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Letters to the Editor

Indian Pediatrics 1999; 36:414-415

Pediatrician as Family Planning Counsellor

The population explosion in our country has reached such a national emergency situation that family planning and family welfare cannot remain the concern of only certain departments in the Government or of certain specialties but be the concern and responsibility of all right thinking citizens.

When parents come with their newborn infants to the pediatrician they are eager to know and learn and trust the pediatrician above all others in caring for their children. Their attitude at this period is most appropriate for the pediatrician to intervene and provide information and guidance for. taking appropriate family planning measures as per their needs. The pediatrician can act as a good family planning counsellor at this stage.

A study conducted in our Hospital to ascertain the family profile of the maternity clients attending the hospital and a KAP study of the husbands of these women on family planning methods highlighted certain features. It was found that even among the service class who are economically and educationally better than the general population a significant number (313 out of 1308; 24%) opted for three 'or more children. The KAP study on men (n=156) showed that their effective knowledge and hence use of contraceptives was quite low. However, it was interesting to note that a large percentage (92.9%) desired to use some method of family planning after the delivery and an equally large number (98%) desired only two children. These studies gave us an insight into the need felt by even educated and employed persons of the society for correct and complete information and guidance to make appropriate choice regarding family planning methods.

A Health Education program on Newborn Care and Family Planning has been initiated in the Hospital by the pediatricians since January 1998 to indoor antenatal and delivered mothers and their husbands. The methodology adopted is by participatory Focal Group discussions involving 20-25 participants. The doctors adopt a non judgemental attitude rather than censorship. This is followed up by interpersonal counseling on family planning methods to the parents when they bring their newborn at 6 weeks age for followup. The experience of the authors has been very encouraging. The parents feel at ease to discuss their family planning needs and seem to be more receptive to the advice given on FP methods. Infact these mothers hardly visit the obstetrician in the postpartum period for various reasons like lack of awareness for selfcare, preference for care of newborn over their own and unwillingness to visit both postnatal and post- partum OPD at onetime. Hence their contact with obstetrician gets limited after the delivery of the baby and becomes a continuous one with the pediatrician. This is an opportunity for the pediatrician to act as a family planning counsellor in addition to being a physician to the child.

All the participants in our counselling program have been unanimous in expressing their appreciation of providing an opportunity to clarify their doubts and fears regarding family planning methods with doctors. The counsellors have realized that there is a high unmet need for dissemination of knowledge on family planning methods and people would accept the same from a proper source with greater credibility. Our experience in the past 9 months has strengthened these beliefs.

M.S. Jayalakshmi,
P.K. Prabhakar,
Kiran Ambwani,
C.G.H.S. Maternity and
Gynecology Hospital,
R.K. Puram,
New Delhi 110 022, India.



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