FAMILY PLANNING

1. Definition of Family Planning

Family planning refers to the voluntary use of contraceptive methods and other techniques
to control the timing and number of children a couple wishes to have.

It includes spacing births, preventing unintended pregnancies, and limiting the

number of children for health, economic, or social reasons.

2. Objectives of Family Planning

• Promote maternal and child health by spacing pregnancies.

• Reduce unplanned pregnancies and unsafe abortions.
• Improve family welfare and economic stability.
• Support women’s empowerment and gender equality.
• Help couples achieve their desired number of children.

3. Importance of Family Planning in Nursing

• Nurses play a critical role in education, counseling, and service delivery.

• Promotes safe motherhood and reduces maternal mortality.
• Encourages informed choice and consent.
• Helps in preventing sexually transmitted infections (STIs) when using barrier
methods.
• Supports adolescents and young adults with reproductive health services.

4. Methods of Contraception

A. Natural Methods

• Abstinence: Refraining from sexual activity.

• Calendar (Rhythm) method: Tracking menstrual cycle to avoid fertile days.
• Withdrawal (Coitus Interruptus): Removing the penis before ejaculation.
• Lactational Amenorrhea Method (LAM): Temporary method used in breastfeeding
mothers.

Pros: No side effects, no cost

Cons: High failure rates if not used correctly

B. Barrier Methods
 • Male condom
• Female condom
• Diaphragm and cervical cap

Prevents both pregnancy and STIs

Accessible and inexpensive

C. Hormonal Methods

• Oral contraceptive pills (combined and mini-pills)

• Injectables (e.g., Depo-Provera)
• Implants (e.g., Norplant, Jadelle)
• Emergency contraception pills

Highly effective if taken correctly

Possible side effects: nausea, weight changes, mood swings

D. Intrauterine Devices (IUDs)

• Copper IUD (non-hormonal)

• Hormonal IUD (e.g., Mirena)

Long-acting (up to 10 years), reversible

Must be inserted by a trained professional

E. Permanent Methods (Sterilization)

• Tubal ligation (for women)

• Vasectomy (for men)

Suitable for individuals/couples who no longer want children

Requires thorough counseling as they are irreversible

5. Factors Influencing Family Planning Choices

• Age and health condition of the woman

• Number of children already born
• Personal beliefs and religious views
• Cultural norms
• Partner’s opinion
 • Access to healthcare services
• Level of education

6. Nursing Responsibilities in Family Planning

• Provide accurate information and counseling on all methods.

• Respect clients’ rights to make informed choices.
• Maintain confidentiality and sensitivity.
• Help identify medical eligibility for methods.
• Provide or refer clients for contraceptive services.
• Monitor for side effects and complications.
• Educate on dual protection (pregnancy + STI prevention).

7. Common Misconceptions

• Family planning is only for women

• Hormonal methods cause infertility
• Contraceptives promote promiscuity
• Only married couples should use family planning

Nurses must debunk myths and provide clear, evidence-based information.

8. Family Planning and Public Health

• Reduces burden on healthcare system.

• Helps achieve sustainable development goals (SDGs).
• Contributes to poverty reduction.
• Supports education, especially for girls.

9. Ethical and Legal Considerations

• Informed consent is essential.

• No coercion should be involved.
• Special attention to adolescents, people with disabilities, and marginalized
populations.
10. Conclusion

Family planning is a key component of reproductive health. As future nurses, understanding

the methods, benefits, and counselling strategies is essential to supporting individual rights
and improving maternal-child health outcomes.

40 Multiple Choice Questions (MCQs)

1. What is the main objective of family planning?

A. To increase the population
B. To control birth defects
C. To help individuals and couples plan and space pregnancies
D. To delay menopause

2. Which of the following is a natural method of contraception?

A. Oral contraceptive pills
B. Condom
C. Withdrawal method
D. IUD

3. Which contraceptive method helps protect against sexually transmitted infections

(STIs)?
A. IUD
B. Male condom
C. Oral contraceptives
D. Injectables

4. The Lactational Amenorrhea Method (LAM) is effective for how long after
childbirth?
A. 1 month
B. 3 months
C. 6 months
D. 12 months

5. Which of the following is a permanent method of contraception?

A. IUD
B. Vasectomy
C. Implant
D. Diaphragm

6. Which hormone is primarily used in most oral contraceptive pills?

A. Progesterone
B. Estrogen
C. Both estrogen and progesterone
D. Testosterone

7. What is a common side effect of injectable contraceptives like Depo-Provera?

A. Hair growth
B. Menstrual irregularities
C. Constipation
D. Increased appetite

8. Which of the following is NOT a barrier method?

A. Male condom
B. Diaphragm
C. Cervical cap
D. Implant

9. Emergency contraception should be taken within how many hours of unprotected sex
for maximum effectiveness?
A. 12 hours
B. 24 hours
C. 72 hours
D. 7 days

