their health conditions, preferences, and family planning goals. The hospital ensures that each patient is given proper guidance on how to use these methods effectively, along with regular follow-up care to address any concerns or complications. With its well-equipped family planning services, Gandaki Hospital plays a crucial role in supporting reproductive health in the community.

Marie Stopes Nepal offers a variety of sexual and reproductive health services, including family planning and abortion services, at an affordable cost and in a safe manner. They provide services through their 22 centers across Nepal, as well as outreach to rural areas through mobile clinics. These services are supported by trained and qualified professionals, ensuring clients receive both medical and emotional support in a welcoming environment.

Marie Stopes Center in Pokhara offers a variety of family planning services to support individuals and couples in managing their reproductive health. These services include contraceptive counseling, where clients receive guidance on selecting the best family planning method based on their needs. They provide oral contraceptive pills, injectable contraceptives given every three months, and both copper and hormonal intrauterine devices (IUDs) for long-term contraception.

According to Senior Nurse at Marie Stopes Pokhara, Pooja Karki, Marie Stopes provides routine health check-ups, screenings, and follow-up care to ensure the effectiveness of the chosen method and address any health concerns. The center also offers contraceptive implants, male and female sterilization (permanent family planning), and emergency contraception pills for preventing pregnancy after unprotected sex.

FPAN (Family Planning Association of Nepal) in Pokhara offers comprehensive family planning services, focusing primarily on providing a wide range of contraceptive methods to help individuals and couples plan their families effectively. The center offers counseling on various family planning options, ensuring that clients understand the benefits, side effects, and suitability of each method based on their health and preferences.

Among the contraceptive methods available, FPAN provides birth control pills, condoms, injectables, implants, and intrauterine devices (IUDs), including both copper and hormonal IUDs, which are highly effective and long-lasting options for pregnancy prevention. These services are designed to meet the diverse needs of the community, offering both short-term and long-term solutions.

According to Senior Nurse of FPAN, Anusha Bhujel, FPAN also educates the public on the importance of family planning and reproductive health, empowering individuals to make informed decisions. For women who have recently given birth, FPAN offers postpartum family planning options to help space pregnancies and ensure better health outcomes.

Family planning is, therefore, a very important aspect of women’s health and well-being, equipping individuals and couples with the ability to make informed choices about their reproductive futures. Institutions like Gandaki Hospital, Marie Stopes, and FPAN are very instrumental in providing family planning services that are accessible and affordable, thus helping women and families responsibly plan their futures.

These hurdles of misinformation, cultural stigma, and a lack of services in place are the areas wherein society can intervene in terms of unplanned pregnancies, avoiding unsafe abortions, for better health of families and societies in general.

Related Article:

A Woman’s Right to Choose: Safe Abortion Services in Pokhara