Combined oral contraceptives. Introduced in 1960, "the Pill" has played an instrumental role in family planning for decades.
Family planning services are defined as "educational, 
comprehensive medical or social activities which enable individuals, 
including minors, to determine freely the number and spacing of their 
children and to select the means by which this may be achieved".
  Family planning may involve consideration of the number of children a 
woman wishes to have, including the choice to have no children, as well 
as the age at which she wishes to have them. These matters are 
influenced by external factors such as marital situation, career 
considerations, financial position, and any disabilities that may affect
 their ability to have children and raise them. If sexually active, 
family planning may involve the use of contraception and other techniques to control the timing of reproduction.
Other aspects of family planning include sex education, prevention and management of sexually transmitted infections, pre-conception counseling and management, and infertility management.
 Family planning, as defined by the United Nations and the World Health 
Organization, encompasses services leading up to conception. Abortion is not considered a component of family planning, although access to contraception and family planning reduces the need for abortion.
Family planning is sometimes used as a synonym or euphemism for access to and the use of contraception.
 However, it often involves methods and practices in addition to 
contraception. Additionally, there are many who might wish to use 
contraception but are not, necessarily, planning a family (e.g., 
unmarried adolescents, young married couples delaying childbearing while
 building a career); family planning has become a catch-all phrase for 
much of the work undertaken in this realm. Contemporary notions of 
family planning, however, tend to place a woman and her childbearing 
decisions at the center of the discussion, as notions of women's 
empowerment and reproductive autonomy have gained traction in many parts
 of the world. It is most usually applied to a female-male couple who wish to limit the number of children they have and/or to control the timing of pregnancy (also known as spacing children).
Purposes
In 2006, the US Centers for Disease Control (CDC) issued a recommendation, encouraging men and women to formulate a reproductive life plan, to help them in avoiding unintended pregnancies and to improve the health of women and reduce adverse pregnancy outcomes.
Raising a child requires significant amounts of resources: time, social, financial, and environmental.
 Planning can help assure that resources are available. The purpose of 
family planning is to make sure that any couple, man, or woman who has a
 child has the resources that are needed in order to complete this goal.  With these resources a couple, man or woman can explore the options of natural birth, surrogacy, artificial insemination, or adoption.
 In the other case, if the person does not wish to have a child at the 
specific time, they can investigate the resources that are needed to 
prevent pregnancy, such as birth control, contraceptives, or physical 
protection and prevention. 
There is no clear social impact case for or against conceiving a child. Individually, for most people,
 bearing a child or not has no measurable impact on person well-being. A
 review of the economic literature on life satisfaction shows that 
certain groups of people are much happier without children:
- Single parents
 - Fathers who both work and raise the children equally.
 - Singles
 - The divorced
 - The poor
 - Those whose children are older than 3
 - Those whose children are sick
 
However, both adoptees and the adopters report that they are happier after adoption.
 Adoption may also insure against costs of prenatal or childhood 
disability which can be anticipated with prenatal screening or with 
reference to parental risk factors. For instance, older fathers and/or Advanced maternal age increase the risk of numerous health issues in their offspring, including autism and schizophrenia.
Resources
When
 women can pursue additional education and paid employment, families can
 invest more in each child. Children with fewer siblings tend to stay in
 school longer than those with many siblings. Leaving school in order to
 have children has long-term implications for the future of these girls,
 as well as the human capital of their families and communities. Family 
planning slows unsustainable population growth which drains resources 
from the environment, and national and regional development efforts.
Health
The WHO states about maternal health that:
- "Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death."
 
About 99% of maternal deaths occur in less developed countries; less than one half occur in sub-Saharan Africa and almost a third in South Asia.
Both early and late motherhood have increased risks. Young 
teenagers face a higher risk of complications and death as a result of 
pregnancy. Waiting until the mother is at least 18 years old before trying to have children improves maternal and child health.
Also, if additional children are desired after a child is born, 
it is healthier for the mother and the child to wait at least 2 years 
after the previous birth before attempting to conceive (but not more 
than 5 years). After a miscarriage or abortion, it is healthier to wait at least 6 months.
Joselyne When planning a family, women should be aware that 
reproductive risks increase with the age of the woman. Like older men, 
older women have a higher chance of having a child with autism or Down syndrome, the chances of having multiple births increases, which cause further late-pregnancy risks, they have an increased chance of developing gestational diabetes, the need for a Caesarian section
 is greater, older women's bodies are not as well-suited for delivering a
 baby.  The risk of prolonged labor is higher. Older mothers have a 
higher risk of a long labor, putting the baby in distress. 
Modern methods
Modern methods of family planning include birth control, assisted reproductive technology and family planning programs. 