10. Which of the following is true about IUDs?

A. They are inserted in the bladder
B. They prevent ovulation
C. They are inserted in the uterus
D. They protect against HIV

11. Which contraceptive method is reversible and lasts up to 10 years?

A. Vasectomy
B. Copper IUD
C. Implant
D. Emergency pill

12. What is the primary mechanism of action for hormonal contraceptives?

A. Destroy sperm
B. Prevent ovulation
C. Kill eggs
D. Strengthen the uterus

13. Which family planning method is most suitable for a woman who is breastfeeding?
A. Combined oral pills
B. Copper IUD
C. Emergency contraception
D. Mini-pill (progestin only)

14. Which method requires a health professional for insertion?

A. Condom
B. IUD
C. Withdrawal
D. Calendar method
15. What is a benefit of family planning for adolescents?
A. Promotes early marriage
B. Reduces school attendance
C. Prevents teenage pregnancies
D. Encourages large families

16. Which of the following is a sign that a woman should consult a health provider after
IUD insertion?
A. Mild cramping
B. Spotting
C. Foul-smelling vaginal discharge
D. Slight breast tenderness

17. Which method of contraception is most effective at preventing pregnancy?

A. Condom
B. Oral pills
C. IUD
D. Withdrawal

18. What is dual protection in family planning?

A. Using two condoms
B. Using contraception and protection against STIs
C. Using two contraceptive methods
D. None of the above

19. Which group should be especially targeted for family planning education?
A. Only married women
B. Only men
C. Adolescents and young adults
D. Only elderly people

20. Which is a myth about contraceptives?

A. They prevent pregnancy
B. They cause infertility
C. They reduce maternal mortality
D. They can be used by men and women

21. Which of the following contraceptive methods is suitable for emergency use?
A. Implant
B. IUD
C. Emergency contraceptive pill
D. Mini-pill

22. What is one role of nurses in family planning services?

A. Choosing a method for the client
B. Providing counseling and accurate information
C. Refusing services to unmarried clients
D. Performing surgeries

23. The mini-pill contains which hormone?

A. Estrogen only
B. Testosterone
C. Progestin only
D. Both estrogen and progestin

24. One of the advantages of using a male condom is:

A. Long-term protection
B. No need for consent
C. Protection from STIs
D. Irreversibility

25. Which of these is NOT a hormonal method?

A. Implant
B. IUD (copper)
C. Emergency contraceptive pills
D. Injectable

26. Which contraceptive method is suitable for men?

A. Diaphragm
B. Female condom
C. Vasectomy
D. IUD

27. What is a common side effect of oral contraceptive pills?

A. Bone fracture
B. Headache and nausea
C. Hair growth
D. Hearing loss

28. When can a woman start using a contraceptive method after childbirth?
A. Immediately
B. 3 years later
C. After menopause
D. After one year

29. Which of the following can reduce maternal mortality?

A. Unsafe abortion
B. Family planning
C. Teenage pregnancies
D. Early marriage

30. The diaphragm is placed:

A. In the uterus
B. In the bladder
C. Over the cervix
D. Inside the ovary
31. Which method provides continuous long-term protection without user action?
A. Condom
B. Oral pill
C. Implant
D. Withdrawal

32. What should be done before providing any contraceptive method?

A. Force the method
B. Ignore the client’s wishes
C. Provide informed consent and counseling
D. Charge extra fees

33. One limitation of natural methods is:

A. They are costly
B. They cause infertility
C. They require discipline and consistency
D. They involve surgery

34. What does “informed choice” mean in family planning?

A. Forcing clients to choose a method
B. Giving one option only
C. Allowing clients to decide after full information
D. Choosing for the client

35. Which contraceptive method is most prone to human error?

A. IUD
B. Oral pill
C. Implant
D. Injectable

36. Which method prevents fertilization by altering cervical mucus and ovulation?
A. Barrier methods
B. Hormonal methods
C. Natural methods
D. Vasectomy

37. What is a major benefit of spacing births by at least 2 years?

A. Lowers healthcare cost
B. Reduces infant and maternal death
C. Increases population
D. Reduces family love

38. Which of the following is true about vasectomy?

A. It affects sexual performance
B. It is immediately effective
C. It is a permanent male method
D. It is done for women

39. Which of the following is NOT a family planning myth?

A. Contraceptives make women sterile
B. Contraceptives cause cancer
C. Family planning promotes good health
D. Contraceptives harm the womb

40. Which of the following best describes “unmet need” in family planning?
A. Lack of food
B. Lack of family support
C. Wanting to avoid pregnancy but not using contraception
D. Wanting more children but being infertile

Case Study 1: Postpartum Contraception

Case:
Marie, a 27-year-old woman, delivered her second child two months ago. She is exclusively
breastfeeding and is not ready for another pregnancy. She is looking for a contraceptive
method that will not interfere with breastfeeding.

