Love, Children Family Planning

Love, Children

and

Family Planning

Seven discussion guides for Christian small groups

Institute for Reproductive Health

Christian Connections for International Health

Revised January 2013

Love, Children

and

Family Planning

Seven discussion guides for

Christian small groups

Institute for Reproductive Health

Christian Connections for International Health

Revised January 2013

Love, Children and Family Planning was produced by Georgetown

University’s Institute for Reproductive Health and Christian Connections

for International Health in collaboration with Judith Brown, PhD.

is guide was published under the project, Mobilizing Faith-based

Organizations to Expand Access to and Choice in Family Planning,

supported by the World Bank under the 2011 Population and Reproductive

Health Capacity Building Grant Program. Views reected in this

publication do not necessarily reect the views of Georgetown University

or the World Bank.

4301 Connecticut Avenue, NW, Suite 310

Washington, DC 20008 USA

Email: irhinfo@georgetown.edu

Website: www.irh.org

Any part of this publication may be reproduced and excerpts from it may

be quoted without permission, provided the material is distributed free of

charge and the Georgetown University Institute for Reproductive Health

is credited as the source of all copies, reproductions, distributions and

adaptations of the materials.

TABLE OF CONTENTS

Acknowledgements ......................................................................................... iv

Introduction .......................................................................................................1

How to use this book ........................................................................................3

Section One

Seven Bible studies for small groups

1 e love between husband and wife.......................................................6

I Samuel 1: 1-8

2 Be my disciple . . . count the cost ..............................................................9

Luke 14:25-29

3 Wives & husbands, children & parents ..............................................13

Ephesians 5:21-33, Ephesians 6: 1-4

4 Do not deny yourselves to each other .................................................. 17

I Corinthians 7: 1-6

5 At the creation .......................................................................................... 20

Genesis 1:26-28

6 e story of Onan ....................................................................................24

Genesis 38: 6-10

7 Two psalms ...............................................................................................27

Psalms 127 & 128

Section Two

Methods of family planning ..........................................................................31

irteen ways to ensure healthy timing and spacing of pregnancies

Annexes

A E-mails from Malawi: A couple’s love .................................................50

B Abortions: Do family planning methods

cause them or prevent them?.................................................................53

C Resources .................................................................................................. 57

ACKNOWLEDGEMENTS

ank you to all who contributed to the content and the method of the

discussion guides suggested in this book.

Democratic Republic of Congo:

Mme. Yvette Mulongo and the family planning team of the Medical

Oce of the Eglise du Christ au Congo, Kinshasa

Mr. Kalala Ngandu and his neighborhood Bible study group, Kananga

Kenya

Ms. Becky Mugambo and the family planning team at Chogoria Mission

Hospital, Meru South

Dr. Samuel Mwenda, Dr. Stanley Kiplangat and Pastor Joseph Oyongo,

Christian Health Association of Kenya, Nairobi

Malawi

Mr. Paul Kawale, MPH and the young Christian couples group,

Lilongwe

Rwanda

Mr. Ignace Singirankabo, Rwanda Faith-Based Organization

Network, Kigale

Tanzania

Dr. Jane Kahabi, Christian Social Services Commission, Dar es Salaam

United Kingdom

Dr. Glen Williams, Strategies for Hope Trust, Oxford

United States

Mr. Raymond Martin, Dr. Douglas Huber, Dr. Judith Brown, and Ms.

Devina Patel, Christian Connections for International Health, McLean,

Dr. Victoria Jennings and Ms. Lauren Van Enk, Institute for

Reproductive Health, Georgetown University, Washington, DC

Dr. Sarla Chand and Ms. Erika Pearl, IMA World Health,

New Windsor, MD

INTRODUCTION

Why this book?

Family planning is not oen discussed in churches in Africa. Why not?

Some are afraid their ideas will cause controversy or will not be accepted

by other Christians. Some have heard a lot of talk about abortions, and

they wonder if any family planning methods do cause abortions. Others

have heard someone say that family planning is against the teachings

of the Bible. And other Christians have simply been so busy with

HIV/AIDS in their communities that family planning has been almost

forgotten.

Meanwhile, a whole new generation of young people has come of age,

married and started having children. ey have probably learned a

lot about health topics -- child immunizations, good nutrition, the

importance of ante-natal visits, and HIV testing. But they may not have

heard much about healthy timing of pregnancies and family planning.

Churches can help their members, both older and younger, to

understand why couples should make good plans for having children,

and why spacing children is best for the health of the mother, baby, and

the family. Pastors, lay leaders and Christian health workers will nd

much strength and help in the Bible, in its many stories and passages

about couples, families and children. at is why we have written this

book.

is book was a cooperative eort of Christian health workers, pastors,

church leaders, youth, and members of churches. Contributions and

comments came from DRCongo, Kenya, Malawi, Rwanda, Tanzania,

and the United States. We are grateful for their interest and willingness

to share their ideas and their experiences.

Our dream for families in Africa

• atfamilyplanningwillbecomearightforeverywomanand

family

• atfamilyplanningwillceasetoberestrictedtohospitals

(whereitisoeredasmedicaltreatment),butinsteadwillbe

transformedintoanopportunityforfamilycenteredhealthcare

• atfamilyplanningeducationandoptionswillbecomeeasily

accessiblethroughacommunity-basedsystem

~ Dr. Samuel Mwenda, General Secretary

Africa Christian Health Associations Platform

HOW TO USE THIS BOOK

e book has two sections. e rst contains Bible passages and

suggestions for discussing them in small groups. e second section

gives information about the many dierent family planning methods

available from health providers.

is book is meant to be used by small groups – in churches, in

neighborhoods and in Christian nursing schools and health centers. It

is meant to be discussed and debated by Christians in all walks of life.

In this kind of Bible study, no one is a “total expert”. Of course, some

people will be able to share their knowledge about when the Bible

passage was written, what the situation was then, and what certain

words originally meant. Others will be able to speak from their personal

experiences living in couples, in families, and in communities. Other

group members will have knowledge about the human body and will

be able to explain some of the health subjects. No one person is an

expert in all those areas, and everyone will have something to say and

something to learn.

e group organizer has just three tasks:

• Beginwithprayer,andasksomeonetoreadtheBiblepassage,

• Dividepeopleintosmallgroups(eachwith5-8members)andbe

sureeachgrouphasacopyoftheBiblepassageandthequestions

tobediscussed.

• Keeptrackofthetime,andcallthegroupsbacktogetherforthe

lastfewminutes.

We suggest that you begin with Bible study 1 (“e love between

husband and wife”). Aer that, the other Bible studies can be done in

any order you like.

A word about different Bible translations:

e many books of the Bible were originally written about 2000-3000

years ago, some in Hebrew and some in Greek. e rst translations

into the English language were done about 500 years ago. Since then,

many other English translations have been done.

e Bible passages quoted in this book are from the Good News Bible:

Today’s English Version, Second Edition, American Bible Society, 1992.

e preface to the Good News Bible says: “is translation seeks to state

clearly and accurately the meaning of the original texts, in words and

forms that are widely accepted by all people who use English as a means

of communication… It was translated and published by the United Bible

Societies for use throughout the world.”

Some members of your own group will have dierent English

translations of the Bible. Some will have Bibles in other languages.

Encourage them to bring their dierent Bibles, so the group can

compare the words and phrases in the passages as you talk together.

Section One

Seven Bible studies for small groups

1 e love between husband and wife ..........................................6

I Samuel 1: 1-8

2 Be my disciple...count the cost ...................................................9

Luke 14:25-29

3 Wives & husbands, children & parents ..................................13

Ephesians 5:21-33, Ephesians 6: 1-4

4 Do not deny yourselves to each other ...................................... 17

I Corinthians 7: 1-6

5 At the creation ..............................................................................20

Genesis 1:26-28

6 e story of Onan ........................................................................ 24

Genesis 38: 6-10

7 Two psalms ...................................................................................27

Psalms 127 & 128

Bible Study 1

The love between husband and wife

I Samuel 1:1-8

1 erewasamannamedElkanah….

2 Elkanahhadtwowives,HannahandPeninnah;Peninnahhad

childrenbutHannahdidnot.

3 EveryyearElkanahwentfromRamahtoworshipandoer

sacricestotheLordAlmightyatShiloh….

4 EachtimeElkanahoeredhissacrice,hewouldgiveoneshare

ofthemeattoPeninnahandonesharetoeachofherchildren.

5 AndeventhoughhelovedHannahverymuchhewouldgive

heronlyoneshare,becausetheLordhadkeptherfromhaving

children.

6 Penninah,herrival,wouldtormentandhumiliateher,because

theLordhadkeptherchildless.