In regard to the use of modern methods of contraception, The United Nations Population Fund
 (UNFPA) says that, “Contraceptives prevent unintended pregnancies, 
reduce the number of abortions, and lower the incidence of death and 
disability related to complications of pregnancy and childbirth.” 
 UNFPA states that, “If all women with an unmet need for contraceptives 
were able to use modern methods, an additional 24 million abortions (14 
million of which would be unsafe), 6 million miscarriages, 70,000 
maternal deaths and 500,000 infant deaths would be prevented.” 
In cases where couples may not want to have children just yet, 
family planning programs help a lot. Federal family planning programs 
reduced childbearing among poor women by as much as 29 percent, 
according to a University of Michigan study.
Adoption
 is another option used to build a family. There are seven steps that 
one must make towards adoption. You must decide to pursue an adoption, 
apply to adopt, complete an adoption home study, get approved to adopt, 
be matched with a child, receive an adoptive placement, and then 
legalize the adoption.
Contraception
Placard showing positive effects of family planning (Ethiopia)
A number of contraceptive methods are available to prevent unwanted pregnancy. There are natural methods and various chemical-based methods, each with particular advantages and disadvantages. Behavioral methods to avoid pregnancy that involve vaginal intercourse include the withdrawal and calendar-based methods, which have little upfront cost and are readily available. Long-acting reversible contraceptive methods, such as intrauterine device
 (IUD) and implant are highly effective and convenient, requiring little
 user action, but do come with risks. When cost of failure is included, 
IUDs and vasectomy are much less costly than other methods. In addition to providing birth control, male and/or female condoms protect against sexually transmitted diseases (STD). Condoms may be used alone, or in addition to other methods, as backup or to prevent STD. Surgical methods (tubal ligation, vasectomy) provide long-term contraception for those who have completed their families.
Assisted reproductive technology
When, for any reason, a woman is unable to conceive by natural means,
 she may seek assisted conception. For example, some families or women 
seek assistance through surrogacy, in which a woman agrees to become pregnant and deliver a child for another couple or person.
There are two types of surrogacy: traditional and gestational. In traditional surrogacy, the surrogate uses her own eggs and
 carries the child for her intended parents. This procedure is done in a
 doctor's office through IUI. This type of surrogacy obviously includes a
 genetic connection between the surrogate and the child. Legally, the 
surrogate will have to disclaim any interest in the child to complete 
the transfer to the intended parents. A gestational surrogacy occurs 
when the intended mother's or a donor egg is fertilized outside the body
 and then the embryos are transferred into the uterus. The woman who 
carries the child is often referred to as a gestational carrier. The 
legal steps to confirm parentage with the intended parents are generally
 easier than in a traditional because there is no genetic connection 
between child and carrier.
Sperm donation is another form of assisted conception. It involves donated sperm being used to fertilise a woman's ova by artificial insemination (either by intracervical insemination or intrauterine insemination) and less commonly by invitro fertilization (IVF), but insemination may also be achieved by a donor having sexual intercourse with a woman for the purpose of achieving conception. This method is known as natural insemination (NI).
Mapping of a woman's ovarian reserve, follicular dynamics and associated biomarkers can give an individual prognosis about future chances of pregnancy, facilitating an informed choice of when to have children.
Finances
Family planning is among the most cost-effective of all health interventions.
  "The cost savings stem from a reduction in unintended pregnancy, as 
well as a reduction in transmission of sexually transmitted infections, 
including HIV".
Childbirth and prenatal health care cost averaged $7,090 for normal delivery in the United States in 1996. U.S. Department of Agriculture
 estimates that for a child born in 2007, a U.S. family will spend an 
average of $11,000 to $23,000 per year for the first 17 years of child's
 life.  (Total inflation-adjusted estimated expenditure: $196,000 to $393,000, depending on household income.)
 Breaks down cost by age, type of expense, region of country.  
Adjustments for number of children (one child — spend 24% more, 3 or 
more spend less on each child.) 
Investing in family planning has clear economic benefits and can 
also help countries to achieve their “demographic dividend,” which means
 that countries productivity is able to increase when there are more 
people in the workforce and less dependents. UNFPA says that, “For every dollar invested in contraception, the cost of pregnancy-related care is reduced by $1.47.”
UNFPA states that,
The lifetime opportunity cost related to adolescent pregnancy – a measure of the annual income a young mother misses out on over her lifetime – ranges from 1 per cent of annual gross domestic product in a large country such as China to 30 per cent of annual GDP in a small economy such as Uganda. If adolescent girls in Brazil and India were able to wait until their early twenties to have children, the increased economic productivity would equal more than $3.5 billion and $7.7 billion, respectively.
In the Copenhagen Consensus produced by Nobel laureates in 
collaboration with the UN, universal access to contraception ranks as 
the third highest policy initiative in social, economic, and 
environmental benefits for every dollar spent.
