Reproductive Life Planning (RLP)

A reproductive life plan is a set of goals that men and women make about childbearing. It takes into account the who, what, when, where, why and even “if” of family planning. Everyone should have a reproductive life plan, regardless of whether or not they want to have children. A reproductive life plan is not set in stone; rather it is a fluid document that allows for individual responsibility across the life span.

In fact, reproductive life planning is so important that the Centers for Disease Control and Prevention (CDC) has named it its number one recommendation for improving preconception health. In North Carolina, the need to educate people about reproductive life planning is especially important because 43.8 percent of pregnancies are unintended.1
Unintended pregnancies are a concern because they often result in:
  • Increased chances of infant morbidity and mortality including preterm birth, low birth weight, and birth defects
  • Increased abortion rate
  • Increased child abuse and neglect
  • Increased Medicaid costs
  • Increased risk of physical abuse for mothers
  • Poorer health status for women
Furthermore, lack of pregnancy planning and pregnancy spacing, poor management of health conditions affecting pregnancy outcomes, negative health behaviors affecting pregnancy outcomes, and environmental risk factors lead to:
  • Increased risk for preterm births
  • Increased risk for low birth weight births
  • Increased rates of birth defects
  • Poorer health status for women
  • Increased health disparities
To date there are no published studies demonstrating effective reproductive life planning techniques in the clinical setting. There is much work to be done in this area. But that doesn’t mean you can’t talk to your patients now. Here are a few tips to bring reproductive life planning into your practice:
  • Start with no assumptions about your patient.
  • Allow the patient to find his/her own voice.
  • Empower the patient to move from chance to choice.
  • Tailor your interactions to fit each patient’s unique set of circumstances.2
Here are a few basic questions to ask individuals about their plans to have children:
  • When?
  • How many?
  • How often?
Also ask them how they can implement their plan and maintain their health now, their health during pregnancy and their baby’s health in the future.
Considerations to discuss with patients:
  • Relationship with partner
  • Readiness to become a parent
  • Current health status
  • Hereditary risk factors
  • Health behaviors
  • Age
  • Educational goals
  • Career plans
  • Living situation
  • Financial situation
  • Social support

Reproductive Life Planning Resources

In order to help you counsel patients on reproductive life planning, the Women’s Health Branch at the NC Department of Public Health has created an interactive booklet “Are you ready?: Sex and your future.” The evidence-based booklet was focus-tested in North Carolina and is currently available here.
You may also refer patients to the consumer-focused reproductive life planning section of our website. The pages can be printed and used as consumer handouts.
Additional downloadable reproductive life planning tools:
Other helpful sites:
A provider training on reproductive life planning is also available from the NC Department of Public Health. Click here to download the slides.
Sources:
PRAMS, North Carolina Mothers Who Report Unintended Pregnancies, 2006-2008. PRAMS is an ongoing, population-based, randomized survey of North Carolina resident women who have recently given birth. Information is collected on pregnancy risk factors, access to health care services and other issues related to improving the health of both the mother and the baby. It is conducted by the NC Center for Health Statistics.
Merry-K. Moos, Reproductive Life Plans, National Healthy Start Interconception Care Learning Collaborative webinar, Feb 25, 2010. Available at www.beforeandbeyond.org.