Family planning may encompass sterilization, as well as pregnancy termination. It also includes raising a child with methods that require significant amount of resources namely: time, social, financial and environmental. Family planning measures are designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family has access to limited resources. The first attempt to offer family planning services began with private groups and often aroused strong opposition. Activists, such as Margaret Sanger in the U.S., Marie Stopes in England and Dhanvanthis Rama Rou in India, eventually succeeded in establishing clinics for family planning and health care. Today, many countries have established national policies and encouraged the use of public family services (The United Nations and World Health Organisation offer technical assistance, 2006).
The concept of informed choice in family planning can be applied to a wide range of sexual and reproductive health decisions. It focuses on whether to seek, to avoid pregnancy, whether to space and time one’s childbearing, whether to use contraception, what family methods to be used, and whether or when to continue or switch methods. The term family planning choice could also refer to the family decision making (Diaz et al., 1999).
The principles of informed attitude of women of childbearing age focus on the individual; however, it also influences a range of outside factors such as: social-economic,cultural norms, gender roles, social networks, religious and local beliefs. To a large extent, these community norms determine individual childbearing preferences and sexual and reproductive behaviour. It is usually thought that community and culture affect a person’s attitudes towards family planning, desire for sex of children, preferences about family size, family pressures to have children and whether or not family planning accords with customs and religious beliefs.
Community norms also reflect how much autonomy individuals have in making family planning decisions. The larger the differences in reproductive intentions within a community, the more likely that community norms support individual choices (Barnett and Stein, 2001). Household and community influences can be so powerful that they can obscure the line between individual desires and community norms. For instance, in some culture, many women reject contraception because bearing and raising children is the path to respect and dignity in the society (International Planned Parenthood(Cherkaoui, 2000). In either country, most women use contraception because having small families is the norm (Mkangi, 2001; Lutz, 2003).
People are often unaware that such norms influence their choices. In other cases, they are particularly aware. For example, young people often decide not to seek family planning because they do not want their parents or other adults to know that they are sexually active, while many fear ridicule, disapproval and hostile attitude from service providers and others (Jejebhoy, 2004).
A person’s social environment usually has more influence on family planning decisions that influence the attributes of specific contraceptives. In Kenya, for example, when new clients were asked to give a single reason for their choice of a specific family planning method, most cited the attitudes of their spouse or their peers, or their religious value (Kim et al., 1998). In many countries, family planning programmes are part of the national economic and social development efforts. Efforts to foster equity in decision making and raise awareness about reproductive right of the family, community and society also promote informed choice of family planning (Jaconson, 2000). As a woman gain more autonomy, they are better able to claim their rights as individuals including the right to act and protect their own reproductive health. People chose contraceptive methods that are commonly used in their community because they know that it is socially acceptable to do so, and they tend to know more about these methods (Rogers and Kincaid, 2004).
Many women use the same family planning methods that others in their social network use (Godley, 2001). A 1998 study in urban Nigeria found that the more widely used method was the one that was popular in other cities and villages. The entire community may be encouraged to one type of contraceptive based on the choices of early contraceptive users, rather than individual needs (Potter, 1999).