 Providing universal access to sexual and reproductive health services 
and eliminating the unmet need for contraception will result in 640,000 
fewer newborn deaths, 150,000 fewer maternal deaths and 600,000 fewer 
children who lose their mother. At the same time, societies will 
experience fewer dependents and more women in the workforce, driving 
faster economic growth. The costs of universal access to contraceptives 
will be about $3.6 billion/year, but the benefits will be more than $400
 billion annually and cut maternal deaths by 150,000.
Fertility Awareness
Fertility awareness refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynecological
 health. Methods of identifying infertile days have been known since 
antiquity, but scientific knowledge gained during the past century has 
increased the number and variety of methods. Various methods can be used
 and the Symptothermal method has achieved a success rates over 99% if 
used properly.
These methods are used for various reasons: There are no drug-related side effects, it is free to use and only has a small upfront cost, it works both ways, or for religious reasons (the Catholic Church promotes this as the only acceptable form of family planning calling it Natural Family Planning).
 Its disadvantages are that either abstinence or backup method is 
required on fertile days, typical use is often less effective than other
 methods, and it does not protect against sexually transmitted disease.
Media campaign
Recent
 research based on nationally representative surveys supports a strong 
association between family planning mass media campaigns and 
contraceptive use, even after social and demographic variables are 
controlled for. The 1989 Kenya Demographic and Health Survey found half 
of the women who recalled hearing or seeing family planning messages in 
radio, print, and television consequently used contraception, compared 
with 14% who did not recall family planning messages in the media, even 
after age, residence and socioeconomic status were taken into account.
The Health Education Division of the Ministry of Health conducted
 the Tanzanian Family Planning Communication Project from January 1991 
through December 1994, a project funded by the U.S. Agency for 
International Development (USAID).
 The program intended to educate both men and men of reproductive age 
about modern contraception methods. The major media channels and 
products included radio spots, radio series drama, Green Star logo 
promotional activities (identifies sites where family planning services 
are available), posters, leaflets, newspapers, and audio cassettes. In 
conjunction with other non-project interventions sponsored by other 
Tanzanian and international agencies from 1992–1994, contraception use 
among women ages 15–49 increased from 5.9% to 11.3%. The total fertility
 rate dropped from 6.3 lifetime births per individual in 1991–1992 to 
5.8 in 1994.
Providers
Direct government support
Direct
 government support for family planning includes providing family 
planning education and supplies through government-run facilities such 
as hospitals, clinics, health posts and health centers and through 
government fieldworkers.
In 2013, 160 out of 197 governments provided direct support for 
family planning. Twenty countries only provided indirect support through
 private sector or NGOs. Seventeen governments did not support family 
planning. Direct government support has continued to increase in 
developing countries from 82% in 1996 to 93% in 2013, but is declining 
in developed countries from 58% in 1976 to 45% in 2013. Ninety-seven 
percent of Latin America and the Caribbean, 96% of Africa, and 94% of 
Oceania governments provided direct support for family planning. In 
Europe, only 45% of governments directly support family planning. Out of
 172 countries with available data in 2012, 152 countries had 
implemented realistic measures to increase women's access to family 
planning methods from 2009–2014. This included 95% of developing nations
 and 65% of developed nations.
Private sector
The
 private sector includes nongovernmental and faith-based organizations 
who typically provide free or subsidized services to for-profit medical 
providers, pharmacies and drug shops. The private sector accounts for 
approximately two-fifths of contraceptive suppliers worldwide. Private 
organizations are able to provide sustainable markets for contraceptive 
services through social marketing, social franchising, and pharmacies.
Social marketing employs marketing techniques to achieve 
behavioral change while making contraceptives available. By utilizing 
private providers, social marketing reduces geographic and socioeconomic
 disparities and reaches men and boys.
Social franchising designs a brand for contraceptives in order to expand the market for contraceptives.
Drug shops and pharmacies provide health care in rural areas and 
urban slums where there are few public clinics. They account for most of
 the private sector provided contraception in sub-Saharan Africa, 
especially for condoms, pills, injectables and emergency contraception. 
Pharmacy supply and low-cost emergency contraception in South Africa and
 many low-income countries increased access to contraception.
Workplace policies and programs help expand access to family 
planning information. The Family Guidance Association of Ethiopia, which
 works with more than 150 enterprises to improve health services, 
analyzed health outcomes in one factory over 10 years and found 
reductions in unintended pregnancies and STIs as well as sick leave. 
Contraception use rose from 11% to 90% between 1997 and 2000. In 2016, 
the Bangladesh Garment Manufacturers Export Association partnered with 
family planning organizations to provide training and free 
contraceptives to factory clinics, creating the potential to reach 
thousands of factory employees.