Question:

1. Which method is MOST suitable for Marie?

A. Combined oral contraceptive pill
B. Copper IUD
C. Progestin-only pill (Mini-pill)
D. Emergency contraception

Case Study 2: Adolescent Reproductive Health

Case:
Fola, a 17-year-old girl, visits a clinic asking for information on how to prevent pregnancy.
She is sexually active but hesitant to talk to her parents.

Question:
2. What should the nurse do FIRST?
A. Refuse to help because she is a minor
B. Call her parents
C. Educate and provide confidential counseling
D. Give her an implant immediately

Case Study 3: Side Effects of Pills

Case:
Sarah has been using combined oral contraceptive pills for two months. She complains of
nausea and mild headache.
Question:
3. What advice should the nurse provide?
A. Stop the pills immediately
B. Change to injectables
C. Reassure her as these are common side effects
D. Take double dose of pills

Case Study 4: Vasectomy Counseling

Case:
A couple visits the clinic. The woman has health issues that make pregnancy risky. The man
is open to vasectomy but wants to understand more.

Question:
4. Which of the following is TRUE about vasectomy?
A. It affects sexual desire
B. It is reversible immediately
C. It is a permanent method of male contraception
D. It prevents STIs

Case Study 5: Emergency Contraception

Case:
Lisa had unprotected sex 48 hours ago. She is worried about getting pregnant and wants
advice.

Question:
5. What is the best action for the nurse?
A. Tell her it’s too late
B. Offer emergency contraception
C. Ask her to wait for her period
D. Recommend a permanent method

Case Study 6: Religious Beliefs and Family Planning

Case:
A couple refuses hormonal contraceptives due to their religious beliefs. They want a natural
method.

Question:
6. Which of the following should the nurse recommend?
A. Implant
B. Withdrawal method
C. Calendar method
D. IUD

Case Study 7: Male Involvement

Case:
Peter accompanies his wife to a family planning clinic and wants to learn more about male
options.

Question:
7. Which is a suitable male contraceptive method?
A. Diaphragm
B. Vasectomy
C. Implant
D. Injectable

Case Study 8: Missed Pills

Case:
Fatima missed two days of her oral contraceptive pills and had unprotected sex on the third
day.

Question:
8. What should the nurse advise?
A. Do nothing
B. Take emergency contraception and resume the pills
C. Take 4 pills at once
D. Stop using pills completely

Case Study 9: STI Risk

Case:
John and Mary are in a new relationship. They want a contraceptive method and also want to
avoid STIs.

Question:
9. Which method is most suitable for them?
A. Oral pills
B. IUD
C. Condom
D. Vasectomy
 Case Study 10: Long-Term Planning

Case:
Angela is 35 years old, has 4 children, and wants a long-term method that doesn’t require
daily attention.

Question:
10. Which method is most appropriate?
A. Condom
B. Oral pills
C. Implant
D. Withdrawal

STRUCTURED CASE STUDY TEMPLATE:

FAMILY PLANNING
1. Patient Profile (Demographics)

• Name: (use pseudonym, e.g., “Mrs. A”)

• Age:
• Marital Status:
• Parity: (number of pregnancies/live births)
• Occupation:
• Location (optional):

2. Presenting Problem / Reason for Visit

Describe the concern or reason for seeking family planning (e.g., "The client came to the
clinic for contraception after delivery" or "client reports missed pills and unprotected sex").

3. Medical and Obstetric History

• History of chronic illness (hypertension, diabetes, etc.)