7 iswentonyearaeryear;whenevertheywenttothehouse

oftheLord,PeninnahwouldupsetHannahsomuchthatshe

wouldcryandrefusetoeatanything.HerhusbandElkanah

wouldaskher,“Hannah,whyareyoucrying?Whywon’tyou

eat?Whyareyoualwayssosad?Don’tImeanmoretoyouthan

tensons?”

~ from the Good News Bible

Part 1.

Begin with the whole group together (10 minutes)

Begin by praying for wisdom, learning, and a helpful discussion.

Hear the story

Ask a person with a strong voice to read aloud slowly I Samuel 1: 1-8.

Ask these questions to make the story clear:

• Whoarethethreemaincharacters?

• Foreachperson,whatisthesituation?

• Whatdideachpersondo?

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should

make sure everyone in the group has a chance to say something, at least

once, during their time together.)

Read the Bible passage out loud again.

Questions for discussion and reection

• ForPeninnah,whocountedmore—herhusbandorherchildren?

• ForHannah,whocountedmore—herhusbandorhavingsome

children?

• AndforElkanah,whocountedmore—hiswives,hisdaughtersorhis

sons?

• Whattitlewouldyougivetothisstory?

Some ideas = “A love story”

“Children don’t matter”

“Can a man love two wives?”

Here are some real comments about this Bible passage. If someone said

these things to you, how would you reply?

Aman:  “Acouplecanloveeachotherandstaytogetherwithouthaving

children.Loveisnotdependentonthepresenceofchildren.”

Aman: “ForusAfricans,theobjectiveofanymarriageistoengender

children. A marriage without children is hardly accepted by the

societyanditisinconceivable.”

Apastor: “Marriagehasforitsbasethelovebetweenamanandhiswife.

Aslongasthislovepersistsbetweenthecouple,amarriagecan

existandcontinueeveniftheyhavenochildren.”

Awoman:“Childrenareablessingfortheparents.”

Ayoungperson:

 “Moreandmorecouplesliveharmoniouslywithoutchildren

andespeciallynowwhensurvivalisbecomingharderand

h a r d e r.”

If you still have some time le, turn to Annex A of this book, and

read some of the interesting E-mails about Hannah and Elkanah – and

couples today.

Part 3.

When just 5-10 minutes remain, call everyone together again.

Each small group can share the key points of their discussions. Or

someone can simply read the passage aloud one more time.

End with prayer.

Bible Study 2

Be my disciple . . . count the cost

Luke 14:25-29

25 OncewhenlargecrowdsofpeopleweregoingalongwithJesus,

heturnedandsaidtothem,

26 “osewhocometomecannotbemydisciplesunlesstheylove

memorethantheylovefatherandmother,wifeandchildren,

brothersandsisters,andthemselvesaswell.

27 “osewhodonotcarrytheirowncrossandcomeaerme

cannotbemydisciples.

28 “Ifoneofyouisplanningtobuildatower,yousitdownrstand

gureoutwhatitwillcost,toseeifyouhaveenoughmoneyto

nishthejob.

29 “Ifyoudon’t,youwillnotbeabletonishthetoweraerlaying

thefoundation;andallwhoseewhathappenedwillmakefunof

y o u .”

~ from the Good News Bible

Suggestion: Invite a community health worker or a nurse, with knowledge

of family planning methods, to be ready to answer questions during Part 3

of this discussion.

Part 1.

Begin with the whole group together (10 minutes)

Pray for wisdom, learning, and a helpful discussion.

Hear the scripture

Ask someone with a strong voice to read aloud slowly the Bible verses

above from the Gospel of Luke.

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should

make sure everyone in the group has a chance to say something, at least

once. You may want to ask someone to take notes or write ideas on a

chalkboard.)

Questions for reection and discussion

• Intoday’sreading(Luke14:25-29),whatisJesussayingaboutfamily

ties?

• TofollowJesus,mustyouhateyourfamily?

• Whomorwhatmustyourenounce?

• WhatwasJesus’exampleoflackofplanning?

• Let’sthinkaboutplanningwithinfamilies.Canyougiveexamplesof

poorplanning?

• Whatkindofplanningisnecessaryforayoungmarriedcouple?

Whataboutamiddle-agedcouple?

Whatplanningdooldermembersofafamilyneedtodo?

Here are real comments some people had about this Bible passage. If

someone said these things to you, how would you reply?

Awoman: “Buildingahouse,buildingafamily—bothtakeplanning.”

Apastor: “Godisthegreatestplanner.”

¿ ¿ ¿

Aman: “eactofgivingbirthisgivenbyGodandshouldbewell

thoughtout.Youhavetotakeresponsibilityforraisingthe

children all the way to the end. Otherwise, it’s a sin. You

havetoplanbirthsaccordingtotheresourcesthatwillbe

needed.”

Awoman:“WhenmyhusbandandIwererstmarried,weplanned

tohavesixchildren.Butlater,wedecidedtostopwithtwo.

Why?Toraiseourtwochildrenproperly,andalsosothatwe

couldgiveourtimetoourwork,whichistohelppoorand

needychildren.”

¿ ¿ ¿

Aman: “Likeanyprojectwhichneedsaplanandanorganizationto

be successful, a family also requires a plan, an organization

andmethodstosucceedintheeducationofthechildren.”

Apastor: “Getmarried,andtheGodofallcomfortwillprovidetherest

inhisimmenselove.”

Awoman: “You should not burden yourself with children you will

notbeabletoeducateandraisecorrectly.Itisnecessaryto

choose a number of children related to the means your family

possesses.”

Part 3.

When you have about 10-20 minutes le, call the whole group together.

Ask the community health worker or nurse to talk about a special kind

of planning – “family planning”.

Here is a list of 13 contraceptive methods, arranged according to how

much planning is necessary to use each method:

Methods that require planning & constant cooperation between

husband and wife:

• Withdrawalmethod(seepage41)

• StandardDaysMethod®,withCycleBeads®(page40)

• Malecondoms(page42)

• Femalecondoms(page43)

Methods that require careful planning by the wife :

• LactationalAmenorrheaMethod(LAM),whilesheis

breastfeeding a baby less than 6 months old, and her menstrual

bleeding has not returned, and she is not giving any other foods or

liquids (page45)

• Mini-pillsthatshemusttakeeveryday--ifsheisbreastfeedinga

baby 6 weeks to 6 months old (page35)

• Regularcontraceptivepillsthatshemusttakeeveryday--ifsheis

not breastfeeding a baby (page34)

• Injections-shemustgetoneevery2or3months(page37)

Methods that do not require constant planning by the wife or the

husband:

• Implants(page38)

• IUD(page39)

• Malesterilization(vasectomy)(page47)

• Femalesterilization(page46)

What if a couple forgets? What if they have been praying & planning

carefully, but someone forgets to use the contraceptive method. What

can they do?

• Emergencycontraceptivepills–thatthewifemusttakewithin5

days (page36)

Some people may want to ask questions about the Bible or about

contraceptive methods.

End with prayer.

Bible Study 3

Wives & husbands, children & parents

Ephesians 5:21-33

21 Submityourselvestooneanotherbecauseofyourreverencefor

Christ.

22 Wives,submityourselvestoyourhusbandsastotheLord.

23 ForahusbandhasauthorityoverhiswifejustasChristhas

authorityoverthechurch,andChristishimselftheSaviorofthe

church,hisbody.

24 Andsowivesmustsubmitthemselvescompletelytotheir

husbandsjustasthechurchsubmitsitselftoChrist.

25 Husbands,loveyourwivesjustasChristlovedthechurchand

gavehislifeforit.

26 HedidthistodedicatethechurchtoGodbyhisword,aer

makingitcleanbywashingitinwater,

27 inordertopresentthechurchtohimselfinallitsbeauty–pure

andfaultless,withoutspotorwrinkleoranyotherimperfection.

28 Menoughttolovetheirwivesjustastheylovetheirownbodies.

Amanwholoveshiswifeloveshimself.

29-30(Noneofuseverhateourownbodies.Instead,wefeedthem,

andtakecareofthem,justasChristdoesthechurch;forweare

membersofhisbody.)

31 Asthescripturesays,“Forthisreasonamanwillleavehisfather

andmotherandunitewithhiswife,andthetwowillbecome

o n e .”

32 ereisadeepsecrettruthrevealedinthescripture,whichI

understandasapplyingtoChristandthechurch.

33 Butitalsoappliestoyou:everyhusbandmustlovehiswifeas

himself,andeverywifemustrespectherhusband.

~ from the Good News Bible

Ephesians 6:1-4

1 Children,itisyourChristiandutytoobeyyourparents,foritis

therightthingtodo.