Non-governmental organizations (NGOs)
NGOs
 may meet the needs of local poor by encouraging self-help and 
participation, understanding social and cultural subtleties, and working
 around red tape when governments do not adequately meet the needs of 
their constituents. A successful NGO can uphold family planning services
 even when a national program is threatened by political forces. NGOs 
can contribute to informing government policy, developing programs, or 
carry out programs that the government will not or can not implement.
International oversight
Family planning programs are now considered a key part of a 
comprehensive development strategy. The United Nations Millennium 
Development Goals (now superseded by the Sustainable Development Goals)
 reflects this international consensus. The 2012 London Summit on Family
 Planning, hosted by the UK government and the Bill and Melinda Gates 
Foundation, affirmed political commitments and increased funds for the 
project, strengthening the role of family planning in global 
development.
  Family Planning 2020 is the result of the 2012 London Summit on Family
 Planning where more than 20 governments made commitments to address the
 policy, financing, delivery, and socio-cultural barriers to women 
accessing contraception formation and services. FP2020 is a global 
movement that supports the rights of women to decide for themselves 
whether, when and how many children they want to have.
 The commitments of the program are specific to each country, as 
compared to the generalized main goals of the 1995 conference program of
 action. FP2020 is hosted by the United Nations Foundation and operates 
in support of the UN Secretary-General's Global Strategy for Women's, 
Children's and Adolescent's Health. 
The world's largest international source of funding for population and reproductive health programs is the United Nations Population Fund (UNFPA). In 1994, the International Conference on Population and Development set the main goals of its Program of Action as:
- Universal access to reproductive health services by 2015
 - Universal primary education and ending the gender gap in education by 2015
 - Reducing maternal mortality by 75% by 2015
 - Reducing infant mortality
 - Increasing life expectancy at birth
 - Reducing HIV infection rates in persons aged 15–24 years by 25% in the most-affected countries by 2005, and by 25% globally by 2010
 
The World Health Organization (WHO) and World Bank
 estimate that $3 per person per year would provide basic family 
planning, maternal and neonatal health care to women in developing 
countries.  This would include contraception, prenatal, delivery, and post-natal care in addition to postpartum family planning and the promotion of condoms to prevent sexually transmitted infections.
Coercive interference with family planning
Forced sterilization
Compulsory or forced sterilization programs or government policy 
attempt to force people to undergo surgical sterilization without their 
freely given consent. People from marginalized communities are at most 
risk of forced sterilization. Forced sterilization has occurred in recent years in Eastern Europe (against Roma women), and in Peru (during the 1990s against indigenous women). China's one-child policy was intended to limit the rise in population numbers, but in some situations involved forced sterilisation.
Sexual violence
Rape can result in a pregnancy. Rape can occur in a variety of situations, including war rape, forced prostitution and marital rape.
In Rwanda,
 the National Population Office has estimated that between 2,000 and 
5,000 children were born as a result of sexual violence perpetrated 
during the genocide, but victims' groups gave a higher estimated number of over 10,000 children.
Human rights, development and climate
Access
 to safe, voluntary family planning is a human right and is central to 
gender equality, women's empowerment and poverty reduction. The United Nations Population Fund
 (UNFPA) says that, “Some 225 million women who want to avoid pregnancy 
are not using safe and effective family planning methods, for reasons 
ranging from lack access to information or services to lack of support 
from their partners or communities.” UNFPA says that, “Most of these women with an unmet need for contraceptives live in 69 of the poorest countries on earth.” 
Over the past 50 years, right-based family planning has enabled 
the cycle of poverty to be broken resulting in millions of women and 
children's lives being saved.
UNFPA says that, 
Global consensus that family planning is a human right was secured at the 1994 International Conference on Population and Development, in Principle 8 of the Programme of Action: All couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education, and means to do so.
As part of the United Nations Millennium Development Goals
 (MDGs) universal access to family planning is one of the key factors 
contributing to development and reducing poverty. Family planning 
creates benefits in areas such as, gender quality and women's health, 
access to sexual education and higher education, and improvements in 
maternal and child health. Note that the Millennium Development Goals have been superseded by the Sustainable Development Goals. 
UNFPA and the Guttmacher Institute say that,
Serving all women in developing countries that currently have an unmet need for modern contraceptives would prevent an additional 54 million unintended pregnancies, including 21 million unplanned births, 26 million abortions and seven million miscarriages; this would also prevent 79,000 maternal deaths and 1.1 million infant deaths.
Since climate change is directly proportional to the number of 
humans, family planning has a significant impact on climate change. The research project Drawdown estimates that family planning is the seventh most efficient action against climate change (ahead of solar farms, nuclear power, afforestation and many other actions).
Quality-quantity trade-off
Having
 children produces a quality-quantity trade-off: parents need to decide 
how many children to have and how much to invest in the future of each 
child.
 The increasing marginal cost of quality (child outcome) with respect to
 quantity (number of children) creates a trade-off between quantity and 
quality.
