Women Ask Wednesday: How do I make a reproductive life plan?

Happy Wednesday! Did you guys see the launch of the contraception tool last week? You all were so receptive and supportive – that means the world to me. Let me know how you use the tool or which populations you use it with! If you have a recommendation on how to improve it, I would love to hear that too. The tool went through so many versions that I had to start saving them as v1…v2…v3…v4 because it was so fluid in the creation stages. Making a tool was exhausting and rewarding at the same time.

Speaking of rewarding, today we’re talking something that can be immensely rewarding to a woman’s life and ties right into the contraception tool from last Monday — the reproductive life plan, or commonly shortened to RLP. I don’t love the acronym (fun fact: if you send me an email with an acronym I don’t know, I have a tendency to delete it – please blame the military for this terrible habit!).

A reproductive life plan is simple – it’s a woman’s plan or intentions to achieve or prevent pregnancy during different time periods of her life. The reproductive life plan is the foundation of good contraception counseling. I realized something when we launched my clinic’s quality initiative last fall – if a woman receives truly comprehensive contraception counseling from a provider, it’s likely she might never need such in-depth counseling again. Think about it – if you understand all the facets of each method, you have a knowledge base to access as you move through the phases of your life – that’s pretty dang powerful! The average woman uses three different forms of contraception throughout her lifetime. And different desires or phases of life may dictate which contraception is preferred at a certain time for each woman!

Now, the caveat to that statement is that evidence and medicine are always changing, but contraception has been slower to change over the years and if anything, it’s expanding options for each method, not creating new methods. For example, look at how many types of IUDs are on the market now versus 40 years ago! (Fun fact: the Paragard IUD has been around for 40 years!)

Okay, onto the topic today: How do you make a reproductive life plan?

In order to make your plan, you must answer a series of questions. These questions vary depending on the source you are using but all sources are very similar. At the end of the series of questions, you assess all of your answers and look for the overarching themes and desires that you wrote down – that’s your reproductive life plan. The beautiful thing is that everyone’s plan is different!

Typically you can start your family planning conversation with the One Key Question we chatted about last Wednesday. This flowchart depicts the One Key Question with the series of possible answers.

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I don’t want to reinvent the wheel because there are many family planning resources available. These are some of the family planning resources available on the web. Take a look at a few of them and try to answer most of the questions if you can!

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The Centers for Disease Control and Prevention (CDC) used to have a family plan that was published on their site. I can’t find it on their site anymore and I think they may have taken it down. However, I found it on a county’s website in the state of Maryland. In particular, I like the examples of family plans – it goes to show that there are many different family plans! (If anyone knows the current link to the CDC’s family plan handout please shoot me an email!)

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My favorite family planning handout is from the American College of Nurse Midwives (ACNM). I like the handout because I think the series of questions are well thought out and easy for women to understand. Also, my standard for a good handout is do they offer you additional resources to continue your education about the topic. The Share with Women handouts do that extremely well and I use these handouts DAILY in my midwifery practice.

Here’s ACNM’s handout:

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Now, a question for you: What’s your family plan?

Can you clearly articulate it? Do you need to complete one of the handouts referenced today? Do you need to chat with your significant other? Did you have a family plan but are entering a different phase of your life and need to think about a new one? Whatever your answer, start with these tools and see where they take you! Remember, everyone’s plan is different and your plan will change from phase to phase of your life.

Family planning is really quite simple, but like anything worth doing, you must make time for it! Also, if you are in a relationship, I recommend completing the plan by yourself and then with your significant other as well!

A few more things about family planning….

Healthy People 2030 has a 14 goals aimed at family planning for the current decade! Their main goal is to improve pregnancy planning and prevent unintended pregnancy. It’s a nice, simple overarching goal. Last week we chatted about how unplanned pregnancies account for about half of all pregnancies and that outcomes are poorer for mamas and babies of unplanned pregnancies than to those mamas that planned their pregnancies. Education about contraception and having a family plan helps reduce unplanned pregnancy!

If you’re interested in reading a book about the power of what family planning can do for women, I highly recommend Melinda Gates’ book The Moment of Lift. She narrates the audiobook as well and I found her personal story so interesting – did you know she is a computer science whiz herself?

If you prefer a handout in Spanish, the Every Woman California site published by the Preconception Health Council of California has one available here!

If you are a provider that gives contraception counseling, this report published in Morbidity and Mortality Weekly Report (MMWR) provides an excellent summary on the components of comprehensive contraception counseling. My personal opinion is no one teaches contraception counseling in school well. You have to learn it on your own!

As a practicing midwife, I don’t think we give out enough education on family planning. Often times, clinic is time-constrained and too busy. But pregnancy is the perfect time to talk to families about their family plan. Early third trimester is a great time to plant these seeds 🙂

And that’s a wrap for Wednesday! Hope this was a helpful post. As always, the RESOURCES page was updated with all resources mentioned here today. I feel like I updated the RESOURCES page at least a few times a week!

And if you have any resources to share, please let me know here!

Happy hump day 🙂

Jamie


1 year ago on the blog…Student spotlight: 11 tips on how to prepare for midwifery clinicals


Resources

American College of Nurse-Midwives. (2011). Planning your family: Developing a reproductive life plan. Journal of Midwifery & Women’s Health, 56(5), 535-536. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1542-2011.2011.00057.x

Centers for Disease Control and Prevention. (2010). Preconception health and health care: My reproductive life plan. https://www.montgomerycountymd.gov/HHS-Program/Resources/Files/PHSDocs/reproductivelifeplan-worksheet.pdf

Women’s Health & Family Planning Center at Columbus Public Health. (2016). Reproductive health & wellness program reproductive life plan. https://odh.ohio.gov/wps/wcm/connect/gov/df862ff6-7e1f-48cf-a07c-10997dc76597/Columbus-Public-HD-Reproductive-Life-Plan.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-df862ff6-7e1f-48cf-a07c-10997dc76597-mnOToyg


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