The Art Of Natural Family Planning In The Light Of John F. Kippley
NATURE OF FAMILY PLANNING
- What Is Family Planning
Family planning according to the Oxford Advance English Learners dictionary is defined as the process of planning the number of children, intervals between births, etc in family by using birth control method. Family planning, says a character on a television show aired in Nigeria Television Authority (NTA) channel 8, Enugu, Nigeria on 16th April 1996, means having children when you TO PLACE AN ORDER FOR THE COMPLETE PROJECT MATERIAL, pay N3, 000 to: BANK NAME: FIRST BANK ACCOUNT NAME: OKEKE CHARLES OBINNA ACCOUNT NUMBER: 3108050531 After payment, text the name of the project, email address and your
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After payment, text the name of the project, email address and your names to 08064502337want to. Further, for Williams, family planning programmes provide information and services to help people achieve their own fertility objectives. It should be noted that at the time organized family planning campaigns were first extended to the southern hemisphere in the 1950s, there was absolutely no indigenous support for them.
The family planning campaign uses incentives to persuade people to try contraceptives. Cash payments are paid to sterilization acceptors, and financial rewards or bonuses are given to upholders of family planning in the
clinic. The incentive approach was also extended to the private sector, where large employers (often multinational corporations) make it known that workers are expected to use family planning. This tactic has been widely implemented in Brazil, Nigeria and India, and is supported by U.S. Agency for International Development (USAID). Family planning itself is a deceptive, which aims in hiding the fact that fewer children are the sponsor’s long-range and only objective. The report also suggested the use of incentives such as payment to acceptors for sterilization or disincentives such as giving low priorities in the allocation of housing and schooling to those with larger families. The incentive programmes, which have been in use in some parts of Asia for almost twenty years, works best when people are hungry. A study published in 1990 by the Population Council, a U.S. government population control contractor, examined the incentive programmes in Bangladesh. Under that programmes, persons who agree to permanent surgical sterilization are paid a fee for doing so. The Population Council’s report contains among all other cases, a story of Khairul, a labourer with a young wife and three small children. His earnings were so low, says the publication, that if Khairul fails to find employment for a single day he has to borrow money from neighbours to buy food. For two days before his surgery, the Population Council publication says, Khairul had no job and no food for the family. Still, he resisted sterilization. He sold an aluminum-cooking utensil and bought a small amount of rice, which kept the family alive for two more days. Then, in desperation, he accepted the sterilization to save himself and the children.
- Origin of Family Planning
The origin of family planning is traceable to Thomas Robert Malthus (1766-1834), an Anglican clergyman and a British economist who was the first person that raised alarm in the year 1798 that the earth’s population was growing at a faster rate which could soon outrun the earth’s resources. For a way of checkmating population growth, he suggested the issue of late marriage and total abstinence once a family reached the parents’ desired size. But then, when he made this assertion, much attention was not given to his dire warning until it seemed about to come true in a dramatic way as the world at then seemed to be reduced more and more in size because of improved means of transportation and of communications. Then, people began to become very conscious of each other such that the world suddenly appeared to be cramped, confined and overcrowded. It was this issue that Marshall Mchuhan spotlighted when he asserted that the earth has been reduced to the dimensions of a small village
As this was going on and as the dust, which Malthus raised was yet to settle, demographers came up with the most alarming figures imaginable. Their research showed that the line of the population graph moved slowly and evenly until it reached the level of 1000 million people by the year 1800AD. By 1850, the graph began to take an unexpected curve upwards. It swiftly passed the 1500 million mark so that in less than fifty years, the world population increased by almost half as many people as in the past three million years.
No wonder the demographers got alarmed and started shouting that the earth’s population if allowed to continue in this way could outrun the earth’s resources. In 1860, Charles Goodyear accidentally discovered how to vulcanize rubber, and this new technology was soon applied to the making of condoms, which had previously been made from animal skins or intestines. In the 1860s, the neo-Malthusians dropped the morality of Malthus and promoted contraception with the new condoms. And then, the state of Indiana in the USA was the first place in the world to pass legislation based on eugenic principles. In 1907, it passed a compulsory sterilization law aimed at confirmed criminals, idiots, rapists and imbeciles. Thirty other states and Puerto Rico were to follow later. Moreover, the first organized movement towards that end developed during the 19th century. The pioneer, Marie Stopes almost single-handedly, and against powerful oppositions, succeeded in promoting public knowledge of, and demand for contraception. Valerie Riches said that after World War II, when the truth about Hitler’s attempt to breed a master race emerged, “the eugenics movement had to go underground and the term birth control, which had strong Nazi connotations were dropped in favour of family planning. The noble idea that the world was overpopulated gave them the justification they needed and the population control movement was born..
