Planning families means more than buying contraception
Family planning covers whether to have children, how many, and when—including choosing none—plus education, pre-conception care, and infertility help. UN definitions stretch past pills and condoms. CDC urged reproductive life plans in 2006 to cut unintended pregnancies and improve health.
A 2017 textbook by Poston and Bouvier separates a couple's own efforts to regulate the number and spacing of births from government-backed programs that supply information and contraceptives. Many developing countries ran such programs between 1950 and 1995, and coercion in China, India and Peru made them controversial, yet a World Bank report concluded they largely worked, driving up contraceptive use and pushing fertility down. A University of Michigan study found that federal programs cut births among poor American women by as much as 29 percent.
Timing matters for health. Waiting until at least 18 to start improves outcomes for mother and child, and spacing births two to five years apart is healthier, with at least six months advised after a miscarriage or abortion. Older mothers face higher chances of Down syndrome, multiple births, gestational diabetes and Caesarean delivery. About 99 percent of maternal deaths occur in less developed countries, almost a third of them in South Asia. Couples are advised to seek fertility counselling after a year of trying, or after six months if the woman is over 35.
The economics are stark. The US Department of Agriculture estimated that a child born in 2007 would cost a family $196,000 to $393,000 over 17 years. UNFPA says each dollar spent on contraception saves $1.47 in pregnancy care, and the Copenhagen Consensus ranked universal access third among policies for benefit per dollar, at roughly $3.6 billion a year against benefits above $400 billion.
Methods vary widely: withdrawal and calendar methods cost little, IUDs and implants need almost no user effort, only condoms also block infections, and counting failures, IUDs and vasectomy come out cheapest. Economists find that having a child makes no measurable difference to most people's well-being.
Source: Family planning
