Family planning is a controversial issue, because for some it is a way to achieve a better quality of life by deciding how many children to have, while for others it is considered immoral.
Bioethics in relation to Family planning is an issue that is related to the way in which health service providers offer different methods, which in many cases is only directed to the offer of modern methods because they are considered safer, and not the natural methods due to the great responsibility that their use entails.
A relevant aspect is the preparation of health personnel for the offer of these family planning services, since they must have an adequate educational methodology, to provide complete, clear and honest counseling, which allows the user to make their decision freely and freely. informed.
It is necessary to consider that the use of modern contraceptive methods in some cases is linked to the unwanted effects that it can generate in women, so it is necessary that the care provided be personalized and of quality.
Keywords: planning, contraceptive methods, information, responsibility, health, ethics, person
INTRODUCTION
To refer to family planning in population or therefore family issues, it has a certain difficulty that has its origin in the nature of individuals since it is about people, so it is not the same to plan something compared to inert beings.
Planning is a priority action in reproductive health, which assures men and women the possibility of freely and responsibly deciding the number of children they wish to have as well as when and how often to have them, it includes the right of people to be informed and the free choice of available contraceptive methods, which avoids having unwanted pregnancies. (Villalobos, 2009)
The behavior of each individual is determined by the society in which they live and certain behaviors are related to cultural aspects, values and some rules of conduct, this is how society influences this aspect.
On the other hand: family planning is like a health policy since it can be used as an instrument in the population, however, the first aspect of it is an individual's awareness and control over their reproductive processes and capacities, for This is a conscious action that is done with a sense of responsibility.
The world health organization (WHO, 2001) reported that family planning has a favorable influence on the health, development and well-being of the family and influences the mother-child relationship. Based on this, in recent years it was revealed that family planning is an essential component in health strategies, since we would speak of health care and this is related to a certain number of people, so it is important to think in the possible causes that may develop such as the culture of each individual, religion, among other aspects.
Planning in itself does not mean restricting births, but rather it is a conscious and responsible action. Planning is a right and a duty of the couple exclusively to decide with love how many children to have and from time to time, provided that the end and the means are ethical. (Rivalola, 2005)
Having family planning is of the utmost importance today and it is an act that all people should bear in mind and that would help in a certain sense the health of the population and therefore each individual.
DEVELOPING
1.- CONCEPT:
Bioethics related to family planning should give an orientation to professionals, make each planning method known, so that the use of any method is not imposed, but the user freely chooses a method based on the complete information that must be provided the professional, without affecting the principles and values that govern society, as well as avoiding behaviors that are against bioethics such as abortion as a means of avoiding pregnancy, especially in adolescents. (Gynecology and Obstetrics Service, 2015)
2.- CLASSIFICATION:
They are classified into different groups:
-Temporary and Permanent. (Gynecology and Obstetrics Service, 2015)
3.- METHODS:
There are many methods to choose from, some are more effective than others, some are easier to use; others, more difficult.
The most difficult to use methods may be less effective if not used correctly. Methods that can be offered now: condoms, pills, injections, breastfeeding method counseling, standard days method counseling, intercourse counseling, emergency contraceptive pills.
Methods offered in the clinic: implants, IUD (Intrauterine Device), female sterilization, vasectomy (WHO, 2010).
4.- INTERVENTIONS OF THE NURSING IN FAMILY PLANNING:
One of the most critical points of contact for a woman attending a family planning visit is the first person she meets at the initial visit. This is the time when the disposition and behavior of the nursing staff paves the way for the person concerned to have the feeling of being accepted and understood and that someone cares about her as an individual.
In excessively crowded health centers, it may not be possible for the nurse to greet patients before they are admitted; however, you can try to make this first contact helpful and cordial. Women who visit for the first time for family planning services gain a new educational experience. Some will be well prepared and only need a little encouragement and reassurance from the nurse. In any case, these circumstances should not be taken for granted and that is why the case should always be investigated. Others will show great ignorance of the situation and will feel uncomfortable or apprehensive. (Edmads, 2015)
During the first interview the nurse assesses the client's knowledge and tries to determine their cultural, ethnic and religious values, as well as their degree of motivation. The nurse may then need to provide you with basic information about the physical and emotional aspects of reproductive physiology in appropriate and easily understandable terms.
The nurse can also give you the terms you need to know in order to ask questions, and reassure you that it is beneficial to ask. This is also the time to inform the woman about the contraceptives she can choose, clarify misinterpretations, and explain clinical procedures.