Moreover, even after the birth of population control movements and the introduction of family planning, the worst was yet to happen to population increase as the population graph soared directly upwards at an astonishing rate. It would be recalled that the earth’s population as at the year 1900, was estimated at 2000 million. But then, at 1930, the population of the world rose to 3000 million. Thus, in less than 30 short years, the earth’s population increased by almost half as many people as in the past million years. Finally, it should be noted that the World Health Organization (WHO) has also helped many countries to organize and promote family planning programmes. WHO also sponsors research programmes on family planning and contraception.
KINDS OF FAMILY PLANNING
- Natural Family Planning
Originally, natural family planning was in the form of what was called “ecological breast-feeding”. Here, couple uses this ecological breast-feeding in spacing their babies. This system is non-systematic. But nowadays, the modern days natural family planning is truly a scientific and systematic method of family planning that is all about systematic observation and recording of recurring events. In its nature, natural family planning is an art. It involves a certain amount of skill in observing and interpreting the monthly signs. It is relatively simple, but still, it has to be learned. It involves the use of reason in the learning process and in making practical judgments. It also involves the use of freedom in making decisions about whether to express mutual marital affection in the coital embrace or in some other way. As in any art, one’s practice of natural family planning improves through experience. It doesn’t require any genius to become skilled in this art, but it does require a little practice in the observation and interpretation of signs in order for the couple to feel really comfortable with it. Through, natural family planning, one can either avoid or achieve pregnancy through natural means
In its definition, Dr. Borkman defined natural family planning from a sociological perspective. For him, natural family planning is “a value oriented interpersonal behavioral innovation”. The Microsoft Encarta encyclopedia sees natural family planning as that which is based on abstinence from sexual intercourse on days when fertility is probable, and its effectiveness depends on accurately predicting the times when the woman is ovulating. 2
- F. Kippley in his view defined natural family planning as “a system in which a woman becomes aware of the fertile and infertile times of her menstrual cycle, and then act accordingly”3. Michael Golden himself took the religious point of view in presenting his definition. Thus, he saw natural family planning as “spirituality, a way of life”4. Natural family planning for him then is synonymous with male and female in union with God through
wich, children are safely born naturally in love and cared for.
- Kinds of Natural Family Planning
There are four kinds of natural family planning and they are as follows:
- The Calendar Method (also called Safe Period, Ogino-Knaus Or Rhythm Method)
- The Basal Temperature Method (B.B.T)
- The Billings Ovulation Method (O.M)
- The Sympto-Therminal Method (S.T)
- The Calendar Method
This method is popularly known as the oldest method of natural family planning. it is otherwise known as the Rhythm or the Ogino-Knaus method. Drs. Kyusaku Ogino of Japan and Hermann Knaus of Germany discovered it in the 1920s in their independent research into the menstrual cycles of a number of women. In their individual works, they discovered that ovulation always occurs in women about two weeks before the onset of the following menses. The original research of Drs. Ogino and Knaus laid the foundation for the development of modern natural family planning methods that are currently more effective than most contraceptives.
Calendar method is therefore based on the assumption and calculation of ovulation time as around fourteen days before the commencement of the next menses. When the calendar method was discovered in the 1920s, it was really a great break-through in science since it enables a woman to calculate and estimate her fertile and infertile period. Moreover, the calendar method can be very difficult to use after childbirth and miscarriage, and when menopause is approaching, because cycle lengths can be very irregular during these times. Despite these odds, users of the rhythm method experience a high user effectiveness rate.
2.1.3 The Basal Body Temperature Method
This method was initiated by Dr. Marshall in the early fifties. It is all about the fact that a woman’s temperature when examined each morning after rising is normally 0.2-0.4Fo higher after ovulation and remains high until the next menses. A woman practicing this method will often also find out that her body temperature dips before ovulation and rises thereafter until menstruation. The temperature method when used accordingly is highly effective.
