Contraception

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presented at fr.muller homoeopthic medical college

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Contraception

  1. 1. CONTRACEPTION Dr John Pradee
  2. 2. POSTCONCEPTIONALMETHODS
  3. 3. MENSTRUAL REGULATION Aspiration of uterine contents 6-14 days of a missed period. Cervical dilatation is indicated only in nullipara or in apprehensive subjects.
  4. 4. Complications IMMEDIATE: Uterine Perforation. Trauma. LATE: Tendency to Abortion. Premature labour. Infertility. Menstrual disorders. Ectopic pregnancy
  5. 5. Differs from Abortion Lack of certainty if a pregnancy is being terminated. Lack of legal restriction. Increased safety of early procedure.
  6. 6. MENSTRUAL INDUCTION
  7. 7. MISCELLANEOUS METHODS
  8. 8. ABSTINENCE • Complete Sexual Abstinence • May causes Temperamental changes and even Nervous breakdown.
  9. 9. COITUS INTERRUPTUS • Male withdraws before ejaculation. • Precoital secretion of the male mey contain sperms. • Even one drop of semen is sufficient to cause pregnancy. SIDE EFFECTS: • Pelvic Congestion. • Vaginismus.
  10. 10. SAFE PERIOD  Women’s menstrual cycles are not always regular.  Programmed sex.  Failure rate: 9 per 100 women.  Method not applicable during the post natal period.
  11. 11. NATURAL FAMILY PLANNING METHODS  Basal Body Temperature (BBT) method.  Cervical mucus method.  Symptothermic method.
  12. 12. BBT Method The rise BBT at the time of ovulation, as a result of increased production in the progesterone. Temperature measured preferably before getting out of bed in the morning. Abstinence is necessary for the entire
  13. 13. Cervical mucus method Also known as “Billings method”. Observation of changes in the characteristics of cervical mucus. Ovulation periodCervical mucus iswatery clear( Raw egg white, smooth,slippery, & profuse)
  14. 14. Symptothermic method Temperature + Cervical Mucus + Calendar Technique
  15. 15. BREAST FEEDING Lactation prolong postpartum amenorrhea. BIRTH CONTROL VACCINE Vaccine prepared from ß- sub unit of Human chorionic gonadotropin (hcG). Antibodies appear 4-6 wks and lasts upto 5 months.
  16. 16. ABORTION Defined as termination of pregnancy before the foetus becomes viable (capable of living independently.) Types: Spontaneous. Induced. 6 million abortions/ year in India. 4 million are Induced & 2 million are Spontaneous.
  17. 17. ABORTIONAL HAZARDSEARLY LATECOMPLICATIONS COMPLICATIONS Haemorrhage  Infertility Shock  Ectopic gestation Sepsis  Increased risk of Uterine perforation Spontaneous Cervical injury abortion  Reduced birth Thromboembolism weight Psychiatric complications.
  18. 18. THE MEDICAL TERMINATIONOF PREGNANCY ACT 1971 Conditions under which a pregnacy can be terminated. Person or persons who can perform such terminations. Place where such terminations can be performed.
  19. 19. Conditions under which pregnancycan be terminated. MEDICAL EUGENIC HUMANITARIAN SOCIO ECONOMIC FAILURE OF CONTRACEPTIVE DEVICES
  20. 20. MEDICAL: where continuation ofpregnancy might endanger the mother’slife or cause grave injury to her physical ormental health.EUGENIC: where there is substantial riskof the child being born with serioushandicaps due to physical or mental
  21. 21.  HUMANITARIAN : where pregnancy is due to rape. SOCIO-ECONOMIC : where actual or reasonably forseeable environments (whether social or economic) could lead to risk of injury to health of the mother.
  22. 22.  FAILURE OF CONTRACEPTIVE DEVICES The anguish caused by an unwanted pregnancy resulting from a failure of any contraceptive device or method can be presumed to constitute a grave mental injury to the health of
  23. 23. PERSON WHO CAN PERFORMABORTION RMP having experience in gynecology and obstetrics ( pregnancy doesn’t exceed 12 weeks). 12-20 weeks – Two RMP’s are necessary to terminate a pregnancy.
  24. 24. WHERE ABORTION CAN BEDONE Hospital established or maintained by government or a place approved for the purpose of this Act by government. Name of the abortion seeker is kept confidential.
  25. 25. MTP rulesApproval by Board : The Chief Medical Officer of the district is empowered to certify that a doctor has the necessary training in gynaecology & obstetrics to do abortions.
  26. 26. Qualification required to do abortion : “If he has assisted a RMP in theperformance of 25 cases of medicaltermination of pregnancy in an approvedinstitution.”The doctor may also qualify to do MTP’s :a. 6 months house manship in OBG.b. A post graduate qualification in OBG.c. 3 years of practice in OBG for those doctors registered before the 1971 MTP Act was passed.d. 1 year of practice in OBG for those doctors registered on or after the date of
  27. 27. The place where abortion is performed : Non-governmental institutions mayalso take up abortions provided theyobtain license from the Chief MedicalOfficer of the district.

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