BOOK REVIEW

Abstract

Glasier Anna and Gebbie Ailsa, editors: Handbook of Family Planning and Reproductive Healthcare, 5th edition, 448 pages. Churchill Livingstone, N 2007. ISBN 9780443068874. Price €44.99/GBP 24.99. In his foreword, John Guillebaud stresses the importance of the subject of this book by quoting James Grant of UNICEF, who in 1992 declared that “family planning could bring more benefits to more people at less cost than any other single technology now available to the human race”. More than half a million women die each year from unsafe abortion, pregnancy and childbirth. Furthermore, there are now more young people on the Earth than ever before, and unless they get knowledge about and access to safe and effective contraception, the global population will continue to grow with escalating demands on energy, food and water supply and most likely further stress on the environment. The first chapter of the book describes different fertility control strategies and emphasizes how women's needs vary over the course of their lives and with the culture they live in. There is also an interesting part on the subject of measuring effectiveness, pointing out the great difference between effectiveness with perfect use and with typical use – abstinence, for instance, is only 75% effective with typical use! The problems with using Pearl index as a measure of effectiveness are described, as well as safety, costs and user considerations. In chapters 3 – 16, all different contraceptive methods known to this reviewer are described with regard to mode of action, effectiveness, side effects, non-contraceptive benefits and user adherence. There are practical guidelines for insertion and removal of IUDs, IUSs and implants and for management of side effects such as breakthrough bleeding. The UK medical eligibility criteria for each contraceptive method are stated on a 4-category scale, from no restriction to unacceptable health risk if the method is used. This is clearly shown in tables for each method described and will be in line with required standards in most countries, although cultural differences may influence the guidelines. There are separate chapters on fertility awareness and postpartum contraception, emergency contraception, abortion and sterilization. The chapter on sexual health services for young people emphasizes the impact of socio-economic factors, sexually transmitted infections, unsafe abortion and sexual abuse, and on the culturally determined gender inequalities which can make it impossible for women to control their sexual activity. The last seven chapters deal with as different subjects as screening, menopause, genital infections, premenstrual syndrome, sexuality and contraception of the future. I find it difficult to identify the target group for this part of the book. The chapter on screening describes the guidelines in the UK, but will be of limited interest in other countries. The other subjects are generally dealt with on a level that is too low to be of interest for specialists. To non-specialists, the chapters may be of help when a quick overview is wanted, but many large and complicated areas are getting such a cursory treatment that it could be more confusing than informative. This is for instance the case for endometriosis, which is covered by one page of text. The probably limited usefulness of the last chapters does not change the fact that this handbook is an extremely thorough and practical guide to family planning. It is also up to date, well written, systematic and easy to find one's way around in. It is highly recommended for these qualities and will be of use both to medical students and health professionals.