Contraception is the intentional prevention of pregnancy during sexual intercourse.
Birth control is the device and/or practice to decrease the risk of conceiving, or bearing an offspring.
About one half of all pregnancies in the Philippines are unplanned.
Most women can become pregnant from the time they are in their early teens until they are in their late 40s.
Birth control can help couples postpone having a baby until the time is right for them—if ever.
How Birth Control Works
Block the sperm from reaching the egg
Kill or damage sperm
Keep eggs from being released each month
Change the lining of the uterus so the fertilized egg does not attach to it
Thicken the mucus in the cervix so sperm can not easily pass through it
Choosing A Method
How well the method works and the side effects
How likely you are to use it according to the directions
Your age and overall health
How often you have sex
Whether a prescription is needed
Whether you want to have children later
Whether it helps protect against STDs
Things to consider about contraceptive methods :
Ability to use a method correctly
How the method will affect sexual enjoyment
Status of a couple’s relationship
Free of side effects
Easy to use and acceptable to both user and sexual partner
Free of effects on future pregnancies
Family Planning – ( WHO ) the use of a range of methods of a fertility regulation to help individuals or couples attain certain objectives:
avoid unwanted birth.
bring about wanted birth.
Produce a change in the no. of children born.
Regulate the intervals between pregnancies.
Control time at which birth occur.
3 important elements in family planning
number of pregnancies
Family welfare – a state of well – being of the family as a whole and the individual.
means a level of satisfaction of the basic needs of family (adequate food, water, shelter, employment, health and education).
Responsible Parenthood – the essence of family planning.
pregnancy is planned and a child us desired and is assured of parent's love, protection, etc.
Benefits to Mother
Reduce the health risk by helping woman bear them children during their healthiest years. Below 20y.o. And above 35 y.o. At risk of developing complications during pregnancy.
Help mother to fully recover from physical strain of child bearing. Those more than 4 children – considered high risk.
Help reduce number of maternal death due to abortion.
Health Benefits to Children
Ensures better chance of survival at birth.
Promote better childhood nutrition.
Promote physical growth and development.
Prevent birth defects.
Health Benefits to Father
Allows father to keep a constant balance between their physical, mental, social, well -being.
More relaxed sexual relationships- confident not to produce unwanted pregnancy.
Increase father sense of respect because he is able to provide the type of education and home environment.
Benefits to Whole Family Health
- help the family enjoy the better kind of life.
Types of family planning
Natural Family Planning methods
No introduction of chemical of foreign material into the body.
Practice maybe due to religious belief, “natural” way is best for them.
Effectiveness varies greatly, depends on couples ability to refrain from having sex on fertile days.
Failure Rates: about 25%
Poses no risk to fetus
NATURAL FAMILY PLANNING
Rhythm (Calendar) method
Basal Body Temperature (BBT)
Ovulation or Cervical Mucus (Billings Method)
Lactation Amenorrhea Method
A. RHYTHM (Calendar) METHOD “It’s a Date”
Abstaining from coitus on the days of menstrual cycle when a woman is most likely to conceive (3 or 4 days before until 3 or 4 days after ovulation).
Woman keeps a diary of 6 menstrual cycles
An illustration of the Standard Days Method. This method may be used by women whose menstrual cycles are always between 26 and 32 days in length Background B.C. typenatural birth control First use1999 (Standard Days) 1930 (Knaus-Ogino) Ancient ( ad hoc methods)
-18 from shortest cycle documented.
-11 from longest cycle
ans. = represents her last fertile day.
If she has 6 menstrual cycles ranging from 25 to 29 days, fertile period would be from 7 th day (25-18) to the 18 th day (29-11).
To avoid pregnancy, avoid coitus/use contraceptive during those days.
B. Basal Body Temperature (BBT) “I'm so hot”
Identifying fertile and infertile period of a woman’s cycle by daily taking and recording of the rise in body temperature during and after ovulation.
Just before ovulation, a woman’s BBT falls about 0.5 ◦F. At time of ovulation, her BBT rises a full degree (influence of progesterone).
This higher level is maintained the rest of menstrual cycle.
How: Woman takes her temp each morning immediately after waking, before she undertake any activity.
She has ovulated, slight dip in temp followed by
Usually combined with calendar method
Ideal Failure rate: 9%
C. Cervical Mucus/Billings/Ovulation “Stretch”
Use changes in cervical mucus with ovulation
Woman: must be conscientious in assessing her vaginal secretions.
Ideal Failure rate: 3%
Would your lifestyle be enhanced if you could: Manage your fertility naturally ? Achieve pregnancy naturally ? While breastfeeding, regulate fertility naturally ? Manage menopause naturally ? The Billings Ovulation Method can assist you with all these areas of your life.
