Family planning

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Family planning

  1. 1. Calendar Method<br /><ul><li>Calendar or Rhythm method is based on assumptions that ovulation tends to occur 14 days (plus or minus 2 days) before the start of the next menstrual period, that sperm are viable for up to 5 days, and that the ovum is viable for about 24 hours.
  2. 2. To use this method, the woman must record her menstrual cycles for 6 to 8 months to identify the shortest and longest cycles. The first day of menstruation is the first day of cycle. The fertile phase is calculated from 18 days before the end of the shortest recorded cycle through 11 days from the end of the longest recorded cycle.
  3. 3. For example, if a woman’s cycle lasts from 24 to 28 days, the fertile phase would be calculated as day 6 through day 17. Once this information is obtained, the woman can identify the fertile phase and the infertile phase of her cycle.</li></ul>Basal Body Temperature<br /><ul><li>Method to detect ovulation.
  4. 4. Requires woman to take BBT every morning upon awakening before any activity and record the readings on a temperature graph by the use of BBT thermometer
  5. 5. Woman with regular cycles should be able to predict when ovulation will occur. The method is Based on the fact that temperature sometimes drops just before ovulation and almost always rises and remains elevated for several days after.
  6. 6. Temperature rise occurs in response to the increased progesterone levels that occur in the second half of the cycle.
  7. 7. To avoid conception, the couple abstains from intercourse on the day of the temperature rise and for 3 days after. Because temperature rise does not occur until after ovulation, a woman who had intercourse just before the rise is at risk of pregnancy. To decrease risk, some couples abstain from intercourse for several days before the anticipated time of ovulation and then for 3 days after.</li></ul>Cervical Mucus Method<br /><ul><li>Sometimes called Ovulation Method or Billing’s method.
  8. 8. Involves assessment of cervical mucus that occurs during menstrual cycle.
  9. 9. The amount and character of cervical mucus change because of the influence of estrogen and progesterone.
  10. 10. During the follicular phase of the cycle(from the end of menses prior to ovulation),cervical mucus is thin and scanty, and may be even more absent. At the time of ovulation, the mucus (Estrogen-dominant mucus)is clearer, more stretchable(a quality called spinnbarkheit), and more permeable to sperm. During the Luteal phase (following ovulation through the time just prior to the onset of menses), Cervical mucus is thick and sticky (Progesterone-dominant mucus) and forms a network that traps sperm, making passage difficult.
  11. 11. Prior to using the cervical mucus method, the woman abstains from intercourse for entire menstrual cycle, during which she assess her cervical mucus daily for amount, feeling of slipperiness or wetness, color, clearness, and spinnbarkheit.</li></ul>Symptothermal method<br /><ul><li>Consists of various assessments made and recorded by the couple.
  12. 12. Includes information regarding cycle length, coitus, cervical mucus changes, and secondary signs such as increased libido, abdominal bleating, mittelschmerz (midcycle abdominal pain), and BBT.
  13. 13. Through various assessments, the couple learns to recognize signs that include ovulation. This combined approach tends to improve the effectiveness of fertility awareness as a method of birth control and is the best taught by an expert in the method.</li></ul> <br />Coitus Interruptus<br /><ul><li>Or Withdrawal is one of the oldest and least reliable methods of contraception. This method requires that the male withdraw from the Female’s vagina when he feels ejaculation is impending. He then ejaculates away from the external genitalia of the woman.
  14. 14. Failure tends to occur for two reasons:
  15. 15. This method demands great self-control on the part of the man, who must withdraw it just as he feels the urge for deeper penetration with impending orgasm.
  16. 16. Some preejaculatory fluid, which can contain sperm, may escape from the penis during the excitement phase prior to ejaculation. Because the quantity of sperm in this preejaculatory fluid is increased after a recent ejaculation, this is especially significant for couples who engage in repeated episodes of orgasm within a short period of time.
