Introduction
This topic covers the physician's role in family planning, the prevention of congenital diseases (primary and secondary), prenatal and postnatal screening, the principles of maternal health care by the GP or gynaecologist, and prevention in the first year of life and the age periods in public health.
Family planning
Family planning refers to factors that may be considered by a couple in a committed relationship, and each individual involved, in deciding if and when to have children. It is a human right to decide if and when to have children.
- Includes consideration of the number of children a couple wishes to have and the age at which the couple chooses to have children.
- Influenced by external factors: marital situation, career considerations, financial position, any disabilities that affect the ability to have children and raise them.
- If sexually active: use of contraception and other techniques to control the timing of reproduction.
- Other techniques commonly used: sexual education prevention; management of STIs; preconception counselling and management; infertility management.
Family planning services are defined as "educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved".
Advantages of family planning
- Prevents pregnancy-related health risks
- Reduces infant mortality
- Prevents HIV/AIDS
- Empowerment and enhanced education
- Reduces teenage pregnancies
- Slows population growth
Best age for childbirth
- The best age is between 20 and 30 years.
- It is not advisable to give birth under the age of 20 because the body is not entirely ready for motherhood; it might increase the risk of disease for the woman.
- Upper age limit: mothers have been exposed to risk factors and habits for longer, which might cause disease that may endanger the pregnancy or be inherited by the child. Overall, the risk of getting a disease increases.
- All women planning pregnancy are advised to take 0.4 mg folic acid daily for 2 months before conception. It reduces the risk of birth defects by up to 70% (development of the spinal cord and brain; forms DNA and ensures proper development of cells). In at-risk pregnancies: 4 mg/day.
Indicators and intervals
- Ideal number of children: the wish of the couple irrespective of their current social-economic state. In Bulgaria usually 3-4.
- Desired number: reflects the opinion of the couple, having in mind no obstacles. Usually 2 or 3.