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Reproductive Life Planning Tool
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Reproductive Life Planning Tool
Instructions:
This tool helps you reflect on your current and future reproductive goals and identify any areas where support or counseling may be helpful. Answer the questions below honestly.
Section 1: Current Status
1. Are you currently planning to have children?
Yes
No
Not Sure
2. If yes, when do you want to have your next child?
Within 1 year
1–3 years
More than 3 years
3. Are you using any contraception currently?
Yes
No
If yes, what method are you using?
4. Do you feel your current contraception method meets your needs?
Yes
No
If no, explain why
Section 2: Future Goals
5. How many children do you plan to have in total?
None
1-2
3 or More
6. Have you or your partner ever had difficulty conceiving?
Yes
No
7. Do you have any medical conditions (e.g., diabetes, hypertension) that may affect pregnancy?
Yes
No
If yes, specify:
Section 3: Concerns and Preferences
8. Are you worried about any of the following? (Select all that apply)
Side effects of contraception
Balancing children with work or family responsibilities
Financial challenges of raising children
Impact of pregnancy on your health
9. Do cultural or family expectations affect your reproductive choices?
Yes
No
If yes, explain briefly:
10. Would you like more information or support in any of these areas?
Choosing a contraception method
Fertility concerns
Managing a healthy pregnancy
Other
Other
Interpretation of Your Results:
Actively Planning Pregnancy: If you’re planning to conceive soon, ensure you are physically and emotionally prepared. Preconception counseling is recommended.
Not Planning Pregnancy: It’s important to explore reliable contraception options to meet your needs and prevent unplanned pregnancies.
Not Planning Pregnancy: It’s important to explore reliable contraception options to meet your needs and prevent unplanned pregnancies.
Uncertain About Future Goals: Counseling can help clarify your reproductive goals and address any concerns you may have.
Disclaimer: This scale is a general modified guide for Pakistani population.
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