Before ovulation: - thick and does not stretch With ovulation (peak day): - copious, thin, watery, transparent . Feels slippery and stretches at least 1 inch before the strand breaks = property known as “spinnbarkeit”. These are Fertile days
C. Symptothermal Method
Combines the cervical mucus and BBT methods
Watches temp daily and analyzes cervical mucus daily.
Watch for midcycle abdominal pain(mittelschmerz)
Couple must abstain from intercourse until 3 days after rise in temp or 4 th day after peak of mucus change.
More effective than BBT or CM method alone
Ideal Failure rate: 2%
D. Ovulation Awareness
Use an OTC ovulation detection kit.
These kits detect the midcycle surge of Luteinizing Hormone (LH) that can be detected in urine 12 to 24 hours before ovulation.
98% to 100% accurate in predicting ovulation
BeSure ™ Ovulation Prediction Test Kits Human LH Hormone Specific Lateral Flow Cassette Type Test All inclusive, 5 day ovulation prediction test kits. One-step, easy to perform, rapid developing, urine based test cassettes for identification of the increased levels of the human luteinizing hormone (LH) immediately proceeding the ovulatory period within the female reproductive cycle.
E. Lactation Amenorrhea Method
Temporary introductory postpartum method of postponing pregnancy based on physiological infertility experienced by Breast Feeding women
Universally available to all postpartum breastfeeding women.
No other FP commodities required
Contributes to improve maternal and child health and nutrition
Only temporary, effective only up to 6 months postpartum
Effectiveness may decrease if mother and child are separated for extended periods of time (working mother).
Difficult to maintain (up to 6 mos.)due to variety of social circumstances
Efficacy and duration of LAM are enhanced with more intense breastfeeding patterns, especially during the earlier weeks and months
F. COITUS INTERRUPTUS “ The pulling out”
One of oldest known methods of contraception
Couple proceeds with coitus until the moment of ejaculation.
Then the man withdraws & spermatozoa are emitted outside the vagina
Offers little protection
Adolescent boys may lack the control or experience to use the method effectively
Barrier methods prevent the man's sperm from reaching the woman's egg. Types of barrier methods include:
Condoms (male and female)
Condoms “The shield”
Made of Latex, Polyurethane, or Animal Skin
Latex condoms also protect against STDs, including HIV
Thin plastic pouch that lines the vagina
Can be difficult to insert
Use if cannot be sure partner will use a male condom
Can be inserted up to 8 hours before sex
B. FEMALE CONDOMS
Latex sheaths made of polyurethane and prelubricated with a spermicide.
Inner ring (closed end)= covers cervix; Outer ring (open end)= rests against vaginal opening
May be inserted any time before sexual activity begins; then remove after ejaculation occurs.
Like male condoms, one time use only. Difficult to use
Offer protection against both conception and STD
OTC but more expensive than male condoms
“ THE RUBBER POEM”
“ D Rubber Poem”
Kissing is a habit
Fucking is a game
Guys get the pleasure
Girls get the pain..
The guy says: “I love u”
You believe its true
But when your tummy
Starts to swell,
He says: The hell with you
10 mins of pleasure 9 months in pain 3 days in the hospital, And a baby without a name.. The baby is a bastard The mother is a whore This wouldn't happen If the rubber was put on.. Bow.. Play safe.. Spread the Word, not the virus..
Spermicides “ the killer” Spermicides often are used in suppositories, foam, cream, jelly, and film (thin sheets that contain spermicide) to kill sperm or make them inactive
Sponge The sponge is a doughnut-shaped device made of soft foam coated with spermicide. To use the sponge, it must be moistened with water. Once inserted in the vagina, it covers the cervix and blocks sperm from entering the uterus.
Diaphragm The diaphragm is a small, latex, dome-shaped device that fits inside the vagina and covers the cervix. It is used with spermicide. A diaphragm requires a prescription and needs to be fitted by a doctor.
It should remain in place for 6 hours following coitus and maybe left for 24 hours.
To be effective used with vaginal creams.
Wash the diaphragm after use in soap and water
It can be used repeatedly for 2-3 years.
Contraindicated for females with abnormalities in cervix.
Cervical Cap The cervical cap is a small, thin, dome-shaped device made of latex or plastic. It fits tightly over the cervix and stays in place by suction. A cervical cap must be fitted and prescribed by a doctor.
Hormonal Methods “The Pill” With hormonal birth control, a woman takes hormones similar to those her body makes naturally. In most cases, these hormones prevent ovulation and change the lining of the uterus. The hormones also cause the cervical mucus to thicken, which makes it hard for the sperm to get through the cervix to the uterus. Hormonal birth control comes in several forms, pill, skin patch, vaginal ring, injection, and implant.
