1. Health and Family Planning Wait to have a child until after girl is aged 17. Mother and child will be more likely to live past 1st year of baby’s life! Allowing girls to finish their schooling also makes them better mothers! Their babies are more likely to live and to thrive! Plan your family - it makes it easier to afford food and school for your whole family. Space your children at least 2 years apart. This will mean: Each child gets to nurse longer and grow stronger Mother can become strong again. She will have a healthier second child! Rhythm Method No cost! Works ONLY if both partners AGREE on method! Must use calendar EVERY MONTH! The days a woman can get pregnant are days 8 to 19 of her menstrual cycle. On those days, the woman MUST abstain from having vaginal sex to avoid getting pregnant. She CAN have vaginal sex using a condom or other barrier method, if these are available. DOES NOT PREVENT SPREAD OF HIV! Example: First day of menstrual cycle: Each month, circle that date on the calendar. Then count to the 8th day and draw an X through the next 9 days. These are the days to abstain from unprotected vaginal sex. All other days of that month are OK for unprotected vaginal sex! It’s ok to have sex while menstruating - just be sure to wash afterwards! To be effective, 3 things must be true: 1)Woman’s monthly menstruation has NOT returned since giving birth. 2) The baby is ONLY breast fed, and fed often, day and night. Once the child takes other food and reduces nursing, this method is less useful. 3) The baby is less then 6 months old. After that, it’s less effective. Nursing works ONLY if both partners AGREE on method! While nursing children for several years is very health for the child, Do NOT rely on nursing alone as birth control after 6 months if your cycle has returned! Does not protect against HIV!! Lactation Method is the use of fully breast feeding to delay return to fertility after having a baby. It is ONLY effective until the mother’s menstrual cycle returns. Responsible fathers make healthier families! 1

2. Male and Female Condoms Prevent pregnancy and HIV transmission! Must apply and use correctly Must use new one each time! Work only if partners agree on method!! Using hormonal methods: Woman control the method Does not interfere with sex –Birth Control Pills Can be stopped any time without a health care provider CAN cause side effects such as high blood pressure and blood clots –Injections Only need to get injection every few months Has similar side effects to pills –Implants Work great and last a long time Must be inserted and later removed by health care worker These methods DO NOT PREVENT the spread of HIV/AIDS! Using the male (left) and female (right) condoms correctly: Carefully open package so condom does not tear. Don’t use teeth! Do not unroll condom before putting it on. Put the condom on end of hard penis. Unroll condom until it covers all of penis. Always put condom on before entering partner. After ejaculation (coming), hold rim of condom and pull penis out before penis gets soft Slide condom off without spilling liquid (semen or come inside. Throw away or bury condom. Other considerations: Do not use grease, oils, lotions or petroleum jelly to make condoms slippery, the oil will break the condom! Contain small amounts of natural substances which stop egg production. Hormonal (Chemical) Methods WAIT! PLAN! SPACE! Health and Family Planning 2

3. When the man feels closed to ejaculating, he should withdraw from the woman and ejaculate outside her body, well away from her genitals If he has ejaculated recently, he should urinate and wipe the tip of his penis before having intercourse ONLY useful if both partners fully agree! NOT AS EFFECTIVE as other methods and doesn’t prevent HIV! Re-usable with care Work better when used with spermicide REDUCES but doesn’t prevent HIV transmission Must stay in for 6 hours after sex Must take care not to damage! NOT AS EFFECTIVE as condoms Spermicides & Diaphragms Withdrawal OTHER METHODS WAIT! PLAN! SPACE! Family planning works best when you both work TOGETHER! Health and Family Planning Sterilization 1. Vasectomy Permanent contraception for men. Through a small incision in the scrotum, the tubes that carries sperm to the penis are blocked by cutting and tying it closed Has few side effects, enhances enjoyment of sex, man shows family responsibility 2. Female Sterilization Permanent contraception for women. Through a small incision in the belly, the tubes that carries the egg to the uterus are blocked by cutting and tying it closed Has few side effects, enhances enjoyment of sex, nothing to remember! 3

4. Traditional Methods that work poorly, can hurt you and/or cause permanent infertility: Mechanical barriers such as: sponges lemon halves, shelled out and placed over cervix (similar to cervical cap), linen pads in vagina, Crocodile or elephant dung(!) Condom-like materials: cecum and bladder of various animals, linen sheaths, receptacles shaped like condoms that are placed into vagina Spermicidal materials : Lemon juice; cola drinks; vaginal pill made of tannic acid; pastes and gums of honey, natron, sodium bicarbonate, oils, ground betelnut Douches of: alum, white oak bark, hemlock bark, red rose leaves, raspberry leaves, roots, zinc sulphate, sodium bicarbonate, coca cola Removal of semen from vagina by mechanical methods such as: wiping with a cloth or jumping up and down, Pessaries or suppositories such as: Gold ball at the base of the “temple of love”, Block pessary with 4 concavities, Beeswax, Opium ball, stones placed in the uterine cavity Systemic preparations: Cup of roots to make woman sterile, such as worm fern roots Sabine (Juniperus sabina) to prevent conception Marjoram, thyme, parsley, and lavender teas Willow tea Do Not Use These Methods!! From: Family Planning: A Handbook for Global Providers Health and Family Planning 4