2 “Respectyourfatherandmother”istherstcommandmentthat

hasapromiseadded:

3 “Sothatallmaygowellwithyou,andyoumaylivealongtime

intheland.”

4 Parents,donottreatyourchildreninsuchawayastomake

themangry.Instead,raisethemwithChristiandisciplineand

instruction.

~ from the Good News Bible

Part 1.

Begin with the whole group together (10 minutes)

Pray for wisdom, learning, and a loving discussion.

Hear the scripture

e session leader can say;

“Todaywewillbereadingpartsofaveryoldletter.Itwaswrittenbythe

apostlePaultothenewchurchinthecityofEphesus(whichstillexists,

inthemoderncountryofTurkey).Paulhadsomeadviceforwives,

husbands, children and parents. Listen carefully for the action words –

whathetoldeachgrouptoDO(obey,love,etc.).”

Ask two people with strong voices to read aloud the two Bible passages

from Ephesians.

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should

make sure everyone in the group has a chance to say something. e

group may ask someone to take notes.)

Questions for reection

What did Paul actually say?

• WhatdidPauladvisewivestodo?(Ephesians5)

• Whatdidheadvisehusbands?

• DidPaulsaythatthehusbandmustlovehiswife,onlyifshesubmitsto

him?

• Didhesaythewifemustrespectthehusband,onlyifhelovesher?

• WhatdidPauladvisechildrentodo?(Ephesians6)

• Whatdidheadviseparentsnottodo?Whatdidheadvisethemtodo?

What do these ideas mean to us?

• DoPaul’swordsofadviceapplyintoday’sworld?

• Whatdopeoplethinktodayabouttherolesofmenandwomen?How

doesthatinuencetherolesofhusbandsandwives?

• Whichismoredicult–respectingorloving?

• Dotheactionsdependonwhattheotherpersondoes?

• Whatifthechildrenarerebellious?

• Dotheseversesspeakof“responsibleparenthood”?

Here are real comments some people had about this Bible passage. If

someone said these things to you, how would you reply?

Aman: eloveofthehusbandforhiswifeandhersubmissionto

himmakethefoundationofthemarriageunion.

Aman: Ourchildrenshouldobeyus,andwehavetheresponsibility

toraisethemwell.Whentherearetoomanychildren,raising

themoenisafailure.Yourunmoreriskoflosingthem

—inaphysicalsense,andalsomorally,intellectually,and

spiritually.

Awomanteacher:

Responsibleparenthooddoesn’tmeanonlyhavingmoneyand

usingittosatisfythechildren’sneeds.Italsomeanshaving

enoughtimetotakecareoftheirtrainingwithinthefamily.

Aman: Allparentshavethedutyandtheresponsibilityofraisingand

educatingthechildrenGodhasgiventhem.

Apastor: Children owe obedience to their parents; that is God’s law.

Adeacon: Butachildabandonedinthestreetcannotthinkofobeying

his irresponsible parents.

Awoman: Children should honor their parents, in order to be happy and

havealonglifeonearth.

Ayoungperson:

eseversesspeakaboutaresponsiblemotherhoodandabout

raising children well in a couple.

¿ ¿ ¿

• Whatisthethemeoftheseverses?

• Lookinseveraltranslationsandindierentlanguagesfortheverbs

thatareusedintheseverses.Whatwordsineachlanguageseemtobe

thebest?Why?

English Other languages

fear

respect

be subject

submit

obey

love

nourish

cherish

Part 3

When you have 5-10 minutes le, call the whole group together:

If you wish, each small group can share the key points of the discussions.

Or someone can simply read the scripture aloud one more time.

End with prayer.

Bible Study 4

Do not deny yourselves to each other

I Corinthians 7: 1-6

1 Now,todealwiththemattersyouwroteabout.[Yousaythat]a

mandoeswellnottomarry.

2 Butbecausethereissomuchimmorality,everymanshouldhave

hisownwife,andeverywomanshouldhaveherownhusband.

3 Amanshouldfulllhisdutyasahusband,andawomanshould

fulllherdutyasawife,andeachshouldsatisfytheother’s

needs.

4 Awifeisnotthemasterofherownbody,butherhusbandis;in

thesamewayahusbandisnotthemasterofhisownbody,but

hiswifeis.

5 Donotdenyyourselvestoeachother,unlessyourstagreeto

dosoforawhileinordertospendyourtimeinprayer;butthen

resumenormalmaritalrelations.Inthiswayyouwillbekept

fromgivingintoSatan’stemptationbecauseofyourlackofself-

control.

6Itellyouthisnotasanorder,butsimplyasapermission.

~ from the Good News Bible

Suggestion: Invite a community health worker or a nurse, with knowledge

of family planning methods, to be ready to answer questions during Part 3

of this discussion.

Part 1.

Begin with the whole group together (10 minutes)

Pray for wisdom, learning, and a respectful discussion.

Hear the scripture from I Corinthians

Remind your group that the apostle Paul wrote this letter almost 2000

years ago to Christians in the city of Corinth. ey seemed to be having

some marital problems.

Ask someone with a strong voice to read aloud 1 Cor. 7:1-6.

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should

make sure everyone in the group has a chance to say something, at least

once. Someone may want to take notes or write ideas on a chalkboard.)

Questions for reection

• Paulsaidthatsexualabstinenceisappropriateandrecommended

when?Ifhewaswritingtoyourchurchtoday,doyouthinkPaul

wouldrecommendsexualabstinence?Forwhom?When?

• ManyAfricansocietieshadtraditionalwaysofensuringaspace

betweenchildren.(Anexample:Whileawifewasbreastfeeding,

sheandherhusbanddidnothavesexualrelations.)Whatwerethe

advantagesanddisadvantagesofthosepractices?Dowomentoday

continuetoobservethosepractices?Whatabouttheirhusbands?

Here are real comments some people had about this Bible passage. If

someone said these things to you, how would you reply?

A man:  ecoupleoweseachothermutualdelity,andtheyshould

havesexualrelationsregularly.Toavoidsexualabstinence,

andalsotoavoidunwantedpregnancies,theyshouldusea

contraceptivemethod.

A pastor:  Prayerhastobethecornerstoneforgoodfamilyplanning.It

helps a couple plan their pregnancies.

An elder:  Godhimself,whogavethelaw,willalsoplanthebirthsatthe

right time.

A man:  Amanandwomanshouldnotdepriveeachother.ey

shouldhaveregularsexualintercoursetostrengthentheirlove

andavoidthetemptationsofthedevil.

A woman: But, during certain fertile periods, they can use means to

preventanon-wishedpregnancy.

Q & A: Questions & answers about specic family planning methods

(For more details, see Section 2 of this book, beginning on page 31)

Q 1: Which methods help a couple know which days the wife can

become pregnant so they can abstain or use a condom?

A:  StandardDaysMethod(SDM)–eSDMidenitifesthedays

(days8-19)ofeverycyclewhenthewomancanpotentiallybecome

pregnant.Toavoidpregnancy,thecoupleeitherusesacondomon

thosedaysordoesnothavesexonthosedays.Cooperationbetween

the husband and wife helps them use the SDM successfully.

Q 2: Which contraceptive methods allow a couple to have sexual

relations at any time, without ever having to “deny each other”?

A: All the other methods allow sexual relations any time, but some

methodshavetoberememberedandusedeverytime,oreveryday.

Here are the details:

Methods that must be used correctly, every time a couple has sex:

•withdrawalbytheman

•condomsusedbythemanorthewoman

Methods that the wife must remember every day:

•mini-pills

•combinedpills

Method that the wife must remember every 2 or 3 months:

•contraceptiveinjections

Method that works only while the wife is breastfeeding a baby less

than 6 months old, and her menstrual bleeding has not returned,

and she is not giving any other foods or liquids:

•LactationalAmenorrheaMethod(LAM)

Methods that last for several years:

•implant(3-5years)

•intra-uterinedevice-IUD(upto12years)

Methods that are permanent (they last forever):

•vasectomy(malesterilization)

•tuballigation(femalesterilization)

Part 3

When you have 5-10 minutes le, call the small groups back together:

If you wish, the groups can share key points of their discussions. Or

someone can simply read the scripture aloud one more time.

End with prayer.

Bible Study 5

At the creation

Note: e creation stories in the book of Genesis in the Bible are very

familiar to 21st century Christians. ey were written many centuries

ago, in the Hebrew language. Here are two translations of the verses. Both

translations are good and are accurate.

GENESIS 1:26-28 (Two translations)

26enGodsaid,“Andnowwewillmakehumanbeings;theywill

belikeusandresembleus.eywillhavepoweroverthesh,

thebirds,andallanimals.domesticandwild,largeandsmall.

