CCIH 2013 Pre-Conf Family Planning Advocacy Huber

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Dr. Douglas Huber discusses a Christian approach to family planning, including technology, programs, and advocacy. He explores attitudes on family planning among various Christian denominations and methods used. He also explains how various methods work to prevent unintended pregnancies.

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CCIH 2013 Pre-Conf Family Planning Advocacy Huber

  1. 1. Christians and Family Planning in 2013—Advances in Technology, Program and Multi- Faith Advocacy Douglas Huber, MD, MSc Family Planning & Reproductive Health Working Group, Christian Connections for International Health Marymount University, Arlington VA 7 June 2013
  2. 2. WHY should we thank God for this technology?
  3. 3. Current USA contraceptive use among women at risk of unintended pregnancy* by religious affiliation (Natl Surv Fam Grwth 2006-08; n=7,356 women) Christian Connections for International Health, at Center for Bioethics & Human Dignity, 13 July 2012 All women Catholic __Protestant__ None Contraceptive Method Mainline Evangelical Highly Effective 69% 68% 73% 74% 62% Sterilization 33 32 34 41 26 Pill & other hormonal 31 31 35 28 30 Intrauterine device 5 5 4 4 6 Condom 14 15 13 10 17 Natural FP 1 2 1 1 1 Other 5 4 4 6 7 None 11 11 10 9 14 * % of women sexually active but not pregnant, post-partum or trying to become pregnant.
  4. 4. Comparing effectiveness of family planning methods, WHO 2007 More effective Less effective Less than 1 pregnancy per 100 women in one year About 30 pregnancies per 100 women in one year Injections: Get repeat injections on time LAM (for 6 months): Breastfeed often, day and night Pills: Take a pill each day Patch, ring: Keep in place, change on time Condoms, diaphragm: Use correctly every time you have sex Fertility-awareness based methods: Abstain or use condoms on fertile days. Newest methods (Standard Days Method and TwoDay Method) may be easier to use. How to make your method more effective After procedure, little or nothing to do or remember Vasectomy: Use another method for first 3 months Withdrawal, spermicide: Use correctly every time you have sex Injectables PillsLAM Male Condoms Female Condoms Diaphragm Spermicide IUDFemale Sterilization Vasectomy Patch Ring Fertility-Awareness Based Methods Withdrawal Implants
  5. 5. Emergency contraceptive pills do not inhibit implantation—mechanism of action for standard levonorgestrel (LNG) pills (e.g., Plan B, Postinor, etc) How do emergency contraceptive pills work?  ECPs prevent or delay release of egg  No changes in lining of the uterus (womb)  Lab studies show no ability to prevent implantation—same in animal studies 1. Does not apply to IUD used for emergency contraception 2. Not yet clear if will be same for new ECP in USA, ulipristal (ella)— expensive and not available in international programs.
  6. 6. Intrauterine Devices (IUD) Copper IUD 380A—works by preventing sperm from meeting egg--primary mechanism  Sperm are incapacitated, especially with high copper content of 380A—main mechanism; distinct from earlier IUDs  Highly effective—99%. Rare evidence of fertilization with sensitive tests & microscopic examination of tubes  Major reduction in ectopic pregnancy compared with inert or lower copper IUDs  Highly effective method prevents induced abortion—major benefit for health & important to many Christians  LNG devices work primarily by thickening cervical mucus to block sperm
  7. 7. Birth Spacing Saves Children’s Lives 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 <18 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60+ Birth Interval (months) RelativeRiskofMortality Neonatal Mortality Infant Mortality Under-Five Mortality Source: Rutstein, 2003
  8. 8. New Christian community- based programs in Africa  Christian Health Assoc. of Kenya and Uganda Protestant Mission Board—taking family planning from the facility to the community (Packard Foundation support)  Religious leaders/clergy engage in family planning education and promotion  Community health workers training with WHO counseling guide  Women’s and men’s Christian guilds welcoming role for educating church members and communities
  9. 9. Faith to Action (F2A)—New Multi-faith Advocacy Network  “Nairobi Declaration” commits multiple faiths to common family health goals  Secretariat established for organizing at country level  Faith leaders speaking to their governments, e.g. Karen Sichinga, Board Chair of African Christian Health Associations—new confident voices and expanded views on youth, commodities, and access
  10. 10. The Way Forward: Are we reaching a “tipping point” for FBO advocacy and access for family planning?  New leadership among CCIH member organizations  Growing interest among secular donors and organizations is supporting FBOs  Multi-faith collaboration on common goals  Understanding on role of family planning, birth spacing and prevention on unintended pregnancies and abortion for Christian health, well-being and wholeness  AND—we have much to do and need your participation, partnerships and prayers

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