2.1.4 The Ovulation Method
This method is one of the modern methods of natural family planning and is also called the cervical mucus charting method. There are several variations of the ovulation method, including the Billings Ovulation Method (BOM) and Dr. Thomas Hilgers’ Creighton Model (1965). The ovulation method is based upon the regular self-observation of the pattern of changes in the cervical mucus during the menstrual cycle. Here, the woman observes the quantity and quality of her mucus in terms of slipperiness, stretchiness, wetness and tackiness, as it continues to change from day to day till she approaches ovulation. Ovulation usually occurs within one day before or after the last day of the most slippery or fertile mucus.
A good aspect of this method is that it can be applied to women with either regular or irregular menstrual cycles and to women who are coming off hormonal contraceptives. Again, breastfeeding mothers find this method to be an excellent method. Another important issue to note is that the ovulation method, as study had shown, had enabled men and women to conceive, especially those who have been finding it very difficult to conceive after many years.
2.1.5 The Sympto-Thermal Method
The Sympto-Thermal Method is the combination of the observations of basal body temperature and ovulation method of natural family planning. Here, it has been noted that the mouth of the cervix opens, rises, and its tip becomes softer during the fertile times while the mouth of the cervix closes, descends, and the tip becomes firmer during the infertile times.
The average experienced couple using the Sympto-thermal method has about nine or ten days of abstinence each cycle. Every time that a fertile type of mucus appears before ovulation, they must abstain for three days. And finally, we should note that this method was discovered recently and it has been marked with a very high success rate when used accordingly.
- The Artificial Method of Family Planning.
The artificial method of family planning includes various unnaturally means through which man controls pregnancy and are mostly used in preventing pregnancy. The use of this method is dated back to the olden days. For instance, the chapter 38 of Genesis tells the story of Onan, his elder brother had just died, and he was bound by an ancient Near Eastern custom called the Law of the Levirate, to marry his brother’s widow, Tamar. He is to have a son, which would be considered the son of the deceased through her so as to keep alive the family line. Onan would go through the process of intercourse but would then spill his seed on the ground5. This is called “withdrawal;” the technical term is “coitus interruptus.” Then again, there was this form of birth control, which was practiced by the pagans in the first century. The practice was that of mixing potions and drinking them so that the potion works by preventing ovulation or killing the sperm or killing the newly conceived baby, or doing the function of all of the above. The Greek word for such mixing of potions is called “pharmakeia”, from where we have the modern word, “pharmacy”6.
The issue of controlling birth artificially has been a human concern for thousands of years. The oldest known medical text, from the 19th century BC, contains information on contraception. The first contraceptive devices were simple mechanical barriers in the vagina that prevented the male sperm, deposited in the vagina during sexual intercourse, from fertilizing the female. Among the many vaginal preparations that have also been used historically to prevent pregnancy are sea sponges, quinine, rock salt, and alum. There are however so many artificial methods of family planning and for the sake of comprehension, we shall group them into two important groups: contraceptives and abortifacients.
Literally, contraceptive means against conception. And then for Michael Golden, conceptive is defined as “the intentional prevention of the fertilization of the human ovum by special devices, drugs and techniques”.7 Generally, whatever seeks to prevent conception is best referred to as a contraceptive. Moreover, for Ifeanyi, contraceptive is defined “as that which consists in preventing the human life from coming into existence at all”8. For the Oxford Advance Learner’s Dictionary, contraceptives are devices or drugs used in preventing a woman from becoming pregnant.9 Some of these contraceptives are treated below.
The combined pill, commonly known as ‘the pill’ contains the hormones oestrogen and progestogen. The pill acts in two natures; the first nature is to act as a contraceptive, which prevents fertilization to happen. In this nature, it interferes with the functions of the brain so that the brain is pushed to block the release of the ovum during the period of ovulation. Also, the pill makes vaginal mucus to be inimical to sperms such that conception is prevented. In its second nature, the pill act as an abortifacient especially when it fails in its first primary function of preventing conception. At this stage now, the pill employs its second nature as an abortifacient by altering the lining of the womb so that the baby cannot feel comfortable in the womb. Consequently,
the baby is aborted. The pill is still very much highly effective when taken according to directions, even though pregnancy had resulted in certain cases of people who were using the pill.
A condom is a sheath that is worn over the penis during the act of sexual intercourse and the aim is to prevent sperm from entering into the cervix. Consequently, this process prevents fertilization since it prevents the sperm from reaching the egg. Condoms are the oldest form, which has been used by men, and they are less effective when used properly with each act of intercourse. But then, with younger and inexperienced users, the failure rate of condoms is higher. Because condoms are inexpensive, easy to use, do not require medical supervision, and have few side effects, they are currently the most common contraceptive devices employed worldwide.
