3. FAMILY PLANNING
WHO - definition
“ A way of thinking and living that is adopted voluntarily, upon
the basis of knowledge, attitudes and responsible decisions by
individuals and couples, in order to promote the health and
welfare of the family group and thus contribute effectively to
the social development of a country.”
4. Objectives:-
1. To avoid unwanted births.
2. To bring about wanted births.
3. To regulate the intervals between pregnancies.
4. To control the time at which births occur in relation to
the ages of the parent; and
5. To determine the number of children in the family.
5. Eligible couples
Refers to a currently married couple wherein the wife is in the
reproductive age,which is generally assumed to lie between
the ages of 15 and 45.
Are in need of family planning services.
The “ Eligible couple register” is a basic document for organising
family planning work
6. ELIGIBLE COUPLES VS TARGET COUPLES
Eligible couples
Currently married couple wherein the wife is in the
reproductive age (15-49 years)
7. Target couples:
Couples who have had 2 – 3 living children
Family planning was largely directed to such couples
Definition enlarged to include families with one child or
even newly married couples with a view to develop acceptance
of the idea of family planning from the earliest possible stage
8. Target couples
• Couples who have had 2-3 living
children
Enlarged to include,
Families with one child
• Or even newly married couples
9. Indicators of Family Planning
• Contraceptives prevalence rate
• Couple protection rate
• Coupe year of protection
12. Contraceptive prevalence rate
• CRP of Nepal = 44% (Annual health report 2073/74)
• Lowest in Province 4
• Highest in Province 2
1996 2001 2006 2011 2016
Contraceptive
prevalence rate
28.5 39.3 48 49.7 53
13. COUPLE PROTECTION RATE
% of eligible couples effectively protected against
childbirth by one or the other approved methods of family
planning like sterilization, IUD, condom or oral pills.
14. % of eligible couples effectively protected against
childbirth by one or the other approved methods of family
planning
COUPLE PROTECTION RATE
15. COUPLE YEARS OF PROTECTION (CYP)
The estimated protection provided by contraceptive
methods during a one-year period, based upon the volume
of all contraceptives sold during that period.
CYP indicates the amount of time a couple will be
protected against an unwanted pregnancy based on the
contraceptive method used.
16. COUPLE YEARS OF PROTECTION (CYP)
CONTD……
IUCD 12 CYP
2000-2008
17. COUPLE YEARS OF PROTECTION (CYP)
CONTD……
IUCD 12 CYP
Norplant 5 CYP
2000-2005
18. COUPLE YEARS OF PROTECTION (CYP)
CONTD……
IUCD 12 CYP
Norplant 5 CYP
pill
19. COUPLE YEARS OF PROTECTION (CYP)
CONTD……
IUCD 12 CYP
Norplant 5 CYP
13 pill cycles 1 CYP
20. COUPLE YEARS OF PROTECTION (CYP)
CONTD……
IUCD 12 CYP
Norplant 5 CYP
13 pill cycles 1 CYP
depo
23. Contraceptive Efficacy
Measuring the no. of unplanned pregnancies that occur
during a specified period of exposure and use of
contraceptive method
Done by 2 methods
1. Pearl Index
2. lifetime table analysis
PI : No. of contraceptives failures or accidental pregnancies
per 100 woman years of exposure(HWY)
PI= Total Accidental pregnancies x 100
Total years of exposure)
PI= Total Accidental pregnancies x 1200
Total months of exposure)
24. Contraceptive Efficacy
2. lifetime table analysis:
Females of reproductive age group are
observed to analyse any accidental
pregnancies.
Calculate failure rate per month of use
Better than pearl index
26. Health Outcome of Family Planning
Women’s Health Foetal Health Infant and Child Health
Through the following ways:-
Avoidance of unwanted pregnancies
Limiting the no. of births and proper spacing.
Timing of births – in relation to age of the mother.
27. Child Health
Decreased child mortality.
Improve child growth, development and nutrients
Decreased infectious diseases.