 The quantity-quality trade-off means that policies that raise benefits 
of investing in child quality will generate higher levels of human 
capital, and policies that lower the costs of having children may have 
unintended adverse consequences on long-run economic growth. When 
deciding how many children, parents are influenced by their income 
level, perceived return to human capital investment, and cultural norms 
related to gender equality. Controlling birth rates allows families to 
raise the future earnings power of the next generation.
Many empirical studies have tested the quantity-quality trade-off
 and either observed a negative correlation between family size and 
child quality or did not find a correlation.
 Most studies treat family size as an exogenous variable because parents
 choose childbearing and child outcome and therefore cannot establish 
causality. They are both influenced by typically non-observable parental
 preferences and household characteristics, but some studies observe 
proxy variables such as investment in education.
Developing countries
High fertility countries have 18% of the world's population but contribute 38% of the population growth.
 In order to become rich, resources must be re-appropriated to increase 
income per person rather than supporting larger populations. As 
populations increase, governments must accommodate increasing 
investments in health and human capital and institutional reforms to 
address demographic divides. Reducing the cost of human capital can be 
implemented by subsidizing education, which raises the earning power of 
women and the opportunity cost of having children, consequently lowering
 fertility.
 Access to contraceptives may also yield lower fertility rates: having 
more children than expected constrains the individual from attaining 
their desired level of investment in child quantity and quality.
  In high fertility contexts, reduced fertility may contribute to 
economic development by improving child outcomes, reducing maternal 
mortality and increasing female human capital. 
Dang and Rogers (2015) show that in Vietnam, family planning 
services increased investment in education by lowering the relative cost
 of child quality and encouraging families to invest in quality.
 By observing the distance to the nearest family planning center and the
 general education expenditure on each child, Dang and Rogers provide 
evidence that parents in Vietnam are making a child quality-quantity 
trade-off.
Demand for Private Tutoring with and without access to family planning
Developed countries
Currently,
 developed countries have experienced rising economic growth and falling
 fertility. As a result of the demographic transition that takes place 
when countries become rich, developed countries have an increasing 
proportion of retired people which raises the burden on the workforce 
population to support pensions and social programs. Encouraging higher 
fertility as a solution may risk reversing the benefits for increased 
child investment and female labor force participation have had on 
economic growth. Increasing high skill migration may be an effective way
 to increase the return to education leading to lower fertility and a 
greater supply of highly skilled individuals.
Demand for family planning
214
 million women of reproductive age in developing countries who do not 
want to become pregnant are not using a modern contraceptive method.
 This could be a result of a limited choice of methods, limited access 
to contraception, fear of side-effects, cultural or religious 
opposition, poor quality of available services, user or provider bias, 
or gender-based barriers. In Africa, 24.2% of women of reproductive age 
do not have access to modern contraction. In Asia, Latin America, and 
the Caribbean, the unmet need is 10–11%. Meeting the unmet need for 
contraception could prevent 104,000 maternal deaths per year, a 29% 
reduction of women dying from postpartum hemorrhage or unsafe abortions.
According to the United Nations Department of Economic and Social
 Affairs: Population Division, 64% of the world uses contraceptives, 12%
 of the world population's need for contraceptives is unmet. In the 
least developed countries, 22% of the population do not have access to 
contraceptives, and 40% use contraceptives.
 The unmet need for modern contraceptives is very high in sub-Saharan 
Africa, south Asia, and western Asia. Africa has the lowest rate of 
contraceptive use (33%) and highest rate of unmet need (22%). Northern 
America has the highest rate of contraceptive use (73%) and the lowest 
unmet need (7%). Latin America and the Caribbean follows closely behind 
with 73% contraceptive use and 11% unmet need. Europe and Asia are on 
par: Europe has a 69% contraceptive use rate and 10% unmet need, Asia 
has a 68% contraceptive use and 10% unmet need. Although unmet need is 
lower in Asia because of the large population in this region, the number
 of women with unmet need is 443 million, compared to 74 million in 
Europe  Oceania has a 59% contraceptive use rate and 15% unmet need. 
When comparing the regions within these continents, Eastern Asia ranks 
the highest rate of contraceptive use (82%) and lowest unmet need (5%). 
Western Africa ranks the lowest rate of contraceptive use (17%). Middle 
Africa ranks the highest unmet need (26%). Unmet need is higher among 
poorer women; in Bolivia and Ethiopa unmet need is tripled and doubled 
among poor populations. However, in the Democratic Republic of Congo and Liberia the rates of unmet need are different by 1–2 percentage points. This suggests that as wealthier women begin to want smaller families, they will increasingly seek out family planning methods.
United
 Nations Department of Economic and Social Affairs, Population Division,
 "Trends in Contraceptive Use Worldwide 2015" New York: United Nations, 
2015.