27SoGodcreatedhumanbeings,makingthemtobelikehimself.

Hecreatedthemmaleandfemale,

28blessedthem,andsaid,“Havemanychildren,sothatyour

descendantswillliveallovertheearthandbringitundertheir

control.Iamputtingyouinchargeofthesh,thebirds,andall

thewildanimals.”

~ from the Good News Bible

26Godsaid“Letusmakemaninourownimage,inthelikenessof

ourselves,andletthembemastersoftheshofthesea,thebirds

ofheaven,thecattle,allthewildanimals,andallthecreatures

thatcreepalongtheground.

27Godcreatedmanintheimageofhimself,intheimageofGodhe

createdhim,maleandfemalehecreatedthem.

28Godblessedthem,sayingtothem,“Befruitful,multiply,llthe

earthandsubdueit.Bemastersoftheshofthesea,thebirds

ofheavenandallthelivingcreaturesthatmoveonearth.”

~fromtheNewJerusalemBible

Part 1.

Begin with the whole group together (10 minutes)

Begin by praying for wisdom, learning, and a loving discussion.

Hear the story

Tell the group members that they will hear the same verses from

Genesis, in two dierent translations, both of them accurate.

Ask someone with a strong voice to read aloud slowly the verses above

from the Good News Bible.

Ask someone else to read the same verses from the New Jerusalem Bible.

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should

make sure everyone in the group has a chance to say something, at

least once. Have one group member take notes or write ideas on a

chalkboard.)

Questions for discussion and reection

(1) As a group, talk about some key phrases in the two dierent

translations.

Good News Bible New Jerusalem Bible

“like himself” = “in the image of himself”

“have many children” = “be fruitful, multiply”

“so that your descendants

will live all over the earth” = “ll the earth”

“and bring it under

their control” = “and subdue it”

(2) Aer your group has talked about the words, think together about

these ideas:

• TowhomdidGodgivetheseinstructions?

• Weretheygiventothersthumanbeingslongago,ortousalso

inourday?

• Weretheygiventoeveryindividualpersonwhoeverlives,orto

mankindingeneral?

• Dotheseversessayanythingonthesubjectoffamilyplanning?

• Dotheyforbidtheuseofcontraceptivemethods?

Here are some real comments about this Bible passage. If someone said

these things to you, how would you reply?

About “the image of God”

A woman: eimageofGodmeansabeingwhoactswithlove,wisdom,

intelligence, and reasoning.

A theologian:

Onetranslationsays“likeHimself”,whiletheothersays“in

theimageofGod”.atideaisthefoundationofhuman

dignity. us it is with dignity that the human being must

beconceivedandborn.Wemusttakehumandignityinto

accountwhenwe“lltheearth”.

A man: e image of God in man is the capacity that God put in man

todistinguishgoodfromevil.

A woman: e breath which God put in the man -- that is His image in

the man.

A minister:

e image of God in the man is the Spirit of God in the man,

the soul. e man who has no Holy Spirit has no image of

God in him. He is similar to an animal.

About “many children”

A man: Children?Yes,youshouldhavethem,butnotinadisorderly

way.“Befruitful”and“multiply”—thosearenotsynonyms

for disorder.

A pastor:  Yes,theseversessaysomethingaboutfamilyplanning.God

gavethecoupletheabilitytohavechildrenandtoreason,in

order to plan a birth in an orderly way, with wisdom.

A young person:

God’s spirit in man helps him to choose what is good and

what is bad; and to choose the number of children he wants to

haveinhishome.

A man: e world is what it is today because people want to interpret

God’s word in their own ways. Be fruitful and multiply means

what it means and nothing else.

About “ll the earth” and “subdue it”

A deacon: God does not change; His commands are unchanging and

theyneverchange.ecommandtolltheearthisaddressed

also to us in this generation.

A pastor:  iscommandmentto“lltheearth”isprobablytheonlyone

wehaveobeyed!

A woman:  ethoughtofGodisnotthethoughtofthehumanbeing.We

havetoobeyGodratherthantheselshthoughtofmen.So,

withoutdiscussion,wemustlltheearth.

An elder: WheretheBiblespeakswehavetospeakandwhereitkeeps

quiet,wehavetokeepquiet.Weshouldmultiplyandllthe

earth according to God’s recommendation.

A young person:

“Subduetheearth”includesthenotionoforganization,

method, planning and in addition the notion of family

planning.

A woman: Godissovereign.Hehasnoadviserandletusnottrytohelp

him.

A pastor:  ecommandfromGod,“Befruitful,multiply,lltheearth

andsubdueit”,meansthataermultiplyingandllingthe

earth, we should subdue our reproduction.

A pastor: Itisllingtheearth,notllingthehouse.Becauseifyouare

llingthehouse,itmeansyouhavemanychildreninone

houseandcannotaordtomaintainthem.Butifyouare

llingtheearth,itmeansyouplusotherpeople—itisnot

solelyyourdutytollit.

Part 3

When you have 5-10 minutes le, call the small groups back together:

If you wish, the groups can share key points of their discussions. Or

someone can simply read the scripture aloud one more time.

End with prayer.

Bible Study 6

The story of Onan

Genesis 38: 6-10

6ForhisrstsonEr,JudahgotawifewhosenamewasTamar.

7Er’sconductwasevil,anditdispleasedtheLORD,sotheLORD

killedhim.

8enJudahsaidtoEr’sbrotherOnan,“Goandsleepwithyour

brother’swidow.Fulllyourobligationtoherasherhusband’s

brother,sothatourbrothermayhavedescendants.”

9ButOnanknewthatthechildrenwouldnotbelongtohim,so

whenhehadintercoursewithhisbrother’swidow,heletthe

semenspillontheground,sothattherewouldbenochildren

forhisbrother.

10WhathediddispleasedtheLORD,andtheLORDkilledhim

also.

~ from the Good News Bible

Suggestion: Invite a community health worker or a nurse, with knowledge

of family planning methods, to be ready to answer questions during Part 3

of this discussion.

Part 1.

Begin with the whole group together (10 minutes)

Pray for wisdom, learning, and a respectful discussion.

Hear the scripture

Ask someone with a strong voice to read aloud slowly the story of Onan.

Tell the listeners to pay close attention to what Onan did, what he did

not do, and exactly what displeased the Lord.

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should let

everyone in the group have a chance to say something, at least once. You

may want to ask someone to take notes or write ideas on a chalkboard.)

A question for discussion

• ExactlywhydidGodpunishOnan?

(Better read the passage again before you try to answer!)

Here’s what some people have said:

A man: God punished Onan because he wasted his semen on the

ground.

A woman: God punished Onan because he did not obey his father’s

request.

A young person:

GodpunishedOnanbecausehehadnoloveforhisbrother.

An elder:  OnanwaspunishedbyGodforhisselshness,fordisobeying

hisfatherandforthrowing(spilling)hissemenontheground,

whichlookslikeanabortionoramurder.

A deacon: InGod’seyes,bycastinghissemenontheground,Onanwas

amurdererlikeCainwhokilledhisbrotherAbel.

A pastor:  Itistheactiontoputthesemenonthegroundwhenhewas

sleeping with the wife of his dead brother Er, so that he would

notgivehisbrotheranyospring.atiswhatdispleased

God who then caused his death.

Summary: People seem to answer the question “Why did God punish

Onan?” in two dierent ways:

• Sometalkabouthisthoughts--hisselsh intentions.

• Otherstalkaboutthe specic way he prevented a pregnancy (e

Bible calls it “spilling his semen”. Health workers now call it “the

withdrawal method.”)

Many Christians nowadays feel that a husband and wife together should

decide when to prevent or postpone pregnancies, and how to do that.

Do you agree?

ree contraceptive methods depend upon the husband to do

something:

• Withdrawal method – eective if he does it quickly and completely,

before he ejaculates (sends out his semen liquid) Seepage41

• Male condom – the man’s many small sperm cannot reach the

woman’s egg to fertilize it. Seepage42

• Male vasectomy – a small operation that allows the man to produce

semen liquid, but no sperm. Seepage47.

Story from a Christian health educator:

Irememberonepastorwhowouldnotletmetalkaboutsexualityor

condomsinhisparish.Evenaeralongconversationaboutthestoryof

Onan,hewasn’tconvinced.Finallyheaskedme,“Haveyoueverused

condomsyourself?”Ianswered,“Ofcourse,manytimes.”enhesaid,

“Okay,ne.Goaheadandtalkaboutthemtoourchurchpeople.

Part 3.

