Counseling is a key component of family planning services. The time dedicated to talking with clients can help ensure correct use of and satisfaction with a chosen contraceptive method.
What does every user of family planning services have the right to expect?
- Information: to understand the advantages and availability of family planning
- Access: to be able to obtain services, regardless of race, creed, social status or lifestyle
- Choice: to make decisions freely regarding family planning and contraceptive methods
- Safety: to practice safe and effective family planning
- Privacy: access to a private space for receiving counseling and services
- Confidentiality: to be certain that any personal information will be kept confidential
- Dignity: to be treated with courtesy, consideration and complete attention
- Comfort: to feel comfortable when receiving services
- Continuity: to receive family planning services and supplies at the times when they are necessary
- Opinion: to express points of view regarding the services being offered
What should family planning counselors be able to do?
- Create a comfortable atmosphere for family planning users
- Have respect for the values and attitudes of users
- Present information clearly
- Encourage the formulation of questions
- Listen and observe attentively
- Be impartial or neutral
- Ask questions in a manner that encourages clients to share information and feelings
- Facilitate effective counselor-user interaction
- Speak the language of the client
What sort of counseling should be provided for specific contraceptive methods? Intrauterine devices (IUDs)
If a woman would like to use an IUD, be sure to discuss the following issues:
- Characteristics of IUDs
- Current and possible future risk of contracting sexually transmitted infections (STIs)
- Mechanism of action and effectiveness of IUDs
- Procedures for inserting and extracting IUDs
- Instructions for use and follow-up visits
- Signs of possible complications
Common side effects of IUDs:
- During insertion: some pain and stomach cramping
- In the first few days: bleeding and mild cramping
- In the first few months: increased menstrual bleeding, light bleeding or cramps between periods
Barrier methods
Strengths, weaknesses and side effects
- How to use the method correctly
- The importance of regular/systematic use
- Ways to incorporate methods into intercourse (where appropriate)
- Common problems (and their solutions) associated with use
- Where to obtain additional supplies
Female and male sterilization Topics to cover when counseling include:
- Information on other methods to ensure informed choice of this method
- Choice of techniques, if possible
- Detailed discussion of the decision to terminate fertility
- Any doubts on the part of the client; if the client has doubts, counselors should recommend that she/he wait longer before undergoing this procedure
- Possible complications
- Time to effectiveness of the method
- Lack of protection against STDs/HIV; counselors should suggest the supplemental use of a barrier method
Progestin-only injectables For DMPA (depo-medroxyprogesterone acetate), it is necessary to inform women of:
- Possible changes in the menstrual cycle, particularly prolonged or excessive bleeding, or amenorrhea
- The significance of amenorrhea
- Delays in the return to fertility
- The need for regular and timely injections
- The lack of protection against STDs/HIV
- Other side effects
- The need to speak with providers about any particular concerns and the need to return to the clinic should any problems arise
Sources: Family Planning Counseling: A curriculum prototype; participant's handbook, AVSC International, New York, 1995. Contraceptive Technology Update (CTU) series, Family Health International, Research Triangle Park, NC.