Diaphragm or cap is a shallow rubber cup that fits over the female cervix to prevent the sperm from reaching the egg. The cup holds a spermicidal jelly or cream that immobilizes any sperm that may be present around the edges of the diaphragm. These devices have few side effects and, are less effective in preventing pregnancy since some women were noted to have conceived even after using this method.
These are prescribed in the form of spermicidal jelly, cream, or foam. Like condoms, spermicides can be used without medical supervision, and must be used with each act of sexual intercourse. They are chemicals that act by killing or interfering with the sperm so that they are rendered inactive. They have few side effects, but are less effective than all other methods.
Surgical sterilizations are available for both men and women. In women, surgical sterilization is done by clipping, tying, or cutting the fallopian tubes such that the egg is prevented from travelling down the fallopian tubes. This process is called tubal ligation. In men, sterilization is done by cutting or tying-up the two vasa deferentia (the tubes that carry sperm from the testes to the penis) such that the flow of sperm during intercourse is prevented. This process is known as vasectomy. Surgical sterilization should be considered a permanent method because surgery to restore fertility in surgically sterilized people is not always successful.
As the name implies this method of family planning do not prevent pregnancy. They allow conception to occur but on the other hand, prevent the foetus from surviving inside the womb. Thus, it is in their nature to terminate the life of the foetus in the womb before they are born. All abortifacient methods occasionally allow a woman to ovulate, so they work by preventing implantation. Literally, abortifacient means, “to make an abortion”.
Throughout the history, there have been innumerable ways of preventing the life of a child from growing in the womb and surprisily; some of these have been practiced as far as ancient times. For instance, there was this oral abortifacient in the form of strong purgatives which were used in the ancient Roman Empire. And nowadays, newer methods of abortifacients are being invented, manufactured and the old ones are from time to time modified in order to suit the designs of the present generation of family planning. However, there are two kinds of abortifacient: Silent Abortion and Direct Abortion.
2.2.3 Silent Abortion
They are called silent abortion because abortion takes place before the woman knows that she was pregnant. In most cases, women who use this method do not even know that they were pregnant before the baby is ejected from their wombs. The nature of silent abortion is to allow fertilization to occur, and prevents the implantation of the newly fertilized ovum from developing in the womb. In other words, they work by killing the life of an already- conceived human being in the womb.
Silent abortions are procured by means of some drugs and devices, which are often sold as contraceptives but which in the actual fact, allow fertilization to occur and then effect an abortion in the first week after fertilization. Examples of these contraceptive drugs that work as abortifacients are treated below:
Intrauterine devices (IUDs)
Intrauterine devices could also be identified as the coil or the loop. The invention of today’s intrauterine devices is supposed to have been rooted from the primitive uses of intrauterine devices more than 2000 years ago. Then, camel drivers knew about the contraceptive effect of intrauterine devices. They would commonly insert small round stones into the uteri of their female camels in order to prevent pregnancy on long journeys. Whether or not human females used this method then are unknown. However, what is known is that the first modern-day Intrauterine devices, the ‘Grafenberg Ring’, were placed on the market in 1915.
The intrauterine device is a foreign body made of a non-reactive plastic such as polyethylene, inserted into the uterus to prevent implantation of the developing human being. The coil works by preventing the fertilized ovum from attaching itself to the wall of the uterus and thus, the child is ejected from the womb. Most Intrauterine devices are made of active chemicals, such as progesterone or copper, which slowly diffuse into the uterus to prevent fertilization. A doctor or nurse must insert an intrauterine device, but once in place, it can remain in place for three to eight years.
Depo-Provera is a form of an injection of progestogen into the body in order to prevent conception. One injection of Depo-Provera lasts up to 12 weeks, and is not reversible during this time. Depo-Provera was originally developed for the treatment of uterine cancer in the 1950s. However, it has been discovered that many women’s menstrual cycles continue when using Depo-Provera so that pregnancy may be the final result.
Norplant is a new form of birth control, which comprises six flexible tubes or rods about the size of matchsticks and are made of silicone rubber. Each of these tubes are inserted with artificial progestogen under the skin of the upper arm, and once inserted, norplant can last up to five years. The progestogen here thickens the cervical mucus, thereby preventing sperm from meeting the egg. A physician must insert norplant and in many cases, removing the six tubes is trickier than implanting them because the tubes become coated with fibrous tissue and gradually anchor into the surrounding tissue. However, norplant does not prevent ovulation all the time as some women still ovulate and conceive even when still using norplant.
