family planning contribution to health and how it works
DESCRIPTION
Dr. Anne Peterson, MD, MPH explains how using family planning to safely time and space births improves maternal and child health and survival and reduces abortion rates. Dr. Peterson also explains how recent research has shown previous beliefs that some contraceptive methods were abortifacients to be inaccurate.TRANSCRIPT
Epidemiology Disease of Major Importance Fall Trimester
Family Planning Contribution to Health amp How it Works
WHO definition
Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births
It is achieved through use of contraceptive methods and the treatment of involuntary infertility
A womanrsquos ability to space and limit her pregnancies has a direct impact on her health and well-being as well as on the outcome of each pregnancy Decreases mother infant amp child death rates
Can reduce abortion rates
Assists in prevention of AIDS
USAID How Contraceptive Use Impacts Mortality 2008
Better Birth Spacing Saves the Lives of
Children
Maternal Factors Associated with High Infant Mortality
Age of mother at birth too young or too old
Preceding birth interval too short Birth order too high Birth size smallbelow average Availability of care Access to care Education
Risk of death among under-five children with a
preceding birth interval of 36-41 months
compared to risk of death at other birth
intervals
317
126
105
316
143
116
281
100
151
82105
137
140
0
100
200
300
lt18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+
Duration of preceding birth interval (months)
Rel
ativ
e ri
sk (p
erce
nt)
Neonatal Mortality Infant Mortality
Under-Five Mortality Perinatal Mortality
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
WHO definition
Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births
It is achieved through use of contraceptive methods and the treatment of involuntary infertility
A womanrsquos ability to space and limit her pregnancies has a direct impact on her health and well-being as well as on the outcome of each pregnancy Decreases mother infant amp child death rates
Can reduce abortion rates
Assists in prevention of AIDS
USAID How Contraceptive Use Impacts Mortality 2008
Better Birth Spacing Saves the Lives of
Children
Maternal Factors Associated with High Infant Mortality
Age of mother at birth too young or too old
Preceding birth interval too short Birth order too high Birth size smallbelow average Availability of care Access to care Education
Risk of death among under-five children with a
preceding birth interval of 36-41 months
compared to risk of death at other birth
intervals
317
126
105
316
143
116
281
100
151
82105
137
140
0
100
200
300
lt18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+
Duration of preceding birth interval (months)
Rel
ativ
e ri
sk (p
erce
nt)
Neonatal Mortality Infant Mortality
Under-Five Mortality Perinatal Mortality
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
USAID How Contraceptive Use Impacts Mortality 2008
Better Birth Spacing Saves the Lives of
Children
Maternal Factors Associated with High Infant Mortality
Age of mother at birth too young or too old
Preceding birth interval too short Birth order too high Birth size smallbelow average Availability of care Access to care Education
Risk of death among under-five children with a
preceding birth interval of 36-41 months
compared to risk of death at other birth
intervals
317
126
105
316
143
116
281
100
151
82105
137
140
0
100
200
300
lt18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+
Duration of preceding birth interval (months)
Rel
ativ
e ri
sk (p
erce
nt)
Neonatal Mortality Infant Mortality
Under-Five Mortality Perinatal Mortality
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Better Birth Spacing Saves the Lives of
Children
Maternal Factors Associated with High Infant Mortality
Age of mother at birth too young or too old
Preceding birth interval too short Birth order too high Birth size smallbelow average Availability of care Access to care Education
Risk of death among under-five children with a
preceding birth interval of 36-41 months
compared to risk of death at other birth
intervals
317
126
105
316
143
116
281
100
151
82105
137
140
0
100
200
300
lt18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+
Duration of preceding birth interval (months)
Rel
ativ
e ri
sk (p
erce
nt)
Neonatal Mortality Infant Mortality
Under-Five Mortality Perinatal Mortality
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Maternal Factors Associated with High Infant Mortality
Age of mother at birth too young or too old
Preceding birth interval too short Birth order too high Birth size smallbelow average Availability of care Access to care Education
Risk of death among under-five children with a
preceding birth interval of 36-41 months
compared to risk of death at other birth
intervals
317
126
105
316
143
116
281
100
151
82105
137
140
0
100
200
300
lt18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+
Duration of preceding birth interval (months)
Rel
ativ
e ri
sk (p
erce
nt)
Neonatal Mortality Infant Mortality
Under-Five Mortality Perinatal Mortality
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Risk of death among under-five children with a
preceding birth interval of 36-41 months
compared to risk of death at other birth
intervals
317
126
105
316
143
116
281
100
151
82105
137
140
0
100
200
300
lt18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+
Duration of preceding birth interval (months)
Rel
ativ
e ri
sk (p
erce
nt)