Birth Control Pills There are many different brands of pills that use certain hormones or a combination of hormones. This variety allows a woman to find a pill that is right for her.
The Pill or COCs (combined oral contraceptives)
With varying amounts of synthetic estrogen combined with a small amount of synthetic progesterone (progestin)
Estrogen – acts on FSH and LH thus suppresses ovulation
Progesterone – cause a decrease in the permeability of cervical mucus thereby limiting sperm motility and access to ova.
Also interferes with tubal transport and endometrial proliferation.
fixed doses of both estrogen and progesterone throughout 21 day cycle
constant amount of estrogen throughout cycle BUT increased amount of progestin during the last 11 days .
Varies level of estrogen and progesterone. Closely mimic natural cycle, reducing breakthrough bleeding (bleeding outside the normal menstrual flow)
COCs must be prescribed by physician after pelvic examination and a Papanicolaou (Pap) smear.
Packed 21 or 28 pills to a container
28 pills ( 21 active pills/7 placebo pills)
Used correctly: 99.7% effective
Typical failure rate: 8%
Contraindications to Oral Contraceptive Use
Breast-feeding & less than 6 weeks postpartum
Age 35 years or older & smoking 15 or more cigarettes per day
Multiple risk factors for arterial cardiovascular disease, such as older age, smoking, diabetes, hypertension
Elevated blood pressure of 160 mm Hg systolic or above or 100 mm Hg diastolic or above
Current or history of deep vein thrombosis or pulmonary embolism
Major surgery that requires prolonged immobilization
Current or history of ischemic heart disease
Complicated valvular heart disease
Current breast cancer
Diabetes with nephropathy, retinopathy, neuropathy, vascular disease, or diabetes of more than 20 years duration
Monilial vaginal infection
Increase blood clotting
Improving facial acne
Oral contraceptives containing only progesterone.
Ovulation may occur but progestin halts endometrium to fully develop: implantation will not occur
Taken everyday, even through menstrual flow
May be taken during breast feeding
Skin Patch The contraceptive skin patch is a small (1.75 inch) adhesive patch that is worn on the skin to prevent pregnancy. With the patch, estrogen and progestin are absorbed through the skin into the bloodstream. The patch may offer many of the same benefits and risks as the combination birth control pill. Once a woman obtains a prescription for the patch, she does not need to visit her doctor to apply or remove it.
Vaginal Ring The vaginal ring is a flexible, plastic ring that is placed in the upper vagina. It releases both estrogen and progestin. The ring may have the same benefits and risks as those of the combination birth control pill.
Injections An injection or "shot" of depot medroxyprogesterone acetate (DMPA) provides protection against pregnancy for 3 months. It works the same way as other forms of hormonal birth control. Side effects: hypocalcemia
Implant A contraceptive implant is a single rod that is inserted under the skin of the upper arm. It protects against pregnancy for 3 years. The implant releases a progestin that works similar to other hormonal methods of birth control—it prevents ovulation.
Intrauterine Device The IUD is a small, T-shaped, plastic device that is inserted and left inside the uterus to prevent pregnancy. There are two types available : the hormonal IUD and the copper IUD. The IUD does not protect against STDs.
Heavy menstrual bleeding
History of PID
Abnormally shaped uterus
Ectopic( tubal ) pregnancy
Emergency Contraception “Plan B ” If a woman has sex without any type of birth control or if she thinks her method did not work (for instance, a condom slipped or broke), she may want to use emergency contraception. Emergency contraception reduces the risk that pregnancy will occur.
Emergency PostCoital Contraception
“ morning-after pills”
With high level of estrogen interfering with progesterone production, prohibiting good implantation
Eg. Yuzpe Regimen (Preven) – specially designed particularly after a sexual assault has occurred
Effectiveness: between 75% & 85%
SURGICAL METHODS “The permanent”
Tubal sterilization – women
Vasectomy – men
Preferred method: most effective, no effect on sexuality
Chosen with great thought and care and should be considered permanent
Small incision made on each side of the scrotum. Vas deferens is then cut & tied, cauterized, or plugged, blocking the passage of spermatozoa
Ambulatory, under local anesthesia
Does not interfere with production of sperm, does not pass beyond severed vas deferens and absorbed at that point. (seminal fluid continues but w/o sperm)
Very effective 3 months after the procedure
Permanent, safe, simple & easy to perform
Can be performed in a clinic, office or at a primary care center
No resupplies or repeated clinic visits
No apparent long term risks
An option for couples whose female partner could not undergo permanent contraception
A man who had vasectomy will not lose his sexual ability and ejaculation
Does not affect male hormonal function
Slightly uncomfortable due to slight pain & swelling 2-3 days after procedure
Reversibility is difficult and expensive
Bleeding may result in hematoma in the scrotum
A few men develop chronic pain after vasectomy (postvasectomy pain syndrome)
Fallopian tubes are occluded by cautery, crushing, clamping, or blocking & thereby preventing passage of both sperm and ova
Laparoscopy – using a lighted laparoscope
Culdoscopy - a tube inserted through the posterior fornix of the vagina
Colpotomy – incision through the vagina
A small as 1 cm is made just under the woman’s umbilicus (under general or local anesthesia)
A lighted laparoscope in inserted through the incision.
