9.4: Reproductive Healthcare and Family Planning
Reproductive healthcare includes regular screenings and testing for sexually transmitted infections (STIs), reproductive cancers, and treatment of reproductive disorders such as infertility, pelvic inflammatory diseases, endometriosis, polycystic ovarian syndrome, and others. Reproductive healthcare also includes counseling and education to help those who want to become pregnant, as well as those who wish to prevent pregnancy. Many families rely on Title X funded clinics (discussed in Chapter 14) for access to reproductive care and contraception. Family planning allows for individuals and couples to make important decisions on when to have children, to ensure they are healthy enough to have children, and to determine the spacing between children if they wish to have more than one child. It is important to note that hormonal contraceptives are also used for purposes beyond preventing pregnancy - they can be used to treat reproductive disorders like dysmenorrhea (painful periods), hormonal imbalances, and even acne (ACOG, 2023a).
Planning for pregnancy and parenthood helps to ensure appropriate resources and support systems are in place, and the health of the whole family is taken into consideration. This process may include considerations to improve fertility in the parents, preventing exposure to teratogens, ensuring adequate nutrition (including folic acid supplementation), and supporting the physical and mental health of the entire family. It can also include planning for parental leave from work, financial commitments (such as physician visits, labor and delivery, daycare, school, etc.), and studying parenting styles. Yet, nearly half of pregnancies in the U.S. are unintended, and have an increased risk of exposure to teratogens, delayed prenatal care (or lack thereof), and risk factors from other social determinants of health (Seabert et al., 2021).