Neonatal Mortality Infant Mortality
Under-Five Mortality Perinatal Mortality
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Positive Outcomes When
Pregnancies well timed
Children born 3 but less than 5 years apart compared to children born less than 2 years apart are
15 times more likely to survive first 7 days 22 times more likely to survive first 28 days 23 times more likely to survive first year 24 times more likely to survive to age 5 After A Miscarriage spacing lt 6 months more than
2x as likely to have low birth weight or preterm delivery compared to spacing of 18- 23
Closely spaced births or births to very young mothers increases the risk of death 2 frac12 to 3 fold compared to births spaced 3-5 years apart for the mothers their newborn children and the previously born child
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
70 6967 66
6462 61 61
59 58 5855
49 48
36
28
34
19
2724
2023
17
24
1618
15
6468
76
6164
2827
3336
27
45
2628
0
20
40
60
80Jo
rdan
Ug
an
da
Mad
hya P
rad
esh
Gu
ate
mala
Utt
ar
Pra
desh
Ph
ilip
pin
es
Nig
eri
a
Mo
rocco
Zam
bia
Eg
yp
t
Bo
livia
Ind
ia
Nep
al
Co
te d
Ivo
ire
Ken
ya
Tan
zan
ia
Peru
Gh
an
a
Ban
gla
desh
Ind
on
esia
Perc
en
t
lt36 months
lt24 months
Percent of Birth Intervals that are Short
Source United States Agency for International Development (USAID) Bureau for Global Health Office of Population and Reproductive Health Washington
DC 20523-3600 December 2002 (WWWUSAIDGOV)
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Increased Contraceptive use impact on mortality
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Deaths averted with Family Planning
If there had been no
change in contraceptive
prevalence there would have been 38m additional maternal
deaths in the two decades between 1985 and 2005
Source John Stover The Policy Project The Futures Group 2006
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Family Planning as a priority in high HIV prevalence areas
For Will reduce pregnancies in known HIV+ women gt
decreased AIDS transmission Will reduce pregnancies in HIV+ women who have not
yet been diagnosed (90 still undiagnosed) Ongoing and regular Family planning ndash will reduce
pregnancy occurring during the first weeks of AIDS when viral load is highest
Birth Spacing allows HIV+ women to recover from previous pregnancies maximizing her health before the challenge of another pregnancy
Against Mixed evidence on increased HIV transmission to men
when on long acting hormone contraception Conclusion Recent WHO technical consultation concluded proven
benefits of FP outweighed the inconsistent potential risks of HIV transmission
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Family Planning Use Impact on Abortion Rates
Classic relationship in post-Soviet countries
Mixed in places with falling fertility where there is very high unmet need for fertility control
Reaffirms need for additional FP access
Increased access to FP estimated to reduce induced abortions in the developing world by 70 (from 35 million to 11 million) also reducing deaths and post-abortion costs due to unsafe abortions International Family Planning Perspectives 2003 29(1)6-13
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
CPR
Coverage globally in 2010 ~28
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Comparing effectiveness of methods More effective
Less effective
Less than 1 pregnancy per 100 women in one year
About 30 pregnancies per 100 women in one year
Injections Get repeat injections
on time
LAM (for 6 months) Breastfeed
often day and night
Pills Take a pill each day
Patch ring Keep in place
change on time
Condoms diaphragm Use correctly
every time you have sex
Fertility-awareness based methods
Abstain or use condoms on fertile
days Newest methods (Standard Days
Method and TwoDay Method) may be easier
to use
How to make your
method most effective
After procedure little or nothing
to do or remember
Vasectomy Use another method
for first 3 months
Withdrawal spermicide Use
correctly every time you have
sex
Injectables Pills LAM
Male Condoms
Female Condoms
Diaphragm
Spermicide
IUD Female Sterilization
Vasectomy
Patch Ring
Fertility-Awareness Based Methods
Withdrawal
Implants
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Side Effects amp Obstacles Oral Contraceptives ndash Take every day IUDs ndash Medical procedure to insert Sterilization ndash Permanent Injectable ndash Menstrual disturbance Norplant ndash Cost Condom ndash Use every time Diaphragm ndash Use every time Natural family planning ndash precision in timing
Myth Family Planning methods are abortifacients IN THE PAST there was an incorrect understanding of the mechanisms of action that limited unified faith-based support for family planning TRUTH Family Planning methods prevent conception Most methods accepted by people of faith as contraceptive But incorrect understanding of EC amp IUD mechanism limited
acceptance
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
How DO EC and IUDs work
Emergency contraception prevent pregnancy
Effective only in the first few days following intercourse
before the ovum is released from the ovary and before the sperm fertilizes the ovum
Prevent ovulation change cervical mucous to inhibits entry of sperm to uterus disrupt sperm binding to the egg
Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo
Hormonal amp Copper IUD prevent pregnancy by
Chemical change that damages sperm and egg before they can meet
Cervical mucous change that inhibits entry of sperm to uterus
