Family Planning at the North West Regional Health Authority (NWRHA)

According to the World Health Organization (2018), family planning assists individuals in achieving their desired number of children and spacing of pregnancies(1). This is facilitated through a variety of contraceptive methods and includes the treatment of infertility(1) .  Approximately 67% of women aged 15 to 49 years in the Latin American and Caribbean countries utilize contraceptive methods(1). However, there exists some 214 million women in these same developing countries who want to prevent pregnancy but are not using a modern contraceptive method (1). Here at the NWRHA, we offer a wide range of contraceptive methods which can bridge this gap in our community.

This article is an attempt to educate the reader on the available contraceptive methods and how to access such services at NWRHA. Contraception can be accessed immediately after delivery at NWRHA. If you would like contraception immediately after delivery please consult the doctors before delivery at the hospital. At the local health centres, family planning is usually given by the family planning nurse. Family Planning appointments are usually made at the 6 to 8 weeks post-partum visit. However, appointments can also be made otherwise. An assessment of the method of contraception best suited for your needs and medical conditions will be made by the family planning nurse and/or the doctor at the health centre.

There are many different methods of contraception. Those available at NWRHA include hormonal and non-hormonal methods. The hormonal methods include combined oestrogen and progestogen, and progestogen only. These can administered via pills, one to three monthly injections, or the Intra Uterine Contraceptive Device (IUCD). There are many benefits as well as side effects to hormonal contraception. These can all be discussed with the family planning nurse or doctor at the local health centre.

Non-hormonal methods include condoms, Copper IUCD (CuT), Bilateral Tubal Ligation (BTL), and vasectomy. Condoms are available from the family planning nurse at the local health centre. The insertion of the CuT IUCD can be done at County St George West local Health Centres and at the Gynaecology Out-Patient Clinics (GOPC) at Port-of-Spain General Hospital (POSGH). Bilateral Tubal Ligation is also available through the GOPC POSGH and Vasectomy at the Urology Outpatient Clinic, POSGH.

BTL is a permanent form of contraception and is one of the most commonly used surgical sterilization procedure for women. This surgery involves either cutting, tying or blocking of the fallopian tubes.  After a BTL, no other form of contraceptive method is needed. However, it does not protect against sexually transmitted infections (2).

Vasectomy is also a permanent form of contraception for men. This is the most common permanent surgical sterilization technique for men. In fact, the American Urologic Association has advised that it should be considered more often than what is the usual practice (4). There are different techniques but they all require isolation and division of the vas and operative management of the vasal ends (4). Also, it is important to note that even though no other form of contraception is needed after this procedure, it does not prevent STIs (4).

The male condom is a barrier method of contraception. It is not a permanent method and provides one of the most effective protection from STI (5).

IUCD are small (<4cm), ‘T-shaped’, flexible, plastic items. These can be inserted into a woman’s uterus via the vagina.  IUCD are one type of long-acting reversible contraception (LARC).  IUCD does not protect against STIs. Please see Table 1 for the two types of IUCD offered at NWRHA (6,7,8).

The NWRHA provides universal health care and the provision of any of the above methods listed can be accessed at no cost to the individual. We are pleased to provide this service and hope that you will take advantage of the professional family planning services provided.

Table 1: Description of  Hormonal and Non-hormonal IUCD

HORMONAL NON-HORMONAL
Active material Progesterone (LNG-IUS) Copper (Cu-IUD)
Mode of pregnancy prevention 1)    Thickening of cervical mucus which ‘traps’ sperm and prevents sperm from reaching and fertilising an egg.

2)    Progesterone containing device which temporarily thins the inner lining of the uterus.

Device with coils of copper metal attached.  Copper is toxic to sperm and thus kills the sperm within the uterus.
Duration of use 3-5 years 10 years

 

References.

  • World Health Organization. Family Planning/Contraception [Internet]. February 8, 2018 [cited 2019 August 18]. Available from: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception
  • Mayo Clinic. Tubal Ligation [Internet]. Mayo Clinic Staff; March 29, 2018 [cited 2019 August 18]. Available from: https://www.mayoclinic.org/tests-procedures/tubal-ligation/about/pac-20388360
  • No Scalpel Vasectomy [Internet]. Stockton M.D. [updated 2019 January 16; cited 2019 August 18]. Available from: https://emedicine.medscape.com/article/148512-overview
  • American Family Physician. Vasectomy Techniques [Internet]. Jacksonville, Florida: Clenney T.L., Higgins J.C. ; July 1, 1999 [cited 2019 August 18]. Available from: https://www.aafp.org/afp/1999/0701/p137.html.
  • Contraception [Internet]. Casey F. E.[updated 2018 December 10; cited 2019 August 18]. Available from: https://emedicine.medscape.com/article/258507-overview
  • American College of Obstetricians & Gynaecologists. Birth Control (Contraception): Resource Overview [Internet]. [cited 2019 August 18]. Available from: https://www.acog.org/Womens-Health/Birth-Control-Contraception
  • National Institute for Health and Care Excellence. Long-acting reversible contraception [Internet]. October 2005. [updated 2019 July; cited 2019 August 18]. Available from: https://www.nice.org.uk/guidance/cg30
  • Faculty of Sexual and Reproductive Health of the Faculty of the Royal College of Obstetricians and Gynaecologists. Section B UK Medical Eligibility Criteria for Contraceptive Use [Internet]. UKMEC; 2016 [cited 2019 August 18].  Available from: http://ukmec.pagelizard.com/2016#sectionb/cover
Published in NWRHA Service