Many times the second measure consists of a group session with new clients, which is usually led by a nurse or, in some cases, by a health educator or social worker. Sometimes non-professionals can perform this role, provided they are properly trained and supervised. The nurse is also responsible for determining the need for the pelvic exam and preparing the client. (Edmands, 2015)
Although most women have already undergone these kinds of tests during childbirth, some may still be found to be extremely apprehensive and do not understand why such measures are necessary. The explanation of the pelvic exam should include information about the Pap test because, unless women know the purpose of this procedure, they often conclude that the contraceptive method they have chosen may cause cancer or other diseases.
During the Exam: The nurse or aide has the duty to first ensure that the client is willing, adequately covered, and as comfortable as possible and, second, to work with the physician to ensure that an appropriate examination can be performed. Naturally, this requires reassuring the customer and having the proper instruments and equipment and sufficient lighting.
The nurse or the assistant should listen to the conversation between the doctor and the woman in order to be able to interpret and reinforce the instructions that the doctor provides. In most practices, after the educational work, laboratory tests, medical advice, and physical examination are completed and after the client has chosen the contraceptive method, a final interview is arranged with the nurse.
During this interview, the nurse examines everything that has happened since the woman entered the office, asks her to repeat the instructions received, clarifies and expands on any necessary information, and makes arrangements for further observations. If a method other than the intrauterine device is chosen, the material is usually delivered this time.
When possible, organizing a post-clinical conference with the doctor and office nurses is highly beneficial and beneficial. At this time, the patients visited during the day can be studied, those who need immediate observation or be referred to another service for more intensive care, evaluate the effectiveness of the procedures, the best use of staff time and, probably the most. valuable of all, to carry out an exchange of information between the doctor and the nurse, which offers a learning experience for all concerned. (Edmands, 2015).
4.- BIOETHICAL IMPLICATIONS IN FAMILY PLANNING
4.1 WORLDWIDE:
At the 2005 World Summit, governments pledged to "achieve universal access to reproductive health by the end of 2015, as stipulated in the International Conference on Population and Development." The importance was validated at the 2010 High Level Plenary meeting of the 65th session of the General Assembly on the Millennium Development Goals.
Governments there pledged to ensure that "all women, men and young people have information on the widest possible range of safe, effective, affordable and acceptable family planning methods, as well as access and choice between them."
As a contribution to monitoring the implementation of those promises, the DEAS Population Division published “Global Contraceptive Use 2010”, which provides data on contraceptive use in 193 countries and on unmet family planning needs in 107 countries. Data were classified by country, region and development of modern and traditional contraceptive use, as well as unmet family planning needs, between 1950 and 2010.
According to the most recent data, contraceptive use among women of reproductive age who are married or in a union ranges from 3 percent in Chad to 88 percent in Norway. Globally, contraceptive use is estimated at 63 percent and is highest in more developed regions.
Trends in contraceptive use contrast among developing groups. In more developed regions, the level has been high for many decades and has changed little since 2000. In less developed regions, contraceptive use has increased substantially in the last decade. However, in sub-Saharan Africa, 48 of the countries with available data have contraceptive use levels below 20 percent, and only 22 percent of women of reproductive age who are married or in a union use contraceptives.
Among the countries with available data, the level of unmet family planning needs ranges from 2 percent in France to 46 percent in Samoa. In Africa, nearly half of the 44 countries with available data have levels of unmet need ranging from 20 percent to 30 percent of all women. In contrast, in Asia, Europe, Latin America and the Caribbean, most of the countries with available data have levels of unmet needs below 20 percent. (WHO, 2015).
4.2 IMPLICATIONS IN MEXICO:
In Mexico in recent years an important change in the sexual habits of the population; moreover, these habits have changed the paradigm of sexuality in the young and adolescent population. It was found that the number of adolescents who start out with a sexual life have increased in recent years, from 15% of the total to 23% between 2006 and 2012, respectively. (Neyro, 2015).
Although it is true that according to official data this increase in sexual activity has been accompanied by knowledge of contraceptive methods (from 69 to 90% in the same period), this knowledge has not had an impact on pregnancy rates, since of the total of of adolescents 12-19 years of age who had sexual intercourse, half (51.9%) reported ever having been pregnant. This entails a serious public health problem, which, at least in Mexico, has not yet been reversed.
This issue is important in the corollary of conscientious objection and contraception, since Mexican society as a whole has stigmatized premarital sex, which has prevented adolescents from approaching the health system (whether public or private). An example is found in a Mexican publication that explored the attitudes towards sexuality in a group of pregnant adolescents under 16 years of age, who mentioned (39.5%) that boyfriends or partners should not have any sexual activity (since they were already pregnant!). (Elorriaga, 2015).
This stigma also extends to health professionals, since in a survey conducted with Mexican gynecologists, when questioned about the barriers faced by the health system to offer contraceptive counseling and prescription to adolescents, they mentioned society ("At this age you should not talk about sexuality and contraception"), parents ("it is feared that parents will be upset") and legal fears ("it can create legal problems, since adolescents are minors") (unpublished data from Josefina Lira Plascencia). (Neyro, 2015).
