There are different methods of family planning that is available for use and these can be classified into natural and artificial. Natural methods are less likely to create side effects to the couple unlike artificial methods which bears consequences, and most of these methods are used into women. Thus, before choosing for the right contraceptive method, various things are need to be considered. There are two broad categories of birth control methods: natural and artificial.

Lactation amenorrhea method (LAM) is a method considered as a natural contraception which took advantage on the natural effect of breastfeeding to a women’s fertility wherein there is a delay of return after child birth. Breastfeeding suppresses the secretion of gonadotropin-releasing hormone by the hypothalamus which eventually inhibits the pituitary gland to release gonadotropin – a hormone needed for the development of the ovarian follicle. This type of method is indicated only if: (1) the menstrual period after birth has not returned yet; (2) breastfeeding is 85% - 100% done, day and night; and (3) the infant is less than 6 months. Since it uses the normal physiology after giving birth, tit is readily available to the couple and this method has no side effects to women. Thus, it is only contraindicated to women who does not make to the criteria mentioned above. As stated by the US MEC, LAM is not restricted to any medical conditions. But some women with a certain condition or have an infant with a condition that makes breastfeeding a contraindication may not still be recommended for this type of contraception. Lastly, this method does not protect the couple from transmitting or acquiring STDs and HIV hence, additional method like condoms might still be needed.

Coitus interruptus (withdrawal) is considered as a traditional family planning method. In this way, the penis is completely removed from the vagina before ejaculation to prevent the semen from being ejected inside the vagina and possibly cause fertilization. Since, this method is highly dependent on the attitude of the couple, this method is only appropriate to couples that: (1) are motivated and is able to use the method effectively; (2) other means of contraception is contraindicated due to religious or philosophical affairs; (3) have no alternative methods available at hand and contraception is needed immediately; (4) are only planning to use this method temporarily while waiting to start another method; and (5) does not do intercourse often. This method is considered economically because it does not involve purchasing a device. Just like the mentioned method above, this method is not contraindicated to woman with any medical condition according to US MEC. Yet, it also cannot protect the couple from STDs and HIV and use of condom might still be recommended.

Intrauterine Device (IUD) includes insertion of a small plastic or metal device into a woman’s uterus. It has one or two strings that hang through the cervical opening into the vagina. which is classified into copper-containing IUD and levonorgestrel-releasing IUD which contains a total of either 13.5 mg or 52 mg levonorgestrel. IUDs may cost a couple some money but it is readily available in the localities. Some of the common side effects of IUDs to woman are pain, cramping, longer and heavier menstrual bleeding and menstrual irregularities. Cancer development is feared of many as a result of using IUD, but development of invasive cervical cancer is one third less frequent in women using IUD (Cortessis et al, 2017). Because this method uses a device and involves invasive procedure, this is restricted if a woman is pregnant, has postpartum sepsis, immediate postseptic abortion and current breast cancer (US MEC, 2016)

Progestin-Only Contraceptives includes progestin-only implants, depot medroxyprogesterone acetate and progestin-only pills. The main action of this method is to suppress ovulation but it also causes changes in the cervical mucus and endometrial lining. Common side effects of these methods are delayed return to fertility for about 1-4 months after use, irregular vaginal bleeding and gradual weight gain. This method requires purchase of the implant and pills. Use of this method does not increases the risk for developing cardio-metabolic diseases (Glisic et al, 2020) but it is still contraindicated to woman with liver conditions, (cirrhosis, hepatitis, tumor), hypertension, diabetes with vascular complication, stroke, myocardial infarction, DVT and history of breast cancer.  

Combined oral contraceptives (COCs) includes low-dose combines oral contraceptives, combined hormonal patch and combined vaginal ring. These are preparations of certain hormones similar to a woman’s natural hormones – estrogen and progesterone. The action of these method is mainly on suppressing ovulation. This method is not considered economical because it required regular resupply if the contraceptive. It has common side effects of nausea, dizziness and breast tenderness. Use of these type increases the risk for cardiovascular disease and benign liver tumors. Specifically, it can significantly increase the risk for venous thromboembolism and this risk depends on the type and dose of estrogen in the pill (Oedingen, Scholz & Razum, 2018). According to US MEC it should not be used to woman with cardiovascular comorbidities as well as liver problems.

Barrier Method is easy to use, which includes condoms such as male latex condoms, male polyurethane condoms, and female condoms; spermicides and diaphragm with spermicide or cervical cap. This is readily available to many but requires constant purchase and it is contraindicated to those with allergy to latex rubber or spermicide ingredients. Also, a diaphragm not removed for more than 48 hours may cause toxic shock syndrome. In the US MEC guidelines, barrier devices with spermicides are not to be used to patients with high risk of HIV.

Male and Female sterilization uses permanent, safe and highly effective method of contraception which includes vasectomy and bilateral tubal ligation. Vasectomy is a surgical procedure that ties or cut the vas deferens and bilateral tubal ligation involves cutting or blocking the two fallopian tubes. This method is not utilized fully with only 6 percent of the US population uses this method (Patel & Wachs, 2020) since this method is permanent and irreversible, this is why it is only indicated to couple who are certain. This also requires a sum of money since it involves surgical procedure and may not be readily available to many. According to US MEC, no medical conditions absolutely restricts a person for sterilization unless he/she is not suitable for operation or has an allergy to the materials used.

On choosing the best method to use, first a client counselling and assessment is done, it requires a face to face and interactive process between me and my patient. The first thing to do is to inform the patient of all the available method for contraception and discussing the following: effectiveness; advantages and disadvantages; and side effects and complications. In choosing the method, any method that poses high risk to the patient must be eliminated primarily. The next thing to consider is the availability and affordability of the patient to the method. Lastly is the ease of the patient to use the method. After the decision has been made, the nurse needs to discuss the in-depth explanation of the usage of the method, prevention of STIs and when to return to facility.

If ever I will encounter a patient who believes in contraceptive methods that were not proven effective by research, the first thing I will do is to acknowledge the patient notion as part of respecting their culture and beliefs. Next is I will provide the patient facts given by research towards the method and educate the patient about the reproductive system for the patient to better understand.