1. Family Planning Counseling
Optional Session Session III

2. Serving Diverse Groups
Different client’s have different needs
What are some of the special needs of these groups: male vs. female, adolescents vs. adults, postabortion or postpartum women vs. interval.
How would you address each of these client’s needs?
Ask participants to form groups of four groups. Give each group one of the case studies from the handout Case Studies, Serving Diverse Groups.
Ask each group to answer the following questions about their case:
What are some of the special needs of the type of client in your case study?
How would you address each of these client’s needs?
Give the participants 10 minutes, and at the end of that time ask them to join the larger group.
Ask each group to present their responses to the questions. If two or more groups worked on the same case, ask these groups to present their responses consecutively. Record each group’s responses on a flip chart. Discuss each case before moving to the next. Use the participants’ responses to summarize and highlight the particular needs of each of the four types of clients, as represented in the case descriptions (adolescents, men, postabortion and postpartum clients). The next 3 slides will summarize correct responses
During the discussion after each presentation, ask the small group(s) that presented on that case the following additional questions:
Was there anything related to these clients’ situations that felt uncomfortable? What are some strategies or tools for handling these types of situations?
After all groups have presented, ask the larger group:
How do you decide when you might not be in the best position to help a client and therefore refer the client?
If participants are CHWs, remind them that if they ever feel that the needs of the client are beyond what they can provide they should refer them to a clinic or other similar resource. <give name of local clinic, health center or clinical provider>

3. Family Planning Counseling Needs of Adolescents
Young people deserve nonjudgmental and respectful care
Show them that you enjoy working with them
Use terms that suit young people
Try to make sure that a young woman's choices are her own
Speak without expressing judgment
Take time to fully address questions, fears, and misinformation
Young people deserve nonjudgmental and respectful care no matter how young they are. Criticism or unwelcoming attitudes will keep young people away from the care they need. Family planning counseling and services do not encourage young people to have sex. Instead, they help young people protect their health.
To serve the needs of adolescents, you can:
Show young people that you enjoy working with them.
Use terms that suit young people. Avoid such terms as "family planning," which may not make sense to unmarried adolescents.
Try to make sure that a young woman's choices are her own and are not pressured by her partner or her family. In particular, if she is being pressured to have sex, help a young woman think about what she can say and do to resist and reduce that pressure. Practice skills to negotiate condom use.
Speak without expressing judgment (for example, say "You can" rather than "You should"). Do not criticize even if you do not approve of what the young person is saying or doing. Help young clients make decisions that are in their best interest.
Take time to fully address questions, fears, and misinformation about sex, sexually transmitted infections (STIs), and contraceptives. Many young people want reassurance that the changes in their bodies and their feelings are normal.
Young people can safely use any contraceptive method. Young women are often less tolerant of side effects than older women. With counseling, however, they will know what to expect and may be less likely to stop using their methods.

4. You are welcome here any time
How can I help you?
Anything you want to discuss?
For example:
Will parents or partner find out?
Need contraception?
HIV/AIDS worries?
Partner problems?
Pregnancy?
About sex?
About the body?
You are welcome here any time

5. Family Planning Counseling Needs of Men
Coach men and women on how to talk with their partners about family planning and STIs.
Encourage men to make decisions about sexual and reproductive health jointly with their partners.
Encourage women to bring their partners to see clinical providers for joint counseling, decision-making, and care.
Suggest to female clients that they tell their partners about health services for men. Give female clients informational materials to take home, if available.
Correct men’s misperceptions and give them information to inform their decisions and opinions.
For family planning counselors, men are important for two reasons. The first reason is the influence that men have on women. Some men care about their partner's reproductive health and support them. Others stand in their way or make decisions for them. Men's attitudes can determine whether women can practice healthy behaviors. In some situations, such as needing to avoid HIV infection or getting help quickly in a medical emergency, a man's actions can determine whether a woman lives or dies.
Men are also important as clients. Men use major family planning methods—male condoms and vasectomy. Men also have their own sexual and reproductive health needs and concerns—such as concerns about sexually transmitted infections (STIs)—which deserve the attention of health care providers.
Meeting the needs of male clients:
Coach men and women on how to talk with their partners about family planning and STIs.
Encourage men to make decisions about sexual and reproductive health jointly with their partners.
Encourage women to bring their partners to see clinical providers for joint counseling, decision-making, and care.
Suggest to female clients that they tell their partners about health services for men. Give female clients informational materials to take home, if available.
Correct men’s misperceptions and give them information to inform their decisions and opinions. Topics important to men include:
Family planning methods for men and for women, including safety and effectiveness
STIs including HIV/AIDS—how they are and are not transmitted and where to go for testing and treatment
The benefits of waiting until the youngest child is two years old before a woman becomes pregnant again
Male and female sexual and reproductive anatomy and function
Where to learn about safe pregnancy and childbirth