Carbon dioxide is then pumped into the incision to lift the abdominal wall upward and out of the line of vision.
The fallopian tube is located through laparoscope & an electrical current to coagulate tissue is then passed through the instrument for 3 to 5 seconds.
Or the tubes are clamped & cut, or filled with a silicone gel to seal them
Can be done as soon as 4 to 6 hours after the birth of a baby or after an abortion
Behavioral method of contraception
COST PREPARATION WORRIES 100% EFFECTIVE
Role of Nurse in Family Planning
Education of client in various methods available, their effectiveness and their side effects
Help the client explore their feelings regarding birth control
Create open relaxed atmosphere allowing clients to express concerns & feelings about birth control
Thorough explanation of how methods works
Instruction of client in possible complications and side effects
This is from Angela…
My friends tease me when I say this, but I knew the moment my son was conceived. My boyfriend & I been together since college so we used a condom until graduation. We had our first job, got married been busy with work and we finally planned our getaway weekend. It was wonderful. We got back some of the magic as we took long walks and talked. Until that weekend, whenever we discussed having children it was always “maybe someday”
On the second night, we decided to skip the condom for the first time. Our love making seemed so special & magical. A true reflection of the emotional closeness we had recaptured. We are convinced that Jayvee is the result of that night together.
THANK YOU FOR LISTENING AND THANK YOU FOR SLEEPING POST TEST AFTER 10 MINUTES
Test Questions 1.Which Contraception practice is BEST? A. The ideal contraceptive should be safe, easily available, economical, acceptable, simple to use, and promptly reversible. B. Morning After pill C. Use it once remember 2. True or False The pill, contraceptive patch, injection and the IUD all protect against STD’s. 3. True or False With a 97% effectiveness rate, the condom also protects against STD’s. 4. True or False The injection works by getting a shot in the butt daily for the whole time you are on it. 5. True or False There are NEVER prescriptions needed for any contraception used.
6. Which kinds of birth control work 100% of the time?
A. The pill, sterilization (getting your tubes tied) and abstinence (not having intercourse)
B. Only sterilization and abstinence
C. Only abstinence
7. “Male condoms prevent pregnancy at least 85% of the time.
8. Of the following kinds of birth control, which one is the most effective?
A. The pill
B. The “male” condom
C. Fertility awareness (“natural family planning”)
9. A woman can use hormones to prevent pregnancy in all of the following ways EXCEPT:
A shot into her muscle
A vaginal ring
An injection into her blood stream
An implant in the arm
A T-shaped plastic device inserted into the uterus
A patch put on the skin
10 . Using two methods (such as a condom and a hormonal method like the pill) is very effective in preventing pregnancy and HIV and other STDs.
True, this may be as effective as sterilization
False, this is probably only about as effective as a “male” condom by itself
False, this is less effective than a “male” condom by itself
11. What is the main way hormonal birth control methods work?
They block the sperm from the egg
They prevent the ovary from releasing an egg
They kill the sperm
12. What does a person have to know to use an IUD correctly?
Check the string once a month
Put it in and take it out every time you have sex.
Take one every day
13. What does a person have to know to use a “male” condom correctly?
Put it on just before you ejaculate (“come/HNY?”)
Check the date on the package to make sure it hasn’t expired
Take one every day
14. Fertility Awareness means figuring out when the woman ovulates (releases an egg) and not having intercourse (or using another method)…
… After that time
… Before and during that time
… During your period
15. How long after unprotected sex or a birth control method failure (like a “male” condom breaking) does a woman have to take emergency contraceptive pills to improve her chances of preventing an unplanned pregnancy?
16. Which of the following has the least health risk?
“ male” and “female” condom
B. The IUD
17. Women who have had more than one sex partner in the last couple of years, or who think they might in the next couple of years, should probably not use the IUD.
18. Who should probably not use the pill, patch or ring?
Women over age 35 who smoke
Women under age 20
Women who have had more than one sex partner in the last couple of years
19. Who can buy condoms?
Only people over age 18
Only people with a prescription
People under age 18 who have a note from their parents
20. What % of 18 year olds in the Philippines have not yet had sexual intercourse? Guess.