Foetal Health
Prevention of feotal mortality; abnormal development
28. FAMILY PLANNING METHODS
( Contraceptive Method)
Ideal Contraceptive:-
1. Safe,
2. Effective,
3. Acceptable,
4. Inexpensive,
5. Reversible
6. Simple to administer
7. Independent of coitus
8. Long-lasting
9. Require little or no medical supervision.
*Conventional contraceptive
29. FAMILY PLANNING METHODS
1. Barrier Methods
i. Physical methods
ii. Chemical methods
iii. Combined methods
2. Intrauterine devices
3. Hormonal Methods
4. Post-Conceptional
methods
5. Miscellaneous
Spacing Methods Terminal Methods (Permanent)
1. Male Sterilization
2. Female Sterilization
1. Condom - male and female
2. Diaphragm
3. Vaginal Sponge
1. Foams
2. Creams, jellies & pastes
3. Suppositories
4. Soluble films
*Conventional contraceptives
30. QUESTIONS THAT CAN BE ASKED
• Identify the specimen
• What is its composition?
• What is its mode of action?
• What are its side effects?
• What are its advantages?
• What is its Contraceptive Prevalence
Rate(CPR)?
• What is its Couple Years of Protection(CYP)?
• What is its effectiveness?
• What is its failure rate? Etc……….
Dr
Smriti/
Dr.
Leela
34. CONDOM
Male condom: They are made of:-Latex sheath or skin.
The condom is fitted on the erect penis before
intercourse
Female condom
Is a pouch made of polyurethane, which lines the vagina.
An internal ring in the close end of the pouch covers the
cervix and external ring remains outside the vagina.
Inserted in vagina
Mode of Action:
Forms a physical barrier between penis and vagina and
prevents the deposition of semen in the vagina
Dr
Smriti/
Dr.
Leela
35. Condom…
Can be used in conjunction with spermicidal
agent
Spermicide serves additional protection in the
unlikely event that the condom could slip off or
tears
Failure rate: 2-3 %
CPR:4.2%(NDHS 2016)
CYP:150 condoms = 1 CYP
Dr
Smriti/
Dr.
Leela
36. CONDOM:ADVANTAGES/DISADVANTAGES
ADVANTAGES
Cheap and easy to use No side effects
Easily available Protects against STIs
DISADVANTAGES
May break or slip off during
intercourse
Expensive(Female Condom)
Decreases sexual pleasure Decreases sexual pleasure
Dr
Smriti/
Dr.
Leela
37. b. Diaphragm /“Dutch cap”
• Vaginal barrier
• Shallow cup made of synthetic rubber or plastic material
• Ranges in diameter from 5- 10 cm (2-4 inches)
• Inserted before sexual intercourse and must remain in place for
not less than 6 hours after sexual intercourse.
• Advantages: Total absence of risks and medical
contraindications
• Disadvantages: Physician reqd to demonstrate the technique
• After delivery it can be used only after involution of the uterus
is completed.
• Toxic shock syndrome
38. c. Vaginal sponge
Sponge soaked in vinegar or olive oil
Small polyurethane foam sponge measuring 5 cm x 2.5 cm,
saturated with the spermicide, nonoxynol – 9
39. d. Chemical Methods
• spermicidal (vaginal chemical contraceptives) - used widely in past
• surface active agents
a. Foams: foam tablets, foam aerosols
b. Cream, jellies and pastes – squeezed from a tube
c. Suppositories ; inserted manually
d. Soluble films – C- film inserted manually
Drawbacks -
• high failure rate
• used before intercourse and repeated every time
• mild irritation/ burning & messy
• Teratogenic effect (?)
40. 2. Intra-Uterine Devices
Variants of T device
i. T Cu – 220c
ii. T Cu – 380 A or Ag
Nova T
Multiload Devices
ML – Cu – 250
ML – Cu - 375
Non-medicated Medicated
(First- generation)
(2nd – generation) (3rd - generation)
Lippes Loop
Copper Bearing Devices
Hormonal D.
Progestasert
Earlier Devices
Copper – 7
Copper T-200
Newer Devices
41. 2. INTRAUTERINE CONTACEPTIVE DEVICE (IUCD/IUD)
• A small, T-shaped plastic device that is
wrapped in copper or contains hormones.
Types of IUD
Copper IUD Hormonal IUD
Dr
Smriti/
Dr.
Leela
42.
43.
44. Hormonal IUD Copper IUD
Mode of Action
It makes the cervical mucus thick and
sticky, so sperm can't get through to the
uterus.
It also prevents endometrial growth
and makes it non-receptive for the
fertilized egg
Copper is toxic to sperm
It makes the uterus and fallopian
tubes produce a fluid that kills sperm
-This fluid contains white blood cells,
copper ions, enzymes,& prostaglandins.
Duration of Effectiveness
3-5 years 5-12 years
Failure Rate
0.2 % 0.8%
Contraceptive Prevalence Rate(CPR):1.4%(NDHS 2016)
CYP : 8
Dr
Smriti/
Dr.