When 5-10 minutes are le, call the whole group together:

If you wish, each small group can share the key points of the discussions

(2 min.each). Or someone can simply read the scripture aloud one more

time.

en end with prayer.

Bible Study 7

Two psalms

Psalm 127

1 IftheLorddoesnotbuildahouse,theworkofthebuildersis

useless;iftheLorddoesnotprotectthecity,itdoesnogoodfor

thesentriestostandguard.

2 Itisuselesstoworksohardforaliving,gettingupearlyand

goingtobedlate.FortheLordprovidesforthoseheloves,while

theyareasleep.

3 ChildrenareagifromtheLord;theyarearealblessing.

4 esonsamanhaswhenheisyoungarelikearrowsina

soldier’shand.

5 Happyisthemanwhohasmanysucharrows.Hewillneverbe

defeatedwhenhemeetshisenemiesintheplaceofjudgment.

Psalm 128

1 HappyarethosewhoobeytheLord,wholivebyhiscommands.

2 Yourworkwillprovideforyourneeds;youwillbehappyand

prosperous.

3 Yourwifewillbelikeafruitfulvineinyourhome,andyour

childrenwillbelikeyoungolivetreesaroundyourtable.

4 AmanwhoobeystheLordwillsurelybeblessedlikethis.

5 MaytheLordblessyoufromZion!MayyouseeJerusalem

prosperallthedaysofyourlife!

6 Mayyoulivetoseeyourgrandchildren!

~ from the Good News Bible

Part 1.

Begin with the whole group together (10 minutes)

Begin by praying for wisdom, learning, and a respectful discussion.

Hear the Psalms

Ask two people with strong voices to read aloud slowly Psalm 127 &

Psalm 128.

Tell the listeners to pay attention to the words and images, to picture

them in their minds, and maybe write them down.

Part 2.

Break into small groups (10-20 minutes)

(Note: Each group should have 4-6 people. Group members should

make sure everyone in the group has a chance to say something, at least

once. You may want to ask someone to take notes or write ideas on a

chalkboard.)

Look at Psalm 127 (or read it out loud again)

• Reectonthedierentpicturesandimages,forexample:house,

working hard, arrows, etc.

• HowmanychildrendoyouthinkthePsalmistalkingabout?Girls

or boys or both?

en look at Psalm 128 (or read it aloud)

• Whatnewimagesandpicturesdoyouhear?

• Aretheseimagesstillrelevantinourday?Why?Whynot?

ink about the present and the past

• Whatimagesofchildrenandfamiliesdowehearandseeinour

neighborhoods, on television, and in lms today?

• HowareourtimesdierentfromBibletimes?Howaretheyalike?

• Howareourtimesdierentfromourgrandparents’time?Howare

they alike?

• Askmembersofyourgroupiftheyhavestoriestoshare(from

their own families or friends) about numbers of children, too many

children, or too few children? Did the parents actually make the

decisions?

• WhatdothesePsalmssaytouswhoarelivingtoday?

What can Christian health workers oer to couples who feel that they

probably should not have more children?

Four good contraceptive methods are available. Not every health center

can provide all of them, but health workers can tell couples where to get

each one.

Long-term, non-permanent methods – for couples who feel they

should not have more children in the next few years, but are not sure

about later.

• intra-uterine device (IUD). A nurse places a small “T” in the

woman’s womb. Seepage39formoredetails.

• implant. A nurse places small plastic rods in the woman’s arm. See

page38formoredetails.

Permanent methods – for couples who are very sure that they should

not have any more children, and they are sure they will not change their

minds later. Either the wife or the husband can have a small operation.

• female sterilization. Seepage46formoredetails.

• male vasectomy. Seepage47formoredetails.

If you still have time in your small group, here are real comments about

these two psalms. If someone said these things to you, how would you

reply?

A father:  AnyfamilyhastohaveasmanychildrenasGodgivesthem,

becauseHeistheonewhogivesandwhotakesaway.

A mother: Children are a right and God’s benediction. Any couple has to

engenderthemandhavethem.

A father: Procreation is a blessing and a reward of God to the faithful.

But we shouldn’t abuse it.

¿ ¿ ¿

A grandmother:

Somechildrenbecomeenemiesoftheirparents,selsh....

A father: Some children are a support and a protection for their

parents.

¿ ¿ ¿

A mother: Withoutchildren,theolddaysoftheparentsarenot

guaranteed.

A mother: My children are my jewels, my best dresses, my treasures.

¿ ¿ ¿

A mother: InBibletimes,amanneededalotofsonstodefendhimin

war. at is no longer the case nowadays.

A young person:

Itisalwaysnecessarytohavemanychildren,becauseonedoes

notknowwhichofthemwillbeblessedandwillbecomethe

support of all the family.

A mother: e children are and will remain God’s blessing, because the

futureisnotknowntoanybody.

Part 3.

When you have 5-10 minutes le, call the whole group together:

If you wish, each small group can share the key points of the discussions.

Or someone can simply read the psalms aloud one more time.

End with prayer.

Section Two

Family Planning Methods

to ensure good timing and spacing of pregnancies

Comparing Family Planning Methods ..........................................33

1 Combined pills ..........................................................................34

2 Mini-pills ....................................................................................35

3 Emergency contraceptive pills ...............................................36

4 Injection ...................................................................................... 37

5 Implants ...................................................................................... 38

6 Intra-uterine device (IUD)......................................................39

7 Standard Days Method® with CycleBeads® ..........................40

8 Withdrawal method .................................................................41

9 Male condom .............................................................................42

10 Female condom .........................................................................43

11 Lactational Amenorrhea Method (LAM) ............................45

12 Female sterilization ..................................................................46

13 Male sterilization (vasectomy) ...............................................47

is section is adapted from the dra ip chart, A Guide to Family Planning for

CommunityHealthWorkersandtheirClients,World Health Organization, 2011.

http://www.irh.org/sites/default/les/WHO_FP_Provider_Flipchart-

CHAKversion.pdf

Comparing Family Planning Methods

Most effective in

preventing pregnancy

and easiest to use

Effective in preventing

pregnancy, but must be

carefully used

Fewer side-effects:

Very effective in

preventing pregnancy,

but must be carefully

used

More side-effects—most

are normal:

Pills

Injectables

Fertility

awareness-

based methods

Male and

female

condom

Fewer side-effects,

permanent:

More side-effects--most

are normal:

Implants

IUD

Fewer side-effects:

Breastfeeding

method

Female

sterilization

Vasectomy

Comparing family planning methods

IMPORTANT!

Only condoms

protect

against both

pregnancy and

STIs/HIV/AIDS

1. Combined pills

The Pill

• Safe

• Effective when a pill is taken every day

• Less monthly bleeding and cramps

Week 1

Week 2

Week 3

Reminder pills

The Pill

What it is

– A pill with hormones in it that is taken every day.

– Prevents release of egg, and blocks sperm from meeting egg.

How to use

– Take one pill every day.

– When you finish a pack of pills, start a new pack the next day.

If you miss a pill:

– Take missed pill as soon as possible.

– Okay to take 2 pills at the same time.

– If you miss more than 2 days of pills in a row, use condoms for 7 days and keep taking pills. If

you miss these pills in week 3, ALSO skip the reminder pills and start a new pack.

What to expect

– Sometimes irregular bleeding at first, then followed by lighter monthly bleeding with less

cramping.

– Some women have stomach upset or mild headaches that go away after first few months.

Key points

– Take a pill every day.

– Be sure you have enough pills. Get more before you run out.

– Use condoms if you need protection from STIs or HIV/AIDS.

Pill

Minipill

• Safe

• Most effective when used while breastfeeding

• Start at 6 weeks during breastfeeding—up to 6 month.

• Best to switch to Combined pills (COCs) after 6 month

Week 1

Week 2

Week 3

Week 4

Minipill

What it is

– A pill with a hormone in it that you take every day.

– Blocks sperm from reaching the egg.

How to use

– If breastfeeding, can start 6 weeks after childbirth.

– Take one pill at the same time every day.

– When you finish a pack of pills, start a new pack the next day.

Late taking pill, for women who are breastfeeding:

– Take a pill as soon as you remember, and continue taking pills.

Late taking pill, for women who are not breastfeeding:

– If you take a pill more than three hours late, use condoms for the next 2 days and keep

taking pills.

What to expect, if not breastfeeding

– Changes in monthly bleeding including irregular bleeding, spotting, heavier bleeding or

no monthly bleeding, are common and safe.

– Fewer ectopic pregnancies with COCs than POPs (can be life-threatening)

Key points

– Take a pill at the same time every day, if not breastfeeding.

– Be sure you have enough pills. Get more before you run out.

– Consider what method to use when you stop breastfeeding.

