The Family Planning receptionist laughed as she remembered her children playing with condom boxes at her feet.

When they got into their 20s she would bring condoms home for them, including sending them to Denmark when one of her sons moved overseas.

That might be unusual for the average mother but nothing is sacred when you've worked at the heart of contraception for 44 years like Anne Hilliard.

The 72-year-old spoke to the Herald for World Contraception Day today about the changes she has seen in the industry since she started in the 1970s.

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Family Planning provides a range of sexual and reproductive health services and Hilliard is its longest-serving employee. Most women use some form of contraception for three decades of their life.

Anne Hilliard has worked at Family Planning clinic for over 40 years. Photo / Dean Purcell
Anne Hilliard has worked at Family Planning clinic for over 40 years. Photo / Dean Purcell

One of the biggest changes has been what people use for contraception. While the pill has always been popular since it was introduced in 1961, the 1970s had a few other methods that have since fallen out of popularity.

Women used to be fitted for diaphragms, Hilliard explained. They were popular because they were unhormonal. But now only older nurses knew how to fit them and New Zealand had stopped importing the spermicide needed to insert them.

"It's a dying skill," Hilliard said.

"In those days we had contraceptive foam and tablets [spermicide]. You usually used them with something else... You can't buy that anymore.

"It was like going to bed with a chemist shop."

Some of the other differences Hilliard noticed were that menopausal women have almost stopped coming in for hormone replacement therapy while men have stepped up their attendance.

"We didn't see men so much in those days. Now they come in frequently for STI checks and condoms, some come in to support their partners."

Hilliard was first introduced to the clinics when she was working as a social worker bringing in girls from hospital to get contraception. When a job came up on the front desk she took the opportunity.

The only time she ever thought about leaving was when her husband's business failed and they were tight on money. But that moment passed and she has no plans to retire from her role at the Newmarket clinic.

And that's partially due to the job having lots of golden moments. Hilliard's favourite part is seeing the "little devils in uniform" who don't turn up to appointments and mess the staff around grow into thoughtful young women.

"One of the loveliest things about being here is the girls you might have known at 15, who you found trying. And they are now mothers and working girls.

"It's been lovely to see how people have grown up over the years."

Contraception now

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Changing with the times and making contraception more accessible for Kiwis is Family Planning's goal, chief executive Jackie Edmond explained.

They now offer phone consultations, STI self-testing and have increased their drop in hours. And more developments are on the cards. Edmond wanted to break into tele-consulting over the internet. This would allow clients to reach nurses and doctors from anywhere in the country, or world.

"We've seen some very innovative models used in other areas of medicine and we're working to see if these can be adapted for sexual and reproductive health," she said.

"We're not done with the innovating either and we'll keep on rolling out new options for clients."

Family Planning chief executive Jackie Edmond (left) wants to make sexual health and reproduction services more convenient and accessible. Photo / Nikki Williams
Family Planning chief executive Jackie Edmond (left) wants to make sexual health and reproduction services more convenient and accessible. Photo / Nikki Williams

Family Planning is also advocating to get long-acting reversible contraceptives (Larcs) fully funded. The "fit and forget" methods, which are up to 20 times more effective than oral contraceptive pills, can cost up to $600 if women want a hormonal IUD. The funded implant and copper IUD can give women heavy and painful periods.

Edmond said the more options available the more likely people are to find something that works.

"Larcs can be a great option because you don't have to remember to take a pill everyday or visit the clinic every three months for an injection to avoid an unwanted pregnancy."

A contraceptive for men would be great, but it may still be quite a way off, Edmond believed.

"For it to work, there would need to be a significant shift in gender roles with men taking on much greater responsibility for their role in reproduction.

"Understanding rights and consent would be key."

Phone consultations

Clients can talk with a nurse over the phone at a time that suits them. Phone consultations can occur into the evening and on the weekends for convenience.

STI self-testing

Clients fill out a simple questionnaire and if they meet the criteria, they can take their own urine sample or swab and leave it with the clinic for testing. They don't need to have an appointment or see a nurse.

If the test is positive, Family Planning can start them on treatment as soon as the results are back. Self-testing was implemented to make it easy and reduce or remove any embarrassment that people might feel.

Increased drop in hours

Most clinics now have longer drop in hours where people can just drop in to see them without an appointment.

Visit Family Planning for more advice on drop in hours or other services.