Leela
45. IUCD: ADVANTAGES/ DISADVANTAGES
Advantages: Disadvantages:
Effective birth control for a long
period of time(5-12 years)
They DON’T prevent STIs
Rapid return to fertility following
removal
Can cause mennorrhagia
and dysmennorrhea
The hormonal IUD have
advantages similar to those other
hormonal contraceptives
Can have self expulsion
Can cause PID
Can perforate the uterus
Dr
Smriti/
Dr.
Leela
46. IUCD: SIDE EFFECTS
The hormonal IUD can cause hormonal
similar to those caused by Norplant
Irregular menstrual periods
Breast discomfort
Fluid retention
Increase in acne
Dr
Smriti/
Dr.
Leela
48. Ideal IUD - Candidate
Timing of insertion - Post Menstrual, Post Partum, Post Puerperal
insertion
Follow up - 1,3, 6mth-1yr
Who has borne at least one child.
Has no history of pelvic disease.
Has normal menstrual periods.
Is willing to check the IUD tail.
Has access to follow up and Rx of potential problems
Is in a monogamous relationship
49. Complications: -
Bleeding
Pain
Pelvic-infection 2 to 8 times more
Uterine perforation – 1:150 to 1:9000 insertions.
Pregnancy 3% in first year
Ectopic pregnancy
Expulsion 12-20%
Fertility after removal 70% of previous users conceive within one
year of stopping use.
cancers - no evidence
Mortality - 1 per 100,000 woman yrs of use
51. 1. COMBINED OCPS (EVERYDAY PILLS):
Levonorgestrel 0.3 mg + Ethinylestradiol 0.03
mg.+Ferrous Fumarate 75 mg
1 month supply has 28 pills ( 21 hormone containing
and 7 Iron tablets)
Started at 5th day of menstrual cycle and continued for 21days
7days break ( or iron tablets)
fixed time everyday
Dr
Smriti/
Dr.
Leela
52. COMBINED OCPS (EVERYDAY PILLS):
Mode of Action:
Oestrogen: Inhibits ovulation.
Progestogen:
Inhibit ovulation by inhibiting the secretion
of gonadotropins(FSH and LH)
Also thickens the cervical mucus & forming a
barrier to sperms.
Also induce a thin endometrial lining, less
suitable for implantation.
53. COC and Lactation:
• Adverse effect on milk volume so should be
avoided in the first six weeks postpartum
• May be used without restriction from six months
postpartum, provided there are no
contraindications
• Progesterone-only methods do not have any
adverse effect on milk volume.
54. COMBINED OCPS (EVERYDAY PILLS):
Duration of Effectiveness: As long as it is taken
regularly it is 99.9 % effective
Failure Rate: 0.1-0.3 % (Can be as high as 9)
Contraceptive Prevalence Rate: 4.6%(NDHS
2016)
Couple’s Year of Protection(CYP):
13 pill cycles =1 CYP
Dr
Smriti/
Dr.
Leela
55. OCPS: ADVANTAGES DISADVANTAGES
Advantages: Disadvantages
1.Highly effective and
reversible
1.Does not protect against
STIs
2.Improved cycle control
and less dysmenorrhoea
2.Has to be taken everyday
3.Improvements in acne 3.Cannot be used by women
with some medical problem or
using certain medications
4.May lower the risk of
pelvic infection
Dr
Smriti/
Dr.
Leela
56. OCPS: CONTRAINDICATIONS…
1.Active thrombophlebitis or venous thromboembolic
disorder
2. Acute or chronic obstructive liver disease with elevated
liver enzyme levels or compromised liver function
3. Known or suspected breast cancer
4. Undiagnosed genital bleeding
5. Women over 35 who smoke cigarettes
6. Arterial Thrombosis/Ischemic heart disease
7. Migraines with focal neurologic signs
Dr
Smriti/
Dr.
Leela
57. OCPS: SIDE EFFECTS
Breast tenderness
Nausea
Weight gain/bloating
Headaches
Mood changes
Inter-menstrual bleeding
Amenorrhea
Dr
Smriti/
Dr.
Leela
58. 2. Progestogen – only pill (POP)
commonly referred to as “ minipill” or “
micropill”
Contains progestogen - norethisterone and
levonorgestrel
given in small doses throughout the cycle
Could be prescribed to older women
59. 3. I-pill (Emergency contraceptive pills)
Post – coital contraception
Dr
Smriti/
Dr.