– Use condoms if you need protection from STIs or HIV/AIDS.

Minipill

2. Mini-pills

Emergency contraceptive pills

•Prevent pregnancy

after unprotected

sex

•Work best when

taken as soon as

possible, up to 5

days after

unprotected sex

•Do not cause

abortion

Emergency contraceptive pills

What it is

◦ Pills taken after unprotected sex to prevent pregnancy.

◦ Prevents or delays release of egg.

◦ Does not cause abortion.

How to use

◦ Can take up to 5 days after unprotected sex.

◦ Works best when taken as soon as possible after unprotected sex.

What to expect

◦ Sometimes cause nausea, vomiting, vaginal spotting or bleeding for a few

days.

Key points

◦ Does not prevent pregnancy the next time you have sex. do not protect

against future acts of sexual intercourse.

◦ Regular methods are more effective, consider if there is a method you

would like to use.

◦ Seek treatment if you may have been exposed to STIs or HIV/AIDS.

Get emergency contraceptive pills at __________________.

Emergency

Contraception

3. Emergency contraceptive pills

* hp://www.go.org/les/go-corp/MOA_FINAL_2011_ENG.pdf

4. Injection

Injection

•Safe

•Hormone injection

given every 2 months

or 3 months

•Very effective when

injections are on time

•Use can be kept

private

Injection

What it is

◦ Hormone injection.

◦ Prevents release of egg.

How to use

◦ Get an injection every 2 months (NET-EN) or 3 months (DMPA).

◦ If breastfeeding, can start 6 weeks after childbirth.

◦ Works best if you get your injections on time.

If late for an injection:

◦ DMPA: Can still get an injection up to 4 weeks late.

◦ NET-EN: Can still get an injection up to 2 weeks late.

If later, use condoms and return for an injection as soon as possible.

What to expect

◦ Irregular bleeding at first, then spotting or no monthly bleeding. This is common and

safe.

◦ Possible slight weight change.

◦ After stopping injections, it can take several months to become pregnant.

Key points

◦ Does not cause infertility.

◦ Be sure to get next injection on time.

◦ Use condoms if you need protection from STIs or HIV/AIDS.

Injection

* hp://www.go.org/les/go-corp/MOA_FINAL_2011_ENG.pdf

5. Implants

Implants

•Safe to use

•One of the most effective

methods

•Lasts for 3-5 years

•Can be removed any time

if you want to get pregnant

Implants

What it is

◦ Small tubes placed under the skin of arm

◦ Hormone (similar to one naturally found in the woman’s body) in

the tubes blocks sperm from reaching egg

How to use

◦ Inserted and removed by specially trained provider

◦ Nothing to remember to do

What to expect

◦ Irregular bleeding at first, then spotting or no monthly bleeding –

these changes are normal and safe

Key points

◦ Need to use another method while waiting for appointment

◦ Does not protect against STIs or HIV/AIDS

Where to go: ______________________________

Implants

IUD

•Safe to use

•One of the most effective

methods

•Can be used for up to 12 years

•Can be removed any time if you

want to get pregnant

IUD

What it is

– Small, flexible, plastic "T" wrapped in copper wire that is placed in the

womb.

– Primarily, prevents sperm from meeting the egg.

How to use

– Specially trained provider inserts and removes IUD.

– Can be put in right after you have a baby as well as at other times.

– Nothing to remember to do after insertion.

What to expect

– Some cramping and heavier bleeding during monthly bleeding in the first

few months of use.

Key points

– Use another method if waiting for appointment.

– Use condoms if you need protection from STIs or HIV/AIDS.

Where to go: ________________

IUD

6. Intra-uterine device (IUD)

7. Standard Days Method

with CycleBeads

• Helps you know what days

during the month you could

get pregnant.

• To prevent pregnancy, don’t

have sex or use condoms on

white bead days

• Works well for women with

regular monthly bleeding

Standard Days Method

with Cycle Beads

• Move ring to RED bead

when period starts

• Move ring to next bead

every day. Move ring even

on bleeding days

• Use condoms or abstain

when ring is on WHITE

beads

• BROWN beads are safe

days of no pregnancy

• When period starts again

move ring to red bead to

begin again.

• Always check your period

comes between dark

brown bead and last brown

bead

What it is

How to use

Standard Days Method with CycleBeads

What it is

 Helps women track their cycle to know when they are most fertile

 Prevents sperm from meeting egg by avoiding unprotected sex on fertile days.

How to use

 Using CycleBeads, move a ring daily to know if on fertile or infertile day

 Use condoms or not have sex on 12 fertile days marked by white beads

 Monitor period comes monthly between darker brown bead and last brown bead

When to start using CycleBeads

 Women who know when their last period started can use the SDM right away.

 Women who do not know can begin the SDM when their next period starts.

 Postpartum or breastfeeding women should wait until their periods are regular again.

What to expect

 No side effects. It is natural.

 Woman and partner must agree on how to prevent pregnancy on 12 fertile days

 If monthly bleeding becomes less regular may need to choose another method.

Key points

 Move the ring daily even on days you are having your monthly bleeding

 If you forget whether you moved the ring, check your calendar for date your period started ,

count how many days have passed and place ring on the bead for today.

 Agree with partner in advance about using condoms or abstinence on fertile days.

 Use condoms if you need protection from STIs or HIV/AIDS.

8. Withdrawal method

•No supplies

•No side-effects

•Can be used at any time

•Not as effective as other methods

Withdrawal

What it is

– The man withdraws his penis from his partner's vagina and ejaculates outside

the vagina.

– Works by keeping sperm out of the woman's body.

How to use

– When the man feels he is close to ejaculation he withdraws his penis from the

woman's vagina.

What to expect

– Learning to do this correctly can take time.

– May not be good for men who ejaculate quickly.

Key points

– Other methods provide greater protection from pregnancy for most people.

– Emergency contraceptive pills can be used if ejaculation occurs before

withdrawal.

– Use condoms if you need protection from STIs or HIV/AIDS.

Withdrawal

Male Condom

• Prevents pregnancy and sexually

transmitted infections including

HIV/AIDS

• Effective when used correctly every

time you have sex

• Easy to get and use

9. Male condom

How to use a male condom

Use a new

condom for

each sex act

Before any

contact, place

condom on

tip of erect

penis

with rolled

side out

Unroll condom

all the way

to base of

penis

After

ejaculation,

hold rim of

condom in

place, and

withdraw penis

while it is still

hard

Use only once

Throw away

used condom

safely



 





Female Condom

• A plastic covering that is inserted

into the vagina before sex

• Prevents both pregnancy and

sexually transmitted infections

including HIV/AIDS

• Effective when used every time

you have sex

• Side effects are rare

• Partners must agree to use

• Can be used with other family

planning methods

How to use a female condom

• Open package

carefully .

• Make sure the

condom is well-

lubricated inside.

• Choose a comfortable

position.

•To remove twist outer

ring and pull gently.

•Insert new female

condom into vagina

every time you have sex

•Throw away condom

safely.

•Gently insert inner ring into

the vagina.

•Place index finger inside

condom, and push inner

ring up as far as it will go.

•Make sure outer ring is

outside the vagina and the

condom is not twisted.

•Be sure the penis enters

inside the condom and

stays inside it during

intercourse.

•Squeeze the inner

ring, at the closed

end.

Inner

ring

Open

end











Inner

ring

Outer

ring

10. Female condom

Condoms – for men and women

What they are

― Thin rubber sacks. A man’s condom fits over his erect penis. A woman’s

condom fits inside her vagina.

― Condoms prevent a man’s sperm from meeting the woman’s egg.

― Condoms also protect the man and the woman from STIs or HIV/AIDS.

How to use

― Use a new condom every time you have sex.

― Dispose of properly in a latrine, or bury it.

What to expect

― No side effects.

Key points

Can be used with other family planning methods.

Must be used correctly every time

you have sex.

Be careful not to tear condom when opening package or putting on.

Both partners must agree to using condoms.

If condom breaks or is forgotten, woman can use emergency contraceptive pills.

Condoms

are the only contraceptive

that also help protect

against HIV/AIDS.

Condoms protect the

woman and the man.

11. Lactional Amenorrhea Method (LAM)

Lactational Amenorrhea Method (LAM)

(For breastfeeding mothers)

•Safe with no side-effects

•Effective if:

- you are breastfeeding often, day and

night, and giving no other food or liquids

- your baby is less than 6 months old, and

- your monthly bleeding has not returned

Lactational Amenorrhea Method (LAM)

(For breastfeeding mothers)

What it is

– Breastfeeding in a way that prevents pregnancy.

– Prevents release of egg.