Substantial unmet need has provoked family planning programs by 
governments and donors, but the impact of family planning programs on 
fertility and contraceptive use remains somewhat unsettled. "Demand 
theory" argues that in traditional agricultural societies, fertility 
rates are driven by the desire to offset high mortality, thus as society
 modernizes, the costs of raising children increases, reducing their 
economic value, and resulting in a decline in desired number of 
children. Under this theory, family planning programs will have a 
marginal impact. Bongaarts (2014) shows that using a country case study 
approach, both stronger and weaker family programs reduce the unmet need
 for contraceptives and increases use by making modern contraceptives 
more widely available and removing obstacles to use.
 Also, the demand that is satisfied and the proportion of women using 
modern methods increased. The programs may have an additional effect of 
diffusing the ideas related to family planning and thus raising the 
demand for contraception. As a result, a small decrease in unmet need 
may be offset by a rise in demand. Nonetheless, even in countries where 
it is assumed that family programs will make a marginal impact, 
Bongaarts shows that family planning programs can potentially increase 
contraceptive use and increase/decrease demand depending on the 
preexisting attitudes of the community.
Regional variations
A family planning facility in Kuala Terengganu, Malaysia
Africa
Most of the countries with lowest rates of contraceptive use, highest
 maternal, infant, and child mortality rates, and highest fertility 
rates are in Africa.
  Only about 30% of all women use birth control, although over half of 
all African women would like to use birth control if it was available to
 them.
 The main problems that preventing access to and use of birth control 
are unavailability, poor health care services, spousal disapproval, 
religious concerns, and misinformation about the effects of birth 
control.  The most available type of birth control is condoms.
  A rapidly growing population coupled with an increase in preventable 
diseases means countries in Sub-Saharan Africa face an increasingly 
younger population.
China
China's Family planning policy forced couples to have no more than one child. Beginning in 1979 and being officially phased out in 2015,
 the policy was instated to control the rapid population growth that was
 occurring in the nation at that time. With the rapid change in 
population, China was facing many impacts, including poverty and 
homelessness. As a developing nation, the Chinese government was 
concerned that a continuation of the rapid population growth that had 
been occurring would hinder their development as a nation. The process 
of family planning varied throughout China, as people differed in their 
responsiveness to the one-child policy, based on location and 
socioeconomic status. For example, many families in the cities accepted 
the policy more readily based on the lack of space, money, and resources
 that often occurs in the cities. Another example can be found in the 
enforcement of this rule; people living in rural areas of China were, in
 some cases, permitted to have more than one child, but had to wait 
several years after the birth of the first one.
  However, the people in rural areas of China were more hesitant in 
accepting this policy. China's population policy has been credited with a
 very significant slowing of China's population growth which had been 
higher before the policy was implemented. However, the policy has come 
under criticism that it has resulted in the abuse of women. Often 
implementation of the policy has involved forced abortions, forced sterilization,
 and infanticides. That families desired a male child had a part to play
 in the number of infanticides. The number of girls that die within 
their first year of birth is twice that of boys. Another drawback of the policy is that China's elderly population is now increasing rapidly.
 However, while the punishment of "unplanned" pregnancy is a large fine,
 both forced abortion and forced sterilization can be charged with 
intentional assault, which is punished with up to ten years' 
imprisonment.
Another issue that is raised in the one-child policy in China is the 
information in regards to naturally giving birth to twins or triplets. 
If this situation arises, the family is allowed to keep the children 
because of the natural causes of this impregnation.
Family planning in China had its benefits, and its drawbacks. For
 example, it helped reduce the population by about 300 million people in
 its first 20 years.
 A drawback is that there are now millions of sibling-less people, and 
in China siblings are very important. Once the parent generation gets 
older, the children help take care of them, and the work is usually 
equally split among the siblings.
 Another benefit of the implementation of the one-child law is that it 
reduced the fertility rate from about  2.75 children born per woman, to 
about 1.8 children born per woman in the 1979.
Hong Kong
In Hong Kong, the Eugenics League was found in 1936, which became The Family Planning Association of Hong Kong in 1950. The organisation provides family planning advice, sex education, birth control services to the general public of Hong Kong.
 In the 1970s, due to the rapidly rising population, it launched the 
"Two Is Enough" campaign, which reduced the general birth rate through 
educational means.
The Family Planning Association of Hong Kong, Hong Kong's national family planning association,  founded the International Planned Parenthood Federation with its counterparts in seven other countries.
India
Family planning in India is based on efforts largely sponsored by the Indian government.
 In the 1965–2009 period, contraceptive usage has more than tripled 
(from 13% of married women in 1970 to 48% in 2009) and the fertility 
rate has more than halved (from 5.7 in 1966 to 2.6 in 2009), but the 
national fertility rate is still high enough to cause long-term 
population growth. India adds up to 1,000,000 people to its population 
every 15 days.