Leela
60. 3. Post – coital contraception
(Emergency Contraception Pills)
Post – coital (or “ morning after” contraception is
recommended within 72 hours of an unprotected
intercourse. The method are available.
a. IUD - 5days
b. Hormonal
•
61. •Progesterone (Levonorgrestral) 0.75 mg (ipill/econ) Single
dose only
or
•Two oral contraceptive pills containing 50 mcg of ethinyl
estradiol within 72 hours after intercourse and the same does
after 12 hours.
or
•Four oral contraceptive pills (low dose COC) containing 30
or 35 mcg of ethinyl estradiol within 72 hours and 4 tablets
after 12 hours
or
•Mifepristone 10 mg once within 72 hours
62. Mode of action of oral pills
Prevent the release of the ovum from the ovary
Blocking the pituitary secretion of gonadotropin that is
necessary for ovulation to occur.
Effectiveness
almost 100 percent effective in preventing pregnancy.
Benefits - protection against benign breast disease ,
ovarian cyst, iron deficiency anemia, PID, ectopic pregnancy
and ovarian cancer
63. Adverse effects:-
Beneficial effects:-
Cardio-vascular effects
Carcinogenesis – Cx
cancer
Metabolic effects
Unwanted effects:-
Breast tenderness
Migraine
Wt. gain
bleeding disorder
6 disease protection
1. Benign breast
disorder.
2. Ovarian cysts
3. IDA
4. PID
5. Ectopic Pregnancy
6. Ovarian Cancer
64. Contraindication
Absolute
cancer breast and genitals
liver disease
thromboembolic condition
cardiac abnormality
congenital hyperlipidemia
undiagnosed abnormal ut bleed
Special precautions
Over 40
smoking and age over 35
HTN
renal discease
epilepsy
migraine
lactation
DM
65. 3. Post – coital contraception
(Emergency Contraception Pills)
Each Pill contains Levonorgestrel 1.5mg
Used to prevent pregnancy But it cannot be used as a regular
contraceptive method
Unhealthy if taken more than twice a month.
The pill is to be taken soon after unprotected sex.
It should be taken preferably within 24 hours and before 72
hours.
It is taken by mouth and when taken correctly, it is up to
99.9% effective.
Dr
Smriti/
Dr.
Leela
67. MOA
It may stop an egg being released from the ovary.
If an egg has been released, i-pill may prevent the
sperm from fertilizing it.
It prevents fertilization of an egg by affecting the
cervical mucus or the ability of sperm to bind to the
egg.
If the egg is already fertilized, it may prevent it from
attaching itself to the lining of the womb.
Dr
Smriti/
Dr.
Leela
68. SIDE EFFECTS
Nausea or vomiting.
Dizziness.
Fatigue.
Headache.
Breast tenderness.
Bleeding between periods or heavier
menstrual bleeding.
Lower abdominal pain or cramps.
Diarrhea.
Dr
Smriti/
Dr.
Leela
69. Abortion pills contain drugs known as antiprogestins,
which stop the development of a pregnancy after it has
occurred.
On the other hand, emergency contraceptive pills like
i-pill , which contain common female hormones prevent
pregnancy in the first place and so do not cause an
abortion.
Dr
Smriti/
Dr.
Leel
a
70. 4. Once – a – method ( long – acting ) pill -
Quinestrol
5. Male pill
– gossypol
72. NORPLANT
It is a type of sub-dermal contraceptive implant
Type 1: NORPLANT
Six small silicon rubber soft capsules, each
containing 36mg of synthetic progesterone
(levonorgesterol)
Slowly releases hormone over a long period of time
Contraceptive protection for 5 years
Type 2: NORPLANT II
Same as above
The only difference is that there are only 2 capsules
each containing 75mg of levonorgesterol
Dr
Smriti/
Dr.
Leela
73. NORPLANT CONTD…..
Mode of Action:
Synthetic progestogens inhibit ovulation by inhibiting the secretion of
gonadotropins(FSH and LH)
They also thicken the cervical mucus thereby forming a barrier to sperms.
They also induce a thin endometrial lining, less suitable for implantation.
Duration of Effectiveness: 5 years approximately
Failure Rate: 0.2-1.2 %
Contraceptive Prevalence Rate(CPR): 3.3% (NDHS 2016)
CYP : 5
Dr
Smriti/
Dr.