– Does not protect against STIs or HIV/AIDS – for protection against STIs or

HIV/AIDS, use condoms.

How to use:

– LAM requires three conditions that must be met:

1. You are exclusively breastfeeding (no other food or liquids).

2. Your menstrual periods have not returned.

3. Your infant is less than 6 months old

What to expect

– No monthly bleeding.

– No side effects.

Misconceptions

- Breastfeeding alone will not protect from pregnancy; have to meet all three

criteria.

LAM

Female Sterilization

• Safe and

permanent method

– for women or

couples who will

not want more

children

• One of the most

effective methods

• Simple operation

Female Sterilization

What it is

– Specially trained provider makes one or two small cuts to reach the tubes that

carry eggs to the womb.

– Cuts or blocks the tubes. The womb is not removed.

– Can be done right after you have a baby as well as other times.

What to expect

– After procedure, nothing to remember and no side effects.

– Do not need to be put to sleep during procedure.

– Usually you can go home a few hours after procedure.

– May have soreness for a few days after procedure.

– Monthly bleeding will continue as usual for you.

Key points

– Permanent method.

– Use condoms if you need protection from STIs or HIV/AIDS.

Where to go: ________________

Female

Sterilization

12. Female sterilization

Vasectomy

• Safe and permanent method

– for men or couples who will

not want more children

• One of the most effective

methods

• Simple operation

• After operation must use

back-up method for first 3

months

Tubes cut

here

Vasectomy

What it is

– Specially trained provider makes two small cuts to reach the tubes that carry

sperm.

– Cuts tubes. Testicles are not removed.

– Works by keeping sperm out of semen.

How to use

– 3-month delay in taking effect. Couple must use another method until then.

– After 3 months, nothing to remember.

What to expect

– Do not need to be put to sleep during procedure.

– Usually you can go home a few hours after procedure.

– May have bruising and soreness for a few days after procedure.

Key points

– Does not decrease sex drive, erection or ejaculation.

– Permanent method.

– Use condoms if you need protection from STIs or HIV/AIDS.

Where to go: ________________

Vasectomy

13. Male sterilization (vasectomy)

Blank Page

Annexes

A Emails from Malawi: A couple’s love ....................................50

B How Does Family Planning Prevent Abortions and What

Can Christians Do? .................................................................53

C Resources ....................................................................................57

Annex A

E-mails from Malawi: A couple’s love

A young couples group of Christians in Malawi meets weekly for Bible

study. Aer one meeting, an interesting email exchange occurred among

the group members.

W wrote rst: “We had a very fruitful meeting last Friday discussing

I Samuel 1: 1-8, and I think it will assist in shaping the group and

individual and couple life. What we learned :

• Asyoungcouplesourmandateistopromoteourmarriage-thetwo

of us - the love that we had despite the nancial gains, children or any

other things that God has blessed us with.....is should be evident in

the way we talk, behave, present ourselves to our fellow members and

the community at large.

• Wealsohavetoknowhowtonurturetherelationshipinmarriage

and also with our friends.

• Neveratanytimetrytooendothers,knowinglyorunknowingly......

• Inamarriage,knowthatthehusbandorthewifeistheonethat

counts more to the spouse....Kids and other possessions come second.

• Despitetheculturalsetupofourcommunities,weshouldbe

promoting oneness in the marriages, despite their nancial status,

and whether we have kids or not.

• Great Lesson is: A couple’s love is not dependent on their

possessions or having children. In our Young Couples Ministry,

we should be promoting LOVE to our colleagues, as we may not

know exactly what they are going through.

¿ ¿ ¿

en E sent a message: It was indeed a nice discussion. We focused on

Hannah who didn’t have a child, and her co-wife Peninnah who mocked

her a lot. But to Hannah, her husband mattered most.

Another lesson was that, in our dierent circles, we might have people

who are barren or are failing to have children because of dierent

reasons. Especially in our culture where we all value children, let us

support such friends in a positive way. Sometimes people do not come

out in the open to say why they don’t have kids. Let us watch what we

say to such people; sometimes our jokes might oend them. So let us

mainly put the focus on our oneness as a couple and not as a family.

We even went further to discuss the problems that people face when

they have children of one sex only. We heard dierent experiences.

¿ ¿ ¿

P wrote next: Yes, we agreed that it is the responsibility of the couple

themselves to support each other, if they do not have children. Most

oen we see that one member of the couple tries to “prove” that he or

she is not “the problem”.

We see relatives and friends asking the new couple, “It’s been six months

since you wed. What’s happening?” We as young couples should not

be putting these pressures on our friends. Also we noted another way

of exerting pressure is by “talking proudly about our kids”. is also

causes problems and as a result breaks marriages.

It’s interesting what even one of the church leaders commented to me

aer we were married for about 7 months. My wife was expecting,

and he said to me, “at’s a man!” Now I am wondering what his

comment would have been if she had not been pregnant! All along I

never thought about this, but it just occurred to me during our Bible

discussion about Hannah. It’s a cultural thing, and there is a big

problem out there.

¿ ¿ ¿

Z then wrote: We couldn’t be at Friday meeting, and we knew we had

missed a lot. anks, W, for the glimpse of what you discussed.

My question is this: At ociations, bridal showers, send os, and

marriage seminars, the fact is always made clear that love should not be

dependent on possessions or children. But why do the challenges easily

and secretly creep in and take us by surprise? Why does it seem like an

ambush to many couples? What are the safeguards and check points

which can keep us on our toes, always on watch for these long-range

laser-guided missiles? Shalom.

¿ ¿ ¿

Finally, W reminded the group: e aims of our Young Couples Ministry

are

1. To strengthen love life in our families

2. To strengthen our family spiritual lives

3. To be role models unto those that look forward to getting married

4. To help ministering in other areas of the church

Annex B

How Does Family Planning Prevent Abortions

and What Can Christians Do?

Sections from Christian Connections for International Health documents

1. How do the family planning methods work ?

Family planning methods can work in 5 primary ways:

1) block the man’s sperm from reaching the woman’s egg;

2) change the sperm so they cannot fertilize the egg;

3) prevent the woman’s eggs from being released;

4) thicken mucus in the woman’s cervix, preventing sperm from passing

through; and

5) alter the lining of the uterus (womb) so the fertilized egg does not

attach or implant.

ere is no universally accepted denition of precisely what constitutes

abortion; however, according to most legal, regulatory and medical

authorities “abortion” is the termination of an established pregnancy

aer implantation of a fertilized egg in the uterus (womb). Implantation

occurs at 5-7 days aer ovulation (release of the egg) and fertilization

(which typically occurs within the rst 12 hours aer ovulation).

Actions before implantation that prevent pregnancy are “contraceptive”.

Some faith communities and some individuals consider any action that

prevents implantation of a fertilized egg to be a very early abortion.

For some in these communities, if a contraceptive method’s primary

mechanism of action is to prevent fertilization, it is acceptable. For

others, any possibility of a post-fertilization eect that would prevent

implantation is problematic.

All the family planning methods mentioned in this booklet work

primarily or exclusively by preventing fertilization of a woman’s egg

(before conception).*

* World Health Organization Department of Reproductive Health and Research (WHO/

RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication

Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook

for Providers (2011 update). Baltimore and Geneva: CCP and WHO, 2011. http://www.

fphandbook.org/

Decisions regarding family planning methods are based on several

factors -- the mechanisms of action, eectiveness of the method, safety,

convenience, the family situation, and religious perspectives. CCIH

respects the dierent approaches by faith communities to enable couples

to voluntarily achieve their desired number and timing of pregnancies,

consistent with the communities’ religious teachings and values. We

urge all faith-based groups and secular organizations to do the same.

e need for family planning methods is greatest in the poorest

countries, where current lack of family planning results in many women

seeking unsafe abortions. Family planning is a powerful way to prevent

abortion. Reducing unintended pregnancies and the need for abortion

produces health benets that are strongly embraced by both Christian

and secular health organizations. A maternal death from any cause is a

tragedy—but when a woman dies from a pregnancy she did not want, it

is a double tragedy.

As Christians we have an obligation to weigh all the health

consequences for those we serve when deciding to recommend, provide

or omit any family planning method, since all the methods do reduce

untended pregnancies and abortions. CCIH welcomes others to join

us in faithfully and respectfully discussing issues of reproduction, in

light of our common desire to advance health and wholeness from a

Christian perspective.