  17. 17. Couples who use this method should be aware of emergency postcoital contraceptive options should the man fail to withdraw in time.</li></ul>Male Condom<br /><ul><li> Is small, light weight, disposable and inexpensive.
  18. 18. Has no side effects, requires no medical examination or supervision.
  19. 19. Condom is applied on erect penis, rolled from the tip to the end of the shaft, before vulvar or vaginal contact.
  20. 20. Most condoms have reservoir tip to allow for collection of ejaculate. When using a condom without a reservoir end, a small space must be left at the end to collect the ejaculate, so that the condom does not break at the time of ejaculation.
  21. 21. Care must be taken in removing the condom after intercourse. For optimal effectiveness, the man should withdraw his penis from the vagina while it is still erect and hold the condom rim to prevent spillage.</li></ul>Female Condom<br /><ul><li>Is a thin polyurethane sheath with a flexible ring at each end.
  22. 22. The inner ring, at the closed end of the condom, serves as the means of insertion and fits over the cervix like a diaphragm. The second ring remains outside the vagina and covers a portion of the woman’s perineum. It also covers the base of the man’s penis during intercourse.
  23. 23. A woman needs to be careful not to twist the sheath when she inserts the condom, because twisting makes male penetration possible.</li></ul>Diaphragm<br /><ul><li>Consists of a steel band that forms a ring and is covered with rubber so that when diaphragm is inserted, the ring lodges high in the vagina with the rubber covering of the cervix.
  24. 24. It is used with spermicidal cream or jelly and offers a good level of protection from conception.
  25. 25. Three types of diaphragm are available: the flat spring, coil spring and the arcing spring.
  26. 26. Diaphragm must be inserted before intercourse, with approximately one teaspoonful (or 1.5 inches from the tube) of spermicidal jelly placed around in its rim and in the cup.</li></ul>Cervical Cap <br /><ul><li>Is a cup shaped device, used with spermicidal cream or jelly, the fits snugly over the cervix and is held in place by suction and by positive abdominal pressure.
  27. 27. Effectiveness rates and method of insertion are similar to those for the diaphragm.
  28. 28. Cervical cap should be inserted without rushing, ahead of possible intercourse.
  29. 29. A new form of cervical cap is currently under review. This cap looks like a small sailor’s cap and is made of soft silicone. The “dome” of the cap fits over the cervix while the soft “brim” flares out slightly and conforms to the shape of the vagina. A strap placed over the dome permits easier removal.</li></ul>Vaginal Sponge<br /><ul><li>Available without prescription.
  30. 30. Is a pillow-shaped, soft, absorbent synthetic sponge containing a spermicide.
  31. 31. It is made with a concave cupped area on one side, which is designed to fit over the cervix. It also has a loop for easier removal.
  32. 32. The sponge acts as a contraceptive by releasing the spermicide nonoxymol-9 gradually over a 24 hour period.
  33. 33. Professional fitting is not required, it may be used for up to 24 hours, one size fits all and acts as both a barrier and a spermicide.</li></ul>Intrauterine device (IUD)<br /><ul><li>Is designed to be inserted into the uterus by a qualified health care provider and left in place for an extended period. Providing continuous contraceptive protection.
  34. 34. Advantages of IUD include high rate of effectiveness, continuous contraceptive protection, no coitus-related activity, and relative inexpensiveness over time.
  35. 35. Two IUDs are currently available. The copper T380A (Paragard) is highly effective IUD that can be left in place for up to 10 years. Copper cover parts of the stem and arms of the device. </li></ul>Combined Oral contraceptives (COCs)<br /><ul><li>Commonly called birth control pills or “the pill”.
  36. 36. Are combination of a synthetic estrogen and progestin.
  37. 37. One of the most popular contraceptive options available to women.
  38. 38. Are safe, highly effective and rapidly reversible.
