Chapter 17: Family planning
Sex without intercourse
There are many ways to have sex that do not cause pregnancy. Oral sex (mouth on
genitals) and sexual touch (touching the genitals or other parts of the body) are
both sexual activities that many couples enjoy. They have very low risk of passing
HIV and other STIs and they cannot cause pregnancy. Anal sex also cannot cause
pregnancy, although HIV and other STIs can pass very easily this way.
Avoiding all sexual intercourse is the most sure way to
prevent pregnancy and can be a good way to reduce the
risk of HIV and other STIs. Not having sexual intercourse
may be very difficult for couples to practice for a long time.
In the first 6 months after birth, most women who breastfeed do not
release eggs from their ovaries (see page 29), and so they
cannot get pregnant when they have sex.
Women usually do not get pregnant if they are
breastfeeding as often as the baby wants, including at night,
1. the baby is less than 6 months old, and
2. the woman has not had any monthly bleeding since
giving birth, and
3. the woman is giving the baby only breast milk.
The woman can easily get pregnant if she is giving the baby formula, water, or
other drinks. She may get pregnant if
the baby goes longer than 6 hours between breastfeeding times.
The breastfeeding method does not protect against HIV or other STIs. Also,
getting infected with HIV while breastfeeding creates a danger of passing HIV to
the baby. If there is any chance that the mother’s partner has HIV, they should use
condoms each time they have sex.
Fertility awareness (natural family planning)
A woman can only get pregnant during her fertile time when an egg comes from
her ovary into her tubes and womb — about once a month (see page 29). To use
fertility awareness, a woman must watch her body’s signs to understand when she
is fertile. During the fertile time she and her partner must not have sexual
intercourse (the penis inside the vagina). At these times, they can try other types of
sex like oral sex or sexual touching. Or they can prevent pregnancy by using
condoms or a diaphragm during the fertile time.
A Book for Midwives (2010)