Iran
While Iran's population grew at a rate of more than 3% per year 
between 1956 and 1986, the growth rate began to decline in the late 
1980s and early 1990s after the government initiated a major population 
control program. By 2007 the growth rate had declined to 0.7 percent per
 year, with a birth rate of 17 per 1,000 persons and a death rate of 6 
per 1,000.
 Reports by the UN show birth control policies in Iran to be effective 
with the country topping the list of greatest fertility decreases. UN's 
Population Division of the Department of Economic and Social Affairs 
says that between 1975 and 1980, the total fertility number was 6.5. The
 projected level for Iran's 2005 to 2010 birth rate is fewer than two.
In late July 2012, Supreme Leader Ali Khamenei
 described Iran's contraceptive services as "wrong," and Iranian 
authorities are slashing birth-control programs in what one Western 
newspaper (USA Today)
 describes as a "major reversal" of its long standing policy. Whether 
program cuts and high-level appeals for bigger families will be 
successful is still unclear.
Ireland
The sale of contraceptives was illegal in Ireland from 1935 until 
1980, when it was legalized with strong restrictions, later loosened. It
 has been argued that the resulting demographic dividend played a role in the economic boom in Ireland that began in the 1990s and ended abruptly in 2008 (the Celtic tiger) was in part due to the legalisation of contraception in 1979 and subsequent decline in the fertility rate. In Ireland the ratio of workers to dependents increased due to lower fertility — the reality of which has been questioned — but was raised further by increased female labor market participation.
Pakistan
In agreement with the 1994 International Conference on Population and Development in Cairo, Pakistan
 pledged that by 2010 it would provide universal access to family 
planning. Additionally, Pakistan's Poverty Reduction Strategy Paper has 
set specific national goals for increases in family planning and contraceptive use.  In 2011 just one in five Pakistani women ages 15 to 49 uses modern birth control. Contraception is shunned under traditional social mores that are fiercely defended as fundamentalist Islam gains strength.
Russia
According to a 2004 study, current pregnancies were termed "desired 
and timely" by 58% of respondents, while 23% described them as "desired,
 but untimely", and 19% said they were "undesired".  As of 2004, the 
share of women of reproductive age using hormonal or intrauterine birth 
control methods was about 46% (29% intrauterine, 17% hormonal).
  During the soviet era high quality contraceptives were difficult to 
obtain, and abortion became the most common way of preventing unwanted 
births. Since the dissolution of the Soviet Union abortion rates have 
fallen considerably, but they are still higher than rates in many 
developed countries.
Philippines
In the Philippines, the Responsible Parenthood and Reproductive Health Act of 2012 guarantees universal access to methods on contraception, fertility control, sexual education,
 and maternal care. While there is general agreement about its 
provisions on maternal and child health, there is great debate on its 
mandate that the Philippine government and the private sector will fund 
and undertake widespread distribution of family planning devices such as
 condoms, birth control pills, and IUDs, as the government continues to disseminate information on their use through all health care centers.
Thailand
In 
1970, Thailand's government declared a population policy that would 
battle the country's rapid population growth rate. This policy set a 
5-year goal to reduce Thailand's population growth rate from 3 percent 
to 2.5 percent through methods such as spreading family planning 
awareness to rural families, or integrating family planning activities 
into maternal and child healthcare education.[82] Public figures such as Mechai Viravaidya helped spread family planning awareness through public speakings and charitable activities.
Singapore
Population control in Singapore spans two distinct phases: first to slow and reverse the boom in births that started after World War II; and then, from the 1980s onwards, to encourage parents to have more children because birth numbers had fallen below replacement levels.
United Kingdom
Contraception has been available for free under the National Health Service since 1974, and 74% of reproductive-age women use some form of contraception. The levonorgestrel intrauterine system has been massively popular. Sterilization is popular in older age groups, among those 45–49, 29% of men and 21% of women have been sterilized. Female sterilization has been declining since 1996, when the intrauterine system was introduced. Emergency contraception
 has been available since the 1970s, a product was specifically licensed
 for emergency contraception in 1984, and emergency contraceptives 
became available over the counter in 2001.
 Since becoming available over the counter it has not reduced the use of
 other forms of contraception, as some moralists feared it might. In any year only 5% of women of childbearing age use emergency hormonal contraception.
Despite widespread availability of contraceptives, almost half of pregnancies were unintended in 2005.  Abortion was legalized in 1967.
United States
Despite the availability of highly effective contraceptives, about half of U.S. pregnancies are unintended. Highly effective contraceptives, such as IUD, are underused in the United States. Increasing use of highly effective contraceptives could help meet the goal set forward in Healthy People 2020 to decrease unintended pregnancy by 10%.  Cost to the user is one factor preventing many American women from using more effective contraceptives.
