One approach is for family planning programs to make common cause with other services that reach these women such as prenatal care and childhood immunization programs. In practice, it is often difficult to link family planning with other kinds of services, however (66). "Each country's situation must be judged on its own terms," Sinding and Fathalla advise. Programs must try to avoid dilution of resources but seek links where collaboration makes service delivery more cost-effective (200).

Missing these opportunities means that needs go unmet. For example, in Kenya a study of two hospitals found that only 2% of postpartum women left the hospital with a contraceptive method, but more than 90% wanted to use one (28). Another study in Kenya found that nearly three-quarters of postpartum women who did not receive family planning information during pregnancy nevertheless had wanted it (116).

When both family planning and maternal and child health (MCH) services are readily available in a community, women are more likely to use one or both services than when just one service is available alone (136). Where family planning and other MCH services are linked, levels of contraceptive use typically are higher (66, 118, 158). For example, in Togo an operations research project demonstrated that telling mothers about family planning services when they brought their children for immunizations increased awareness of family planning services by 18 percentage points, from 40% to 58%. Also, the average monthly number of new family planning clients rose by 54% (90).

Providing postpartum family planning and MCH care together might help to reach some women who otherwise might have access to only one service. While MCH services, such as prenatal care, delivery assistance, postnatal visits, and immunization against childhood diseases, still fail to reach many women and their young children, coverage has been improving in many countries (81). Postpartum family planning services, which have existed since the 1960s, are being expanded in many countries, too (116, 180, 212).

Linking services offers opportunities to take account of the special needs of women who have just given birth. For example, many postpartum services offer instruction on and encouragement for breastfeeding. Exclusive breastfeeding offers protection against pregnancy for six months or more after childbirth, but few women breastfeed exclusively for even a few months (182). Thus, linked or combined services can stress the importance of exclusive breastfeeding and also offer contraceptive choices to breastfeeding women, as appropriate (109, 212).

While linking family planning and MCH services can help reach many women with unmet need, such efforts will not serve all women who need reproductive health care (213). To address more women's unmet need, family planning services also need to be linked better to postabortion care (15, 60, 82, 243), assuring that family planning counseling and supplies are available to all. Family planning services can be linked to care for complications of unsafe abortion by coordinating location, staffing, and scheduling of services and by strengthening referral systems (140).