Roussel-Uclaf 38486 (RU-486)
RU-486 acts like progesterone, the hormone that signals the uterus to become receptive to the fertilized egg. RU-486 contains a hormonal imposter that plugs into the uterine progesterone receptors. They are called hormone impostors because they act as if they are true hormones where in the real fact, they do not deliver the message that a true hormone is supposed to transfer naturally. These hormone impostors are called anti-hormones. Once the anti-hormones have occupied the progesterone receptors, the early growing human being is denied attachment and it simply starves for want of nutrients and oxygen. He or she is expelled after several days.
2.2.4 Direct Abortion
In this type, a doctor directly aborts the foetus from the womb in the most obvious way and nobody is deceived that abortion has taken place. Women seek abortion as a last resort especially when all other methods of contraceptives and silent abortions have failed to prevent concept. In 1963, the United States Department of Health, Education and Welfare (HEW) defined abortion as all the measures, which impair the viability of the zygote at any time between the instant of fertilization and the completion of labour.
For Adi, abortion is:
the removal of the non-viable foetus from the mother’s womb by human intervention, either by killing it before removal from the womb, or by exposing it to a condition that would certainly lead to death outside the womb.10
Traditionally, the term abortion has meant the intentional or unintentional expulsion of the preborn child from the uterus before he or she has reached the age of viability.
However, direct abortion is of two kinds and they are, direct and indirect abortion. In the direct abortion, the mother willingly undergoes an abortion in order to achieve her aim. An example of this is when an abortion is done because a woman just simply decides that she does not need a child yet. On the other hand, abortion is indirect when the destruction of the foetus is never intended as a directly willed end. An instance of this is when a baby has to be aborted in order to save the life of the mother. Depending upon the gestational age of the preborn child and the physical condition of the mother, the abortionist has a variety of abortion methods in his arsenal and these are treated below:
The abortionists use this method in most first-trimester abortions and can also use it up to sixteen weeks. The abortionist begins by dilating the cervix. Then he inserts a suction curette (which consists of a hollow tube with a sharp tip) into the uterus. The suction machine tears the developing baby apart, sucks the pieces through the tube and deposits them into a bag.Dilation and Curettage (D & C) Abortion
This method is used during the first trimester of pregnancy. The abortionist inserts a sharp looped knife (curette) into the uterus and cuts the preborn baby apart, removes the body parts, and checks them for completeness. Unlike other abortion methods, the dilation and curettage has an alternative and entirely legitimate use in the sense that physicians often perform curettage after a miscarriage to ensure that the uterus is clean.DilationandEvacuation(Abortion
The dilation and evacuation method of abortion is most commonly used during the first half of the second trimester (13 to 20 weeks), but can be employed up to about twenty-eight weeks. The baby is dismembered, and the pieces are removed one by one. In many cases, the abortionist cuts off one or more of the baby’s limbs and waits until he or she bleeds to death before proceeding with the abortion.
Saline abortion is used for second trimester and early third trimester abortions, but has become less popular due to possible harm to the mother brought on by accidental injection of saline solution into a blood vessel. To begin with, a saline solution is injected into the mother’s uterus, the baby breathes this saline solution and swallows this concentration and dies painfully over a period of hours. The dead baby is then delivered in the next 24 to 48.
Here, the surgeon uses a pair of blunt curved scissors to rip a large opening in the skull of the foetus. Next, he removes the scissors and with a suction catheter, he evacuates the baby away from the womb.
Prostaglandin abortions are used during the late second trimester and third trimester of pregnancy. A prostaglandin hormone is injected into the uterine muscle, and this makes the uterine muscle to contract and expel the baby in an artificially-induced and extremely violent premature labour that takes about 20 hours. This method of abortion is now rarely used because up to seven percent of preborn babies are born alive during the procedure.
A hysterectomy is actually a cesarean section done during the last trimester of pregnancy when other types of abortion may be too dangerous to the mother. The mother’s uterus is surgically opened and the baby is lifted out. The helpless baby is then destroyed.
The abortionist injects potassium chloride or some other fluid into the heart of the foetus which causes an immediate heart attack in the preborn baby. After a period of days, the dead preborn child is delivered naturally.
The selective abortion has been in use since about 1980 and is now generally standardized. The most common method involves inserting a needle through the mother’s abdominal wall into her uterus and injecting potassium chloride into the hearts of the babies. They subsequently die and are reabsorbed by the mother’s
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