• Number of pregnancies
• Delivery mode (vaginal/C-section)
• Breastfeeding status
• Previous contraceptive use
• History of STIs or allergies
 4. Assessment (Nursing Focus)

• Vital signs (if applicable)

• Mental and emotional state
• Knowledge level of contraception
• Religious/cultural beliefs
• Willingness to accept contraceptives
• Partner involvement/support

5. Nursing Diagnosis

Examples:

• Deficient knowledge related to family planning methods

• Risk of unintended pregnancy related to missed pills
• Readiness for enhanced decision-making regarding contraception

6. Goals / Expected Outcomes

• The client will verbalize understanding of at least 2 family planning methods

• The client will choose a contraceptive method suited to her condition
• The client will demonstrate correct usage of the chosen method

7. Nursing Interventions

• Provide information on all suitable contraceptive methods

• Involve client in shared decision-making
• Demonstrate the use of condoms or pill intake schedule
• Refer to physician for long-term methods (e.g., IUD insertion)

8. Evaluation

• Client selected a suitable contraceptive method

• Client shows confidence and correct knowledge in using the method
• Client scheduled for follow-up or further care

9. Follow-up Plan
 • Return visit in 3 months or as advised
• Counseling availability
• Emergency contact for side effects

Example (Short Version):

Name: Mrs. J
Age: 32
Reason for Visit: Wants a long-term method after 3rd delivery
History: 3 full-term deliveries, no chronic illness, breastfeeding
Assessment: Interested in non-daily method, not using contraception currently
Diagnosis: Readiness for enhanced family planning decision-making
Goal: Select and begin using long-term method
Intervention: Educated on IUD and implant options
Evaluation: Chose implant and had it inserted same day
Follow-up: Review in 3 months

Case Study Example 1: Postpartum Family Planning

1. Patient Profile

• Name: Mrs. L (pseudonym)

• Age: 29
• Marital Status: Married
• Parity: G3P3 (3 pregnancies, 3 live births)
• Occupation: Trader
• Location: Urban community clinic

2. Presenting Problem / Reason for Visit

Client came for postpartum follow-up and is interested in a suitable contraceptive method to
avoid another pregnancy in the next few years.

3. Medical and Obstetric History

• No known chronic illnesses

• Last delivery: 8 weeks ago (normal vaginal delivery)
• Breastfeeding exclusively
• No history of STIs or allergies
• Has never used a long-acting method before
4. Assessment

• Physically stable, alert and oriented

• Expresses fear of daily pills and desire for longer protection
• No cultural or religious objection to contraception
• Husband supports her decision

5. Nursing Diagnosis

• Readiness for enhanced decision-making related to family planning

• Risk for unplanned pregnancy related to resumption of sexual activity without
contraception

6. Goals / Expected Outcomes

• Client will identify at least two appropriate methods

• Client will select and initiate one long-term method today
• Client will verbalize proper care and follow-up steps

7. Nursing Interventions

• Provided health education on long-acting reversible contraceptives (LARC)

• Discussed pros and cons of IUD and implant
• Assessed eligibility using WHO Medical Eligibility Criteria
• Supported informed decision-making

8. Evaluation

• Client chose the subdermal implant

• Implant inserted under aseptic conditions
• Client understood when to seek help (e.g., for side effects)
• Booked for 3-month follow-up

9. Follow-up Plan

• Review visit scheduled in 3 months

• Advised to return for any signs of complications
 • Provided contact for questions

Case Study Example 2: Adolescent Counselling on

Contraception
1. Patient Profile

• Name: Miss T
• Age: 18
• Marital Status: Single
• Parity: 0
• Occupation: Student
• Location: University health clinic

2. Presenting Problem / Reason for Visit

Client presents for advice on preventing pregnancy. She recently became sexually active and
wants to avoid unplanned pregnancy without informing her parents.

3. Medical and Obstetric History

• No previous pregnancies
• Menstrual cycles regular
• No known medical conditions
• No current contraception
• Expresses anxiety about confidentiality

4. Assessment

• Anxious but cooperative

• No religious objection to contraception
• Shows willingness to learn
• Prefers a method she can manage independently

5. Nursing Diagnosis

• Deficient knowledge regarding contraceptive options

• Risk for unplanned pregnancy related to unprotected sex and lack of contraception
6. Goals / Expected Outcomes

• Client will demonstrate knowledge of at least two suitable contraceptive options

• Client will choose one method
• Client will verbalize understanding of use and side effects

7. Nursing Interventions

• Provided private, confidential counseling

• Educated on condom use and progestin-only pills
• Demonstrated correct use of condoms
• Addressed myths and answered questions

8. Evaluation

• Client chose condoms for STI protection and ease of use

• Agreed to consider progestin-only pills in the future
• Client expressed confidence in her ability to use chosen method

9. Follow-up Plan

• Offered monthly counseling if needed

• Advised to return anytime if she misses periods or has side effects
• Reassured confidentiality