  39. 39. Taken daily for 21 days ,following one of the two methods:
  40. 40. Day-one start – the woman begins taking the pill the first day of her menstrual cycle. This method prevents ovulation in the first cycle, so no backup method of contraception is needed
  41. 41. Sunday start- the woman begins taking the pill on the Sunday after the first day of the menstrual cycle and ending on a Saturday. In most cases, menses will occur 1 to 4 days after the last pill is taken. The Sunday start is common because it tends to prevent periods on weekends. however, a backup method of contraception is necessary during the first month of use</li></ul>Vaginal Contraceptive ring<br /><ul><li>Another form of low-dose, sustained-release combined hormonal contraceptive.
  42. 42. Is a flexible, soft vaginal ring that is inserted monthly.
  43. 43. One size ring fits virtually all women.
  44. 44. Women with marked vaginal prolapsed should be cautioned to check for expulsion of the ring during early use.</li></ul>Subdermal Implants (Norplant)<br /><ul><li>Consist of Silastic capsules containing levonorgestrel, a progestin, which are implanted in the woman’s arm.
  45. 45. Are effective for up to 5 years in the woman’s arm.
  46. 46. Typically, six rods are inserted, although the manufacturer is currently developing norplant II, which uses only two rods.
  47. 47. Prevents ovulation in most women.
  48. 48. Stimulates the production of thick cervical mucus, which inhibits sperm penetration.
  49. 49. Provides effective continuous contraception that is removed from the act of coitus.
  50. 50. Women should be advised that the implant may be visible, especially in very slender users, and that it requires a minor surgical procedure to insert and remove implants
  51. 51. Possible side effects include spotting, irregular bleeding or amenorrhea, an increased incidence of ovarian cysts, weight gain, headaches, fluid retention, acne, hair loss, mood changes and depression</li></ul>Transdermal Hormonal Contraception<br /><ul><li>Roughly the size of a silver dollar, but square.
  52. 52. Combined hormonal contraception can now be provided transdermally using a weekly contraceptive skin patch.
  53. 53. This patch is applied weekly for 3 weeks on one of four sites : the woman’s abdomen, buttocks, upper outer arm, or trunk (excluding breasts).
  54. 54. The patch is highly effective in women who weigh less than 198 pounds.
  55. 55. Patch users follow the same options for starting as users or oral contraception- Sunday start or day-one start.
  56. 56. The Patch is a safe and effective as COCs and has a better rate of user compliance.</li></ul>Depot-Medroxyprogesterone acetate (DMPA) (DEPO-PROVERA)<br /><ul><li>Provides highly effective birth control for 3 months.
  57. 57. Administered as a single IM injection of 150 mg.
  58. 58. Acts primarily by suppressing ovulation. DMPA Provides levels of progesterone high enough to block the luteinizing hormone surge, thereby suppressing the ovulation.
  59. 59. Also thickens the cervical mucus to block sperm penetration.
  60. 60. Side effects include menstrual irregularities, headache, weight gain, breast tenderness and depression.
  61. 61. Is safe, convenient, private, and relatively inexpensive.</li></ul>Vasectomy<br /><ul><li>Involves surgically severing the vas deferens in both sides of the scrotum.
  62. 62. It takes about 4 to 6 weeks and 6 to 36 ejaculations to clear the remaining sperm from the vas deference.
  63. 63. Side effects of vasectomy include pain, infection, hematoma, sperm granulomas and spontaneous reanastomosis (reconnecting).</li></ul>Tubal Ligation<br /><ul><li>During this procedure, Tubes are ligated, clipped, electro coagulated, banded or plugged. This interrupts the patency of the fallopian tube, thus preventing the ovum and the sperm from meeting.
  64. 64. Complications of female sterilization procedures include coagulation burns on the bowel, bowel perforation, pain, infection, hemorrhage, and adverse anesthesia effects.
  65. 65. Reversal of a tubal ligation depends on the type of procedure performed.

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