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Estimated Annual Cases of STD’s
(source: WHO)
• More than 1 million sexually transmitted
infections (STIs) are acquired every day
worldwide.
• Each year, there are estimated 357 million new
infections with 1 of 4 STIs: chlamydia (131
million), gonorrhoea (78 million), syphilis (5.6
million) and trichomoniasis (143 million).
• 15.3 million in U.S.
Estimated Annual Cases of STDs, U.S.
(American Social Health Association, Dec 1998, “STD’s: How many at What Cost?”)
• Human Papilloma Virus 5,500,000
• Tichomoniasis 5,000,000
• Chlamydia 3,000,000
• Herpes 1,000,000
• Gonorrhea 650,000
• Hepatitis B 77,000
• Syphilis 70,000
• HIV 20,000
• total 15,317,000
CONCEPT OF FAMILY PLANNING
GOALS OF FAMILY PLANNING
OPERATIONAL GOAL
• Prevent voluntary
acceptance of small
family norms.
• To motivate peoples.
• To ensure the easy
availability of
contraceptive.
• To arrange medical &
surgical services.
DEMOGRAPHIC GOAL
• To population control.
• To reduce infant mortality
rate.
• To reduce maternal
mortality rate.
• Universal immunization.
• Prevention of
communicable disease.
SCOPE OF FAMILY PLANNING
(ACC. TO WHO)
• Proper spacing between birth.
• Limited no. of birth.
• Diagnosis of reproductive tract disease.
• Pregnancy test.
• Provided services to unmarried mothers.
• Preparing for first birth.
• Sex education.
• Genetic counselling.
• Marital guidance.
• Adoption service.
Contraception or Birth control
Types of Birth Control
• Hormonal
• Barrier
• IUD
• Methods based on
information
• Permanent sterilization
R
Hormonal Methods
• Oral Contraceptives
(Birth Control Pill)
• Injections (Depo-Provera)
• Implants (Norplant I & II)
Birth Control Pills• Pills can be taken to prevent pregnancy
• Pills are safe and effective when taken properly
• Pills are over 99% effective
• Women must have a pap smear to get a prescription for birth control
pills
• Pills DO NOT prevent STD’s
How does the pill work?
• Stops ovulation
• Thins uterine lining
• Thickens cervical mucus
Positive Benefits of Birth Control Pills
 Prevents pregnancy
 Eases menstrual
cramps
 Shortens period
 Regulates period
Decreases
incidence of
ovarian cysts
Prevents ovarian and
uterine cancer
Decreases acne
•
•
•
Breast tenderness
Nausea
Increase in
headaches
•
•
•
Moodiness
Weight change
Spotting
Side-effects
Taking the Pill
• Once a day at the same time everyday
• Use condoms for first month
• Use condoms when on antibiotics
• Use condoms for 1 week if you miss a pill or
take one late
• The pill offers no protection from STD’s
Depo-Provera
• Birth control shot given once every
three months to prevent pregnancy
• 99.7% effective preventing pregnancy
• No daily pills to remember
How does the shot work?
• The same way as the Pill!
• Stops ovulation
• Stops menstrual cycles!!
• Thickens cervical mucus
SIDE EFFECTS
• Extremely irregular menstrual bleeding and
spotting for 3-6 months!
• NO PERIOD  after 3-6 months
• Weight change
• Breast tenderness
• Mood change
*NOT EVERY WOMAN HAS SIDE-EFFECTS!
The Patch
IMPLANTS
• Implants are placed in the body filled with
hormone that prevents pregnancy
• Physically inserted in simple 15 minute
outpatient procedure
• Plastic capsules the size of paper matchsticks
inserted under the skin in the arm
• 99.95% effectiveness rate
Norplant I vs. Norplant II
• Six capsules
• Five years
• Two capsules
• Three years
The pill works in several ways to
prevent pregnancy. The pill
suppresses ovulation so that an
egg is not released from the
ovaries, and changes the cervical
mucus, causing it to become
thicker and making it more
difficult for sperm to swim into
the womb. The pill also does not
allow the lining of the womb to
develop enough to receive and
nurture a fertilized egg. This
method of birth control offers no
protection against sexually-
transmitted diseases.
Norplant Implant
Norplant Considerations
• Should be considered long term birth
control
• Requires no upkeep 
• Extremely effective in pregnancy
prevention > 99%
Emergency contraception pills can reduce
the chance of a pregnancy by 75% if
taken within 72 hours of unprotected sex!