Leela
74. NORPLANT: ADVANTAGES/DISADVANTAGES
Advantages: Disadvantages:
Effective birth control for 5
years
Doesn’t protect against
STIs
Rapid return to fertility
following removal
Requires minor surgery
during both insertion and
removal of the rods
Safe to use while breast-feeding Chances of infection at
insertion site
Can be used by those for whom
estrogen is contraindicated
Reduces cramps and pain
during menstruation
Dr
Smriti/
Dr.
Leela
75. NORPLANT: SIDE EFFECTS
Irregular menstrual periods
Breast discomfort
Fluid retention
Increase in acne
Dr
Smriti/
Dr.
Leela
78. DEPOPROVERA
DEPOPROVERA a contraceptive method for women.
It contains medroxyprogesterone acetate
Mode of Action:
Due to the action of progesterone
Duration of Effectiveness: 3 months
Failure Rate: 0.2 %- 6 %
Contraceptive Prevalence Rate: 8.9%(NDHS 2016)
Couple Years of Protection(CYP): 4 Inj= 1 CYP
Dr
Smriti/
Dr.
Leela
79. DEPOPROVERA
Advantages:
Eliminates need for daily medication as in cases of
OCPs
Can be used safely during lactation.
No estrogen related side effects
Reduction in menorrhagia and dysmenorrhoea.
Side effects :
Increase in weight
Irregular menstrual bleeding
Occasional phase of amenorrhea
Dr
Smriti/
Dr.
Leela
82. MEDABON..
Combipack for medical termination of pregnancy
before 9 weeks(63 days).
Composition: Mifepristone 200 mg tablet and
Misoprostol 4 x 200microgram tablets
Therapeutic indications: for medical termination of
developing intra-uterine pregnancy of up to 63 days
of amenorrhoea.
Dr
Smriti/
Dr.
Leela
83. Medabon…
• Method of administration
200mg of mifepristone (one tablet) is taken in a
single oral dose, followed 36 to 48 hours later, by the
administration of misoprostol 800 micrograms (i.e. 4
vaginal tablets of 0.2mg each) vaginally in a single
dose.
If the patient vomits shortly after administration of
mifepristone, she should inform the doctor.
Dr
Smriti/
Dr.
Leela
84. MOA:
Mifepristone induces softening and dilatation of the cervix,
Softening and dilatation has been shown to be detectable from 24
hours after administration of mifepristone and increases to a
maximum at approximately 36 - 48 hours after administration.
Misoprostol is a synthetic analogue of prostaglandin E1.
At the recommended dosages, misoprostol induces contractions of
the smooth muscle in the myometrium and relaxation of the
uterine cervix.
The uterotonic properties of misoprostol should facilitate cervical
opening and evacuation of the product of conception.
Dr
Smriti/
Dr.
Leela
85. Contraindication
Pregnancy beyond 63 days of amenorrhoea
Confirmed or suspected extra-uterine pregnancy
Previous known allergy to prostaglandins
Severe asthma uncontrolled by therapy.
Dr
Smriti/
Dr.
Leela
86. BIRTHING KIT OR CLEAN DELIVERY KIT OR (SUTKERI
SAAMAGRI)
It contains:
1. Sterile Razor Blade
2. Plastic Disc
3. Antibacterial Soap
4. Clean Thread
5. Plastic Sheet
6. Pictorial instruction-to show correct use of
kit components
Delivery kits are pre-packaged, single
use, disposable kits that contain
essential items for conducting a clean
delivery.
Dr
Smriti/
Dr.
Leela
87. Post Partum Contraceptives
• Most contraceptives are not harmful to child but many
decrease lactation
• Devices that can be used:
• progestin-only pill (POP) also called the “mini-pill”
• birth control injection (Depo-Provera)
• progesterone-releasing IUD (Mirena)
• birth control implant
• barrier methods
88
88. Post – conceptional methods (Termination of
pregnancy)
1. Menstrual regulation
Aspiration of the uterine contents 6 to 14 days of missed
period, but before most pregnancy tests can accurately
determine whether or not a women is pregnant.
The immediate complications are uterine perforation and
trauma. Late complication (after 6 weeks) include a tendency to
abortion or premature labour, infertility, menstrual disorders,
increase in ectopic pregnancies and Rh- immunization.
89. 2. Menstrual induction
intrauterine application of 1-5 mg solution (or 2.5 – 5 mg pellet) of
prostaglandin F2.
3. Oral abortifacient
•The commonly used regimen is mifepristone(RU 486) 200 mg
orally on day 1, followed by misoprostol 800 mcg vaginally either
immediately or within 6 – 8 hours.
