Family

planning/contraception
methods
9 November 2020
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Key facts
 Among the 1.9 billion Women of Reproductive Age group (15-49 years)
worldwide in 2019, 1.1 billion have a need for family planning; of these, 842
million are using contraceptive methods, and 270 million have an unmet
need for contraception [1,2]
 The proportion of the need for family planning satisfied by modern
methods, Sustainable Development Goals (SDG) indicator 3.7.1, has
stagnated globally at around 77% from 2015 to 2020 but increased from
55% to 58% in the Africa region [3]
 Only one contraceptive method, condoms, can prevent both a pregnancy
and the transmission of sexually transmitted infections, including HIV.
 Use of contraception advances the human right of people to determine the
number and spacing of their children.

Brief overview
Ensuring access for all people to their preferred contraceptive methods advances
several human rights including the right to life and liberty, freedom of opinion and
expression and the right to work and education, as well as bringing significant health
and other benefits. Use of contraception prevents pregnancy-related health risks for
women, especially for adolescent girls, and when births are separated by less than two
years, the infant mortality rate is 45% higher than it is when births are 2-3 years apart
and 60% higher than it is when births are four or more years apart [4]. It offers a range
of potential non-health benefits that encompass expanded education opportunities and
empowerment for women, and sustainable population growth and economic
development for countries.

The number of women desiring to use family planning has increased markedly over the
past two decades, from 900 million in 2000 to nearly 1.1 billion in 2020. Consequently,
the number of women using a modern contraceptive method increased from 663 million
to 851 million and the contraceptive prevalence rate increased from 47.7 to 49.0 per
cent. An additional 70 million women are projected to be added by 2030 [5].

The proportion of women of reproductive age who have their need for family planning
satisfied by modern contraceptive methods (SDG indicator 3.7.1) has increased
gradually in recent decades, rising from 73.6 per cent in 2000 to 76.8 per cent in 2020
[5] .Reasons for this slow increase include: limited choice of methods; limited access to
services, particularly among young, poorer and unmarried people; fear or experience of
side-effects; cultural or religious opposition; poor quality of available services; users’
and providers’ bias against some methods; and gender-based barriers to accessing
services. As these barriers are addressed in some regions there have been increases
in demand satisfied with modern methods of contraception

Contraceptive methods

Methods of contraception include oral contraceptive pills, implants, injectables, patches,

vaginal rings, Intra uterine devices, condoms, male and female sterilization, lactational
amenorrhea methods, withdrawal and fertility awareness based methods. These
methods have different mechanisms of action and effectiveness in preventing
unintended pregnancy. Effectiveness of methods is measured by the number of
pregnancies per 100 women using the method per year. Methods are classified by their
effectiveness as commonly used into: Very effective (0–0.9 pregnancies per 100
women); Effective (1-9 pregnancies per 100 women); Moderately effective (10-19
pregnancies per 100 women); Less effective (20 or more pregnancies per 100 women)

Mechanisms of action and effectiveness of contraceptive methods [6]

Effectiveness:
Effectiveness:
pregnancies per 100
pregnancies per 100
Method How it works women per year with
women per year as
consistent and correct
commonly used
use
Combined oral Prevents the release of 0.3 7
contraceptives (COCs) eggs from the ovaries
or “the pill” (ovulation)
Thickens cervical
Progestogen-only pills
mucous to block sperm
(POPs) or "the 0.3 7
and egg from meeting
minipill"
and prevents ovulation
Thickens cervical
mucous to blocks
Implants sperm and egg from 0.1 0.1
meeting and prevents
ovulation
Thickens cervical
Progestogen only mucous to block sperm 0.2
4
injectables and egg from meeting
and prevents ovulation
Monthly injectables or Prevents the release of
combined injectable eggs from the ovaries 0.05 3
contraceptives (CIC) (ovulation)
Combined
7 (for patch)
contraceptive patch Prevents the release of 0.3 (for patch)
and combined eggs from the ovaries
7 (for contraceptive
contraceptive vaginal (ovulation) 0.3 (for vaginal ring)
vaginal ring)
ring (CVR)
Copper component
Intrauterine device
damages sperm and
(IUD): copper 0.6 0.8
prevents it from
containing
meeting the egg
Thickens cervical
Intrauterine device
mucous to block sperm 0.5 0.7
(IUD) levonorgestrel
and egg from meeting
Forms a barrier to
Male condoms prevent sperm and egg 2 13
from meeting
Forms a barrier to
5
Female condoms prevent sperm and egg 21
from meeting
Male sterilization Keeps sperm out of
0.1 0.15
(Vasectomy) ejaculated semen
Female sterilization Eggs are blocked from
0.5 0.5
(tubal ligation) meeting sperm
Lactational Prevents the release of
amenorrhea method eggs from the ovaries 0.9 (in six months) 2 (in six months)
(LAM) (ovulation)
Prevents pregnancy by
Standard Days Method avoiding unprotected
5 12
or SDM vaginal sex during most
fertile days.
 Prevents pregnancy by
Basal Body Reliable effectiveness
avoiding unprotected
Temperature (BBT) rates are not available
vaginal sex during
Method
fertile days
Prevents pregnancy by
avoiding unprotected 4
TwoDay Method 14
vaginal sex during most
fertile days,
Prevents pregnancy by
Sympto-thermal avoiding unprotected
<1 2
Method vaginal sex during most
fertile
< 1 for ulipristal
Prevents or delays the
Emergency acetate ECPs
release of eggs from
contraception pills 1 for progestin-only
the ovaries. Pills taken
(ulipristal acetate 30 ECPs
to prevent pregnancy
mg or levonorgestrel 2 for combined
up to 5 days after
1.5 mg) estrogen and progestin
unprotected sex
ECPs
The couple prevents
pregnancy by avoiding
unprotected vaginal
Calendar method or Reliable effectiveness
sex during the 1st and 15
rhythm method rates are not available
last estimated fertile
days, by abstaining or
using a condom.
Tries to keep sperm out
Withdrawal (coitus 4
of the woman's body, 20
interruptus)
preventing fertilization