6. Family Planning Counseling Needs of Postpartum Women
Discuss the importance of birth spacing
Explain the rapid return to fertility for women who are not breastfeeding
Discuss return to sexual activity
Explain benefits of LAM and exclusive breastfeeding
Discuss family planning options and when each method can be started
Integrate family planning within maternal, newborn and child health services
Earliest times that a woman can start a family planning method after childbirth
Immediately: Lactational Amennorhea Method or male or female condoms
Wait 6 weeks after childbirth if partially or fully breastfeeding before beginning progestin-only methods such as injectables implants. * Not: This is the current recommendation of WHO. Not all international experts agree and feel that women should be able to start contraception immediately after giving birth.
Combined oral contraceptives can be given:
- immediately if not breastfeeding
  days after childbirth if not breastfeeding
- 6 weeks after childbirth if partially breastfeeding
- 6 months after childbirth if fully breastfeeding
Fertility awareness methods: A woman may start when she has had 3 regular menstrual cycles (for calendar-based methods). This will be later for breastfeeding women than for women who are not breastfeeding.

7. How can I help you? Let’s plan for the future
You can become pregnant soon if you are not breast feeding
Breast feeding will protect you from pregnancy for 6 months if you use it exclusively without giving other food or liquids.
There are many good family planning methods that you can use while you are breastfeeding

8. Family Planning Needs of Postabortion Women
Women who have just been treated for postabortion complications need easy and immediate access to family planning services
A woman who has had postabortion complications needs support.
- Try to understand what she has been through
- Treat her with respect and avoid judgment and criticism
- Ensure privacy and confidentiality
- Ask if she wants someone she trusts to be present during counseling
Explain that fertility returns quickly and discuss family planning options
Women who have just been treated for postabortion complications need easy and immediate access to family planning services. When such services are integrated with postabortion care, are offered immediately postabortion, or are nearby, women are more likely to use contraception when they face the risk of unintended pregnancy.
Counsel with compassion
A woman who has had postabortion complications needs support. A woman who has faced the double risk of pregnancy and unsafe induced abortion especially needs help and support. Good counseling gives support to the woman who has just been treated for postabortion complications.
- Try to understand what she has been through
- Treat her with respect and avoid judgment and criticism
- Ensure privacy and confidentiality
- Ask if she wants someone she trusts to be present during counseling
A woman has important choices to make after receiving postabortion care. To make decisions about her health and fertility, she needs to know:
- Fertility returns quickly—within two weeks after a first-trimester abortion or miscarriage and within four weeks after a second-trimester abortion or miscarriage. Therefore, she needs protection from pregnancy almost immediately.
- She can choose among many different family planning methods that she can start at once. Methods that women should not use immediately after giving birth pose no special risks after treatment for abortion complications.
She can wait before choosing a contraceptive for ongoing use, but she should consider using condoms in the meantime if she has sex. If a woman decides not to use contraceptives at this time, providers can offer information on available methods and where to obtain them. Also, providers can offer condoms, oral contraceptives, or emergency contraceptive pills for women to take home and use later.
To avoid infection, she should not have sex until bleeding stops—about five to seven days.
If she wants to become pregnant again soon, encourage her to wait.
Combined oral contraceptives (the Pill), progestin-only injectables, implants, male condoms, female condoms, and withdrawal can be started immediately in every case.

9. Let’s discuss your needs:
How can I help you? .
Let’s discuss your needs:
You can get pregnant again quickly
I can help you choose and use a method
All family planning methods are safe now if you have no infection

10. Culture/Gender Roles and FP
Explore how cultural beliefs and traditions about roles for men and women affect use of FP
Suggest strategies for:
Empowering women to control their fertility
Changing some of the roles that make women less important or less powerful than men
Instructions for facilitator:
Follow the instructions in the document, Culture, Gender and Family Planning Activity Instructions, to prepare for and conduct this activity. █

11. Spin the Wheel Points 11/30/2018 Instructions for facilitator:
Use the questions and answer key in the document ReviewGame_FP Counseling_Generic.
Give each team one question before continuing to the next team. Display this slide in Slide Show Mode. Spin the wheel (click the mouse) only if the team correctly answers the question.
Keep score on the Team Scores flip chart. hen you have completed the game you will need to end the slide show in order to get to the next slide; if you continue to cl
Points
A Training Resource Package for Family Planning, Counseling—CHW, Presentation, 4/2011