•95 % successful in terminating pregnancies upto 9 weeks
•follow – up visit 14 days
90. MISCELLANEOUS
1. Abstinence
2. Coitus interrupts
• male withdraws before ejaculation, and thereby
tries to prevent deposition of semen into the
vagina
• failure rate- unto 25 percent
3. Safe period (rhythm/calendar method)
• shortest cycle minus 18 days gives the first day
of the fertile period.
• longest cycle minus 10 days gives the last day of
the fertile period.
91. 3.Natural family planning methods
a. Basal body temperature (BBT) method
• Rise of BBT at the time of ovulation - progesterone
• 0.3-0.5 C
b. Cervical mucus method
• “billings method” or “ovulation method”
• ovulation -watery clear resembling raw egg white,
Smooth, Slippery and profuse
• After ovulation -thickens and less(prog)
c. Symptothermic method
combines temperature, cervical mucus and calendar
techniques
4.Breast – feeding
5.Birth control vaccine
beta sub – unit of hCG -clinical trial
92. FAMILY PLANNING METHODS
1. Barrier Methods
i. Physical methods
ii. Chemical methods
iii. Combined methods
2. Intrauterine devices
3. Hormonal Methods
4. Post-Conceptional
methods
5. Miscellaneous
Spacing Methods Terminal Methods (Permanent)
1. Male Sterilization
2. Female Sterilization
1. Condom - male and female
2. Diaphragm
3. Vaginal Sponge
1. Foams
2. Creams, jellies & pastes
3. Suppositories
4. Soluble films
*Conventional contraceptives
93. Guidelines:
• Age of husband 25-50
• Age of wife: 20-45
• 2 living children
• If more than 3 child…..lower limit of age
relaxed
• If acceptor declares …consent of his/her
spouse
94. Male sterilisation
A.) Penis; B.) Urethra; C.)
Scrotum; D.) Testicle; E.)
Epididymis; F.)
Vasectomy; G.) Prostate;
H.) Seminal vesicle; I.)
Bladder; J.) Pubic K.) Vas
deferens
95. • At least 30 ejaculations
• Use contraceptives until aspermia
• Avoid bath for 24 hrs
• Scrotal support-15 days
• Avoid heavy lifting -15 days
• Post Operative Advice:-
98. Patient selection
• HB: >8 gm
• After 6wks of delivery-Laparoscopy
• Minilap can be done Post-partem
• No concurrent medical disorders
• RISKS
• internal bleeding and infection or damage to
other organs
• failure - rare (about 1 in 200 women)
• ectopic pregnancy
100. Abortion Law of Nepal
• Legalized in March 2002
• Implementation of legal services, was approved by the cabinet on December 25,
2003
• Only listed (trained) doctors or health workers can provide safe abortion services
at listed (approved) health facilities, under the following conditions:
• Within the first 12 weeks of pregnancy for any woman on her request. The
permission of husband or guardian is not required for women above 16 years
of age
• Within the first 18 weeks of pregnancy in cases of rape and incest
• At any time if the pregnancy poses danger to the life or physical or mental
health of the pregnant woman or the foetus is seriously deformed and it is
recommended by a doctor. 111
101. Abortion Law of Nepal
• In 2004, a Safe abortion policy was developed in order
to ensure the availability of safe and legal services
which states that pregnancy termination shall not be
performed based on sex selection
• Will be punishable if abortion is performed without
the consent of the pregnant women
• No pro-natalist policy or norms of the government on
the number of child
• Abortion should not be used as a method of family
planning.
112
102. TYPE COMPOSITION FAILURE CPR CYP
•OCP 1. Levonorgestrel 0.3 mg
2. Ethinylestradiol 0.03 mg
3. Ferrous Fumarate 75 mg
0.1-0.3% 4.6% 13 Pill
Cycle=1
CYP
•Norplant Levonorgesterol
36mg/Cap-6
75mg/Cap-2
0.2-1.2% 3.3% 5
•IUD
Cu T 380 A
Copper 380mm2 0.2-0.8% 1.4% 8
•Condom
Male
Female
Made of Latex or Skin
Polyurethrene
Polyisoprene
2-3% 4.2% 150
Condom
=1 CYP
•Depo-
Provera
Medroxyprogesterone
Acetate
0.2-6% 8.9% 4 Depo=1CYP
Dr
Smriti/
Dr.
Leela