For more details about each family planning method, see the full

CCIH publication “Family planning methods: How do they work

and why does it matter?”

www.ccih.org/FP-Methods-how-do-they-work-why-does-it-matter.

pdf

¿ ¿ ¿

2. How do family planning methods prevent abortions?

Every year 210,000,000 women in the world get pregnant

80,000,000 of those did not want to be pregnant

42,000,000 pregnant women end their pregnancies by

induced abortion (one h of all pregnancies)

20,000,000 of the induced abortions (nearly half) are unsafe

– performed by people lacking the necessary skills, or where

minimal medical standards are lacking

67,000 women die because of unsafe abortions – and millions

more suer complications & long-term injuries

ese abortions and deaths occur primarily because eective and safe

family planning methods are not available. If all these women could get

eective family planning, up to 90% of those unintended pregnancies

and abortions could be prevented. Good family planning programs

could potentially prevent 72 million unintended pregnancies and 38

million abortions every year.

¿ ¿ ¿

3. What can Christians do about abortions?

Know and understand the facts

• Familyplanningpreventsunintendedpregnancy&abortion.

Help to make abortions unnecessary

• Provideeducationtoadultsandyoungpeopleaboutsexuality,

pregnancy, abortion, & family planning– based on good science &

good scripture study.

• Informpeopleaboutfamilyplanningandmakesurefamilyplanning

methods, in accordance with faith beliefs, are available in faith-based

health services.

“Preventing abortions is the most compelling reason for

family planning. It really is time for us Christians to speak

out strongly!”

-NancyHarris,Vice-President,JohnSnowInternational

Help women who have just had abortions

• Everywomanwhohasjusthadaspontaneousabortion(miscarriage)

or an induced abortion should get complete counseling and care,

including voluntary family planning.

“If the woman we treat for post abortion complications is

there because she could not get contraception, we have failed

her. If she leaves without family planning, we have failed her

twice.”

-Internationalconsensusstatementofdoctors,midwivesandnurses

From “Family planning reduces abortions – and faith based groups can

help”. Full text available at: http://www.ccih.org/FP%20Reduces%20

Abortion%2012_13_2011.pdf

Annex C

Resources

A. Methods of Bible study

• DoingContextualBibleStudy:AManual. Pietermaritzburg:

Ujamaa Center, 2011.

http://ujamaa.ukzn.ac.za/Libraries/manuals/Ujamaa_CBS_

Manual_part_1_2.sb.ashx

See examples at: http://ujamaa.ukzn.ac.za

• CalltoMe:HowtheBiblespeaksintheageofAIDS.Oxford:

Strategies for Hope Trust, 2010.

http://stratshope.org/b-cc-07-me.htm

• Biblestudiesforfamilyplanning. Christian Connections for

International Health, 2007.

http://www.ccih.org/Bible-studies-help-revitalize-family-

planning-case-study.pdf

B. Other Bible studies on family planning

• ChristiansandMuslimsPromotingMaternalandInfantHealth:A

SermonGuideBasedontheHolyBibleandtheHolyQur’an. IMA

World Health, Rwanda Faith-Based Organizations Network Against

HIV, and USAID, 2009.

Chapter 3 is titled “Family Planning”

English:

https://www.imaworldhealth.org/images/stories/technical-

publications/Rwanda_Christian_Sermon_Guide_-_English.pdf

Kinyarwanda:

https://www.imaworldhealth.org/images/stories/technical-

publications/Rwanda_Christian_Sermon_Guide_-_Kinyarwanda.

pdf

• BiblicalreectionsonacalltoactionforRH/FP,2006. Presentation

by Dr. Gloria Ekpo, http://www.ccih.org/presentations/2006/

Biblical_%20Reections_%20RH-FP_Ekpo_CCIH2006.ppt

• Befruitfulandmultiply:Biblestudiesonresponsibleparenthood.

Chogoria, Kenya, 1999. http://www.ccih.org/doclibrary/bible_

studies_on_fam_plan-eng-be_fruitful.doc

AvailablealsoinFrench: Soyezféconds:Etudesbibliquesausujet

delaparentéresponsable. Kinshasa, DRC, 1997. http://www.ccih.

org/doclibrary/bible_studies_on_fam_plan-fr-soyez_feconds.doc

C. Family planning methods and activities

• FamilyPlanningMethods:Howdotheyworkandwhydoesit

matter? 2010. Christian Connections for International Health with

support from Georgetown University Institute for Reproductive

Health. e decision about which family planning methods are

acceptable varies widely among Christian organizations and

individuals, and is inuenced for some by the whether the method

acts to prevent conception or is thought to act as an abortifacient

(capable of causing an abortion). is paper explains and claries

what is currently known with respect to the specic methods.

http://www.ccih.org/Family-Planning-Methods-CCIH-

November2010.pdf

• FamilyPlanning:AGlobalHandbookforProviders. 2011.

World Health Organization, Johns Hopkins Bloomberg School

of Public Health and USAID. An essential resource for health-

care professionals. Experts from around the world contributed to

the development of the handbook, and many major international

organizations and professional organizations have endorsed and

adopted it. Free download available in 8 languages:

http://www.who.int/reproductivehealth/publications/family_

planning/9780978856304/en/index.html

• ResourcesonNaturalFamilyPlanningfromtheInstitutefor

ReproductiveHealthatGeorgetownUniversity(IRH). Evidence-

based materials and publications for program managers, healthcare

providers, technical experts, researchers and policy makers on

fertility awareness-based methods (FAM) of family planning. A

wide range of materials, including FAM integration tools, training

curricula, provider job aids, client brochures, advocacy briefs,

scientic journal articles and instructional videos.

 StandardDaysMethod(SDM):

Overview: http://www.irh.org/?q=content/standard-days-

method-sdm

Resources: http://www.irh.org/?q=content/standard-days-

method-sdm-resources

 TwoDayMethod(TDM):

Overview: http://www.irh.org/?q=content/twoday-method

Resources: http://www.irh.org/?q=tdm_resources

 LactationalAmenorrheaMethod(LAM):

Overview: http://www.irh.org/?q=content/lactational-

amenorrhea-method

Resources: http://www.irh.org/?q=content/lactational-

amenorrhea-method-resources

• FamilyPlanning:AKeyComponentofPostAbortionCare. 2009.

is consensus applies to 10 million health professionals in 113

countries. It establishes the need and importance of a standard of

practice to provide access to family planning for women following

abortion, either induced or spontaneous (miscarriage). It recognizes

that post abortion family planning services can contribute to a

reduction in subsequent induced abortions, as well as improving

child health outcomes among women who want to be pregnant again

aer a miscarriage.

http://www.usaid.gov/our_work/global_health/pop/techareas/

pac/fp_component.pdf

• FamilyPlanningSavesLives. 4th ed. 2009. Population Reference

Bureau. Well-documented evidence for reduced abortions with

increased contraceptive use; reduced child mortality with longer

birth intervals; the unmet need for family planning; and the benets

of integrating family planning and HIV/AIDS services.

www.prb.org/pdf09/familyplanningsaveslives.pdf

D. Family planning programs of faith-based groups

• FamilyPlanning:AnotherwayfaithgroupscanhelppreventHIV

infections. Christian Connections for International Health

Family planning helps prevent HIV infection in men and women.

What can faith groups do to help? is fact-sheet provides faith-

based information to program managers and decision makers

on how family planning programs can be integrated into existing

HIV/AIDS activities. Faith-based advice for couples and churches

on adding family planning activities into HIV programs is also

provided.

http://www.ccih.org/FP_reduces_HIV_May_2011.pdf

• FamilyPlanningReducesAbortion–andfaith-basedgroupscan

help.Christian Connections for International Health

Many Christians around the world are concerned about abortion.

But the facts linking the availability of family planning with a

reduction in abortions are little understood. is CCIH publication

provides information on the connections between family planning

and abortion, and what the faith community can do to mitigate

abortions worldwide.

http://www.ccih.org/FP_Reduces_Abortion_April_2011.pdf

• AdvancingReproductiveHealthandFamilyPlanningthrough

ReligiousLeadersandFaith-BasedOrganizations. By Mary K.

Burket, Pathnder International, 2006.

http://www.pathnd.org/site/DocServer/FBO_nal_reference.

pdf?docID=6901

• CultureMatters:WorkingwithCommunitiesandFaith-based

Organizations.UNFPA, 2004.

http://www.unfpa.org/webdav/site/global/shared/documents/

publications/2004/CultureMatters_2004.pdf

E. Bible studies on other health topics

• ChristianSermonGuidetoSavetheLivesofMothersand

Newborns:AToolkitforReligiousLeaders.IMA World Health &

USAID, 2009. 58 pages.

English:

http://www.imaworldhealth.org/images/stories/technical-

publications/Christian_Sermon_Guide.pdf

French:

https://www.imaworldhealth.org/images/stories/technical-

publications/christian_sermon_guide_-_french.pdf