  Making contraceptives available without a copay increases use of 
highly effective methods, reduces unintended pregnancies, and may be 
instrumental in achieving the Healthy People 2020 goal.
In the United States, contraceptive use saves about $19 billion in direct medical costs each year. Title X of the Public Health Service Act,
 is a U.S. government program dedicated to providing family planning 
services for those in need.  But funding for Title X as a percentage of 
total public funding to family planning client services has steadily 
declined from 44% of total expenditures in 1980 to 12% in 2006. Current 
funding for Title X is less than 40% of what is needed to meet the need 
for publicly funded family planning. Title X would need $737 million annually to meet the need for family planning services.
 Only 6.2 million women accessed publicly funded services from 10,700 
clinics in 2015, despite an estimated 20 million women who could 
benefit. 
Clinics funded by Title X served 3.8 million of these women with 
access to services.In 2015, publicly funded contraceptive services 
helped women prevent 1.9 million unintended pregnancies; 876,100 of 
these would have resulted in unplanned births and 628,000 abortions.
 Without publicly funded contraceptive services, the rates of unintended
 pregnancies, unplanned births and abortions would have been 67% higher. The rates for teens would have been 102% higher. Title X funded programs saw 1.2 million fewer patients in 2015 compared to 2010 as funding decreased by $31 million. In 2015, an estimated 2.4 million additional women received Medicaid-funded contraceptive services from private doctors.
Medicaid has increased from 20% to 71% from 1980 to 2006. In 2006, Medicaid contributed $1.3 billion to public family planning.  The $1.9 billion spent on publicly funded family planning in 2008 saved an estimated $7 billion in short-term Medicaid costs.  Such services helped women prevent an estimated 1.94 million unintended pregnancies and 810,000 abortions.
About 3 out of 10 women in the United States have an abortion by the time they are 45 years old.
A 2017 paper found that parents' access to family planning 
programs had a positive economic impact on their subsequent children: " 
Using the county-level introduction of U.S. family planning programs 
between 1964 and 1973, we find that children born after programs began 
had 2.8% higher household incomes. They were also 7% less likely to live
 in poverty and 12% less likely to live in households receiving public 
assistance. After accounting for selection, the direct effects of family
 planning programs on parents’ incomes account for roughly two thirds of
 these gains."
Uzbekistan
In Uzbekistan the government has pushed for uteruses to be removed from women in order to forcibly sterilize them.
Obstacles to family planning
There
 are many reasons as to why women do not use contraceptives. These 
reasons include logistical problems, scientific and religious concerns, 
limited access to transportation in order to access health clinics, lack
 of education and knowledge and opposition by partners, families or 
communities plus the fact that no one is able to control their fertility
 beyond basic behavior involving conception. 
UNFPA says that “efforts to increase access must be sensitive to 
cultural and national contexts, and must consider economic, geographic 
and age disparities within countries.” 
UNFPA states that, “Poorer women and those in rural areas often 
have less access to family planning services. Certain groups — including
 adolescents, unmarried people, the urban poor, rural populations, sex 
workers and people living with HIV  also face a variety of barriers to 
family planning. This can lead to higher rates of unintended pregnancy, 
increased risk of HIV and other STIs, limited choice of contraceptive 
methods, and higher levels of unmet need for family planning.” 
For national, international, or local health programs involved in family planning, the use of standard indicators
 is increasingly encouraged, to track barriers to effective family 
planning along with the efficacy, uptake, and provision of family 
planning services.
World Contraception Day
September
 26 is designated as World Contraception Day, devoted to raising 
awareness of contraception and improving education about sexual and 
reproductive health, with a vision of "a world where every pregnancy is 
wanted".  It is supported by a group of international NGOs, including: 
Asian Pacific Council on Contraception, Centro Latinamericano 
Salud y Mujer, European Society of Contraception and Reproductive 
Health, German Foundation for World Population, International Federation of Pediatric and Adolescent Gynecology, International Planned Parenthood Federation, Marie Stopes International, Population Services International, The Population Council, The USAID, Women Deliver.
Abortion
Some pro-life groups claim that the United Nations and World Health Organization advocate abortion as a form of family planning. In fact, the United Nations Population Fund explicitly states it “never promotes abortion as a form of family planning.”
 The World Health Organization states that "Family 
planning/contraception reduces the need for abortion, especially unsafe 
abortion."
The campaign to conflate contraception and abortion is rooted on 
the assertion that contraception ends, rather than prevents, pregnancy. 
According to an amicus brief submitted to the U.S. Supreme Court in 
October 2013 led by Physicians for Reproductive Health and the American 
College of Obstetricians and Gynecologists, a contraceptive method 
prevents pregnancy by interfering with fertilization, or implantation. 
Abortion, separate from contraceptives, ends an established pregnancy.