Among the benefits of increasing contraception among adolescents are: the promotion of safe and responsible sexual relations, the achievement of better living standards, the prevention of unintended pregnancies and the practice of unsafe abortions, in addition to a reduction in the maternal and infant mortality. Adolescents have (as do adults) the right to respectful treatment and the informed consent process. It is vitally important to emphasize that the consent of the parents is not required for them to receive information, counseling and the method they have chosen in their case. (Lira, 2015).
4.3 IMPLICATIONS IN THE STATE OF CHIAPAS:
In what is considered within the state of Chiapas, family planning is not so marked for the population since there are too many rural communities, and therefore there are different cultures and different opinions, however there is a certain percentage of the population that has knowledge about the subject, and therefore is where they carry it out.
It is important to emphasize that in order to have a better knowledge, various studies must be carried out throughout the locality, both of the breadth of contraceptive options offered by the family planning program, and of the contraceptive intention on the part of women and their partners before opt for surgical sterilization, as well as the possible impact of the family planning program on the number of children.
Regarding contraceptive options, it is important to consider that since its implementation in the State of Chiapas, the family planning program has privileged surgical sterilization of women over other contraceptive methods, and currently this entity has the highest proportion of surgical sterilization among users from all over the country (CONAPO, 2000).
In some communities, this method is chosen despite the existence of others, for fear of collateral effects. That is, in general, contraceptive methods are used to limit the number of children and not to space births, which is expressed, in terms of indicators, such as the coexistence of a high prevalence of use of contraceptive methods and a high fertility, behavior that seems to be a pattern in various regions of Chiapas (Salvatierra, 2000).
CONCLUSION
The present topics addressed show us the importance of sexual education in adolescents, as well as the importance of being strengthened by educational and health institutions, to ensure that adolescents act with greater responsibility.
To emphasize this issue, we must start from a very important point, "responsibility." As well as starting an active sex life. It is therefore necessary to go to Contraceptive Methods for good planning.
Strengthening values related to family planning must begin with the family and not continue to consider it as a prohibited subject. Since it allows us to know and prevent unwanted pregnancies and above all not to have any sexually transmitted disease.
A means to achieve family planning, to be ethical, must begin with respect for the person and the human nature of the act, both are topics that today must be discussed more frequently, especially for adolescents since in they are being presented in a light way, and sometimes there is no knowledge of the risks that it may have.
Due to the above described, we come to the conclusion that we are totally in favor of this issue that we address given that it provides us with the necessary knowledge about the importance of family planning and the methods that can be used to be able to lead an adequate sexual life.
BIBLIOGRAPHY
- JL –Bilbao; Elorriaga. MA; Lira. J. - Pleasure. (2015). "Gynecology and Obstetrics Service, Faculty of Medicine and Dentistry" Mexico. World Health Organization (WHO) (2012). “Family planning guide for community health workers and their clients”. (ed. 4). Mexico. Elizabeth N. Edmands, RN, MA (1996) “Nursing in family planning”. World Health Organization (WHO) (2011) '“Global efforts for family planning”. New York.LAS; Clapis.MJ (2010). "Family planning in the Family Health Unit". Av. Bandeirantes, 3900 Bairro Monte Alegre (DF).CONAPO (National Population Council). 2000. Reproductive Health Notebooks. Chiapas. pp: 24-33.Salvatierra, B. 2000. Rural development and population. The case of Soconusco, Chiapas, Mexico. PhD thesis.Rural Development Studies, Institute of Socioeconomics, Statistics and Informatics, Colegio de Postgraduados, México.Herrero J, Valdés O, Cabero C. Contraception: general considerations. Classification of contraceptive methods. Techniques, indications and results of contraception and family planning. In: Cabero RL, Director, Cabrillo RE, General Coordinator, Bajo AJ, et al. Treaty of Gynecology and Obstetrics Gynecology and Reproductive Medicine. 2nd Ed. Madrid: Spanish Society of Gynecology and Obstetrics; 2012: p 615-9.Cabero RL, Director, Cabrillo RE, General Coordinator, Bajo AJ, et al. Treaty of Gynecology and Obstetrics Gynecology and Reproductive Medicine. 2nd Ed. Madrid: Spanish Society of Gynecology and Obstetrics; 2012: p 615-9.Cabero RL, Director, Cabrillo RE, General Coordinator, Bajo AJ, et al. Treaty of Gynecology and Obstetrics Gynecology and Reproductive Medicine. 2nd Ed. Madrid: Spanish Society of Gynecology and Obstetrics; 2012: p 615-9.