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Economic Benefits too Costs amp net health effects of contraceptive methods
Compared with use of no contraception Cost savings over 2 years
US$5907woman for tubal sterilization
US$9936 for vasectomy
Health gains 0088 QALYs for diaphragm
0147 QALYs for depot medroxyprogesterone acetate
Even modest increases in the use of the most effective methods result in financial savings and health gains
Sonnenberg FA Burkman RT Hagerty CG Speroff L Speroff T Contraception 2004 Jun69(6)447-59
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Conclusion
Family planning is one of the most effective life saving interventions we have to reduce maternal and child mortality
Increased use of family planning can significantly reduce abortion rates
Unmet need for contraceptives is still at about 24 for Sub-Saharan Africa
Effective non-abortifacient methods including natural family planning methods exist that are acceptable to people of all faiths
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Take Action
Get the word out
We promote family planning because we value women and children
Use the growing amp compelling evidence
Debunk the myths
People of all faiths can now unify in support of family planning to improve health and well-being of millions
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Thank you
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Unmet Family Planning Need 1st Year Postpartum (blue) amp All Women (purple)
0
10
20
30
40
50
60
70
80
B-desh Haiti Kenya Nigeria
1st Year PP
All Women
Source Borda M and W Winfrey Family Planning Needs
during the First Year Postpartum ACCESS-FP
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Non-users 55 intend to use--Their preferred methods for future (Kenya DHS
08-09)
Injectables 52
Unsure 13
Pill 12
Female sterilization 8
Implants 8
Male condom 2
IUD 2
Periodic abstinence 2
Female condom 03
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Contraceptive use in USA among women at risk of unintended pregnancy by religious affiliation (Natl Surv
Fam Grwth 2006-08 n=7356 women)
Protestant
Contraceptive Method All Women Catholic Mainline Evangelical No Relig Affil
Highly Effective 69 68 73 74 62
Sterilization 33 32 34 41 26
Pill amp other hormonal 31 31 35 28 30
Intrauterine device 5 5 4 4 6
Condom 14 15 13 10 17
Natural FP 1 2 1 1 1
Other 5 4 4 6 7
None 11 11 10 9 14
of women sexually active but not pregnant post-partum or trying to become pregnant
Christian Connections for International Health at Center for Bioethics amp Human Dignity 13 July 2012
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
The 2 classic female hormones (progesterone and estrogen) vary throughout the cycle
Cervical mucus is amenable to sperm penetration only mid-cycle when estrogen peaks and before progesterone rises
Any contraceptive that has progestin in it will make cervical mucus hostile to sperm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
IUDS
Hormonal IUDs - progestin levonorgestrel Prevention of pregnancy due to subsequent thickening of cervical mucus which prevents the passage of sperm inhibition of sperm mobility and inhibition of endometrial growth
Copper IUD ndash endometrium releases white blood cells enzymes and prostaglandins and these reactions of the endometrium appear to prevent sperm from reaching the fallopian tubes In addition release copper ions into the the uterus enhancing the debilitating effect on sperm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Hormonal contraceptive methods have at least 2 major mechanisms of action
Inhibitingdisrupting ovulation
Thickening cervical mucus
Other
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Population growth
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
RH bulge to come
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Health in Afghanistan
Maternal Mortality Rates VA is 7100000 Puerto Rico 18100000 2001 was 1600100000 NE Corner Badakshan
province 6400100000 Now (2010)
337100000
Key Findings
bull Fewer Women die during Pregnancy and Childbirth
bull More Children survive to their Fifth Birthday
bull Women are having fewer children
bull More Women Use Life Saving Care
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
USAID and State Family Planning and Reproductive Health Budgets - FY2009
- FY 2011
FY 2009 Enacted
FY 2010 653(a) Initial
FY 2011 Request
Congressional EarmarkDirective
$545000 $648457
-
Family Planning and Reproductive Health
$572401 $666590
$715740
Delta EarmarkDirective vs Programmed
$27401 $18133
-
FY09 included $50m as a USG contribution to UNFPA FY10 includes $55m as a USG contribution to UNFPA FY11 includes $50m as a USG contribution to UNFPA
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Funding comparisons
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Equity for the Moms and Babies
We cannot be complacent
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Impact of FP on abortion rates
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant
The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm
Resources Jim Shelton FP Myths Mary Ellen Stanton MH
National Family Planning and Reproductive
Health Association ndash httpwwwnfprhaorgmainindexcfm
WHO Family Planning Site - httpwwwwhointtopicsfamily_planningen
K4Health (knowledge for Health)project Hopkins Family Planning Guidebook for providers amp Wall chart
CEDPA womenrsquos empowerment amp RH PATH new technology amp coverage expansion FHIhttpwwwfhiorgenindexhtm