Hesperian Health Guides

How family planning methods work

Every day 20,000 people visit the HealthWiki for lifesaving health information. A gift of just $5 helps make this possible!

Make a giftMake a gift to support this essential health information people depend on.


HealthWiki > A Health Handbook for Women with Disabilities > Chapter 9: Family planning > How family planning methods work


Every month, there are times when a woman is fertile and can become pregnant, and times when she is not fertile and cannot become pregnant. Most women produce one egg each month. The egg is released from the woman’s ovary. The egg lives for about 24 hours (one day and one night) after it is released from the ovary. The man’s sperm can live up to 2 days inside the woman’s body. If the woman’s egg has been released while the man’s sperm is inside her body, she can become pregnant.

Family planning methods work to change a woman’s fertility and prevent pregnancy in different ways:

  • Barrier methods (condom for men, condom for women, diaphragm, cervical cap) stop a man’s sperm from reaching the woman’s egg .
  • Intrauterine devices (IUD, IUCD, IUS, Copper T, the Loop) keep a man’s sperm from fertilizing the woman’s egg .
  • Hormonal methods (pills, injections, implants) keep the woman’s ovary from releasing an egg. Some also affect the womb or the mucus in the cervix so sperm cannot fertilize an egg there .
  • Natural methods help a woman know when she is fertile (the time in a woman’s cycle when she can get pregnant), so she can avoid having sex during that time.
  • Permanent methods (sterilization) are operations that stop a man from releasing sperm, or prevent a woman’s eggs from reaching her womb.


Below is a chart that shows how well each method works to prevent pregnancy and to protect against STIs. The chart also shows what the possible side effects are for each method and other important information about how the method may affect your disability. Each method has stars to show how well it prevents pregnancy. Some methods have fewer stars even if they are fairly effective methods, because they are often used incorrectly. When a man and a woman use a method correctly every time they have sex, the method will work better.

FAMILY PLANNING METHOD
Protection from Pregnancy Protection
from STIs
Other Important Information
Condom for men
WWD Ch9 Page 188-1.png
★★★
VERY GOOD

good STI protection.

GOOD
Most effective when used with spermicide and lubricant.
Condom for women

WWD Ch9 Page 188-3.png
★★
GOOD

good STI protection.

GOOD
May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, or get muscle spasms in your upper legs.
Diaphragm and cervical cap

WWD Ch9 Page 188-5.png
WWD Ch9 Page 188-6.png
★★
GOOD

some STI protection.

SOME
More effective when when used with spermicide. May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, or get muscle spasms in your upper legs.
Sponge with spermicide
WWD Ch9 Page 188-8.png

SOME

some STI protection.

SOME
May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, or get muscle spasms in your upper legs.
Home-made sponge
WWD Ch9 Page 188-10.png

SOME

some STI protection.

SOME
May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, or get muscle spasms in your upper legs.
Spermicide
WWD Ch9 Page 188-12.png

SOME

no STI protection.

NONE
May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, or get muscle spasms in your upper legs.
Hormonal Methods

(Birth control pill, patch, injections, implants)
WWD Ch9 Page 188-14.png

WWD Ch9 Page 188-15.png
★★★★
BEST

no STI protection.

NONE
Low-dose pills are OK for women who are paralyzed if they are active or exercise every day. Women with epilepsy should use pills that contain only progestin.
IUD, IUS
WWD Ch9 Page 188-17.png
★★★★
BEST

no STI protection.

NONE
May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, get muscle spasms in your upper legs, or if you have difficulty managing monthly bleeding (this is less of a problem with the IUS that contains hormones).
Fertility awareness
WWD Ch9 Page 188-19.png
★★
GOOD

no STI protection.

NONE
May not be suitable if you have limited hand movement, cannot reach your vagina, cannot open your legs very wide, or get muscle spasms in your upper legs.
Sex without intercourse
WWD Ch9 Page 188-21.png

SOME

some STI protection.

SOME
Because couples may have a hard time sticking to this method, pregnancy often results.
Pulling out (Withdrawal)
WWD Ch9 Page 188-23.png

SOME

some STI protection.

SOME
More effective when used with another method like spermicide or diaphragm.
Breastfeeding (during the first 6 months only)
WWD Ch9 Page 188-25.png
★★
GOOD

no STI protection.

NONE
To use this method, a woman must give her baby only breast milk, and her monthly bleeding must not have returned yet.
Sterilization


WWD Ch9 Page 188-27.png
WWD Ch9 Page 188-28.png
★★★★
BEST

no STI protection.

NONE
After a man has been sterilized, a couple needs to use another method for about 12 weeks.