Emergency Contraception
Emergency Contraception (ECP)
• Must be taken within 72 hours of the act of
unprotected intercourse or failure of
contraception method
• Must receive ECP from a physician
• 75 – 84% effective in reducing pregnancy
ECP
• Floods the ovaries with high amount of
hormone and prevents ovulation
• Alters the environment of the uterus, making it
disruptive to the egg and sperm
• Two sets of pills taken exactly 12 hours apart
BARRIER METHODS
• Spermicides
• Male Condom
• Female Condom
• Diaphragm
• Cervical Cap
BARRIER METHOD
• Prevents pregnancy blocks the egg and
sperm from meeting
• Barrier methods have higher failure rates
than hormonal methods due to design and
human error
SPERMICIDES• Chemicals kill sperm in the vagina
• Different forms:
-Jelly
-Foam
-Film
-Suppository
• Some work instantly, others require pre-insertion
• Only 76% effective (used alone), should be used in combination
with another method i.e., condoms
MALE CONDOM
• Most common and effective barrier method when used properly
• Latex and Polyurethane should only be used in the prevention of
pregnancy and spread of STD’s (including HIV)
MALE CONDOM
• Perfect effectiveness rate = 97%
• Typical effectiveness rate = 88%
• Latex and polyurethane condoms are
available
• Combining condoms with spermicides
raises effectiveness levels to 99%
FEMALE CONDOM
• Made as an alternative to male condoms
• Polyurethane
• Physically inserted in the vagina
• Perfect rate = 95%
• Typical rate = 79%
• Woman can use female condom if partner
refuses
Reality  : The Female Condom
The female condom is a
lubricated polyurethane sheath,
similar in appearance to a male
condom. It is inserted into the
vagina. The closed end covers
the cervix. Like the male condom,
it is intended for one-time use
and then discarded.
Vaginal Ring (NuvaRing)
• 95-99% Effective A new ring is inserted into the vagina
each month
• Does not require a "fitting" by a health care provider,
does not require spermicide, can make periods more
regular and less painful, no pill to take daily, ability to
become pregnant returns quickly when use is stopped.
NuvaRing is a flexible
plastic (ethylene-vinyl
acetate copolymer)
ring that releases a
low dose of a
progestin and an
estrogen over 3
weeks.
DIAPRAGHM
• Perfect Effectiveness Rate = 94%
• Typical Effectiveness Rate = 80%
• Latex barrier placed inside vagina during
intercourse
• Fitted by physician
• Spermicidal jelly before insertion
• Inserted up to 18 hours before intercourse and
can be left in for a total of 24 hours
DIAPHRAGM
The diaphragm is a flexible rubber cup that is filled with spermicide and self-inserted over
the cervix prior to intercourse. The device is left in place several hours after intercourse.
The diaphragm is a prescribed device fitted by a health care professional and is more
expensive than other barrier methods, such as condoms
CERVICAL CAP
• Latex barrier inserted in vagina before
intercourse
• “Caps” around cervix with suction
• Fill with spermicidal jelly prior to use
• Can be left in body for up to a total of 48 hours
• Must be left in place six hours after sexual
intercourse
• Perfect effectiveness rate = 91%
• Typical effectiveness rate = 80%
Cervical Cap
The cervical cap is a flexible rubber cup-like device that is filled with spermicide and self-
inserted over the cervix prior to intercourse. The device is left in place several hours after
intercourse. The cap is a prescribed device fitted by a health care professional and can
be more expensive than other barrier methods, such as condoms.
Sponge
The sponge is inserted by the
woman into the vagina and covers
the cervix blocking sperm from
entering the cervix. The sponge
also contains a spermicide that kills
sperm. It is available without a
prescription
INTRAUTERINE DEVICES
(IUD)
• T-shaped object placed in the
uterus to prevent pregnancy
• Must be on period during
insertion
• A Natural childbirth required to
use
IUD
• Extremely effective without
using hormones > 97 %
• Must be in monogamous
relationship
The intrauterine device (IUD) shown uses copper as the active
contraceptive, others use progesterone in a plastic device. IUDs are very
effective at preventing pregnancy (less than 2% chance per year for the
progesterone IUD, less than 1% chance per year for the copper IUD).
IUDs come with increased risk of ectopic pregnancy and perforation of the
uterus and do not protect against sexually transmitted disease. IUDs are
prescribed and placed by health care providers.
Copper T vs.. Progestasert
• 10 years
• 99.2 % effective
• Copper on IUD acts as
spermicide, IUD blocks
egg from implanting
• Must check string before
sex and after shedding of
uterine lining.
• 1 year
• 98% effective
• T shaped plastic that
releases hormones over
a one year time frame
• Thickens mucus, blocking
egg
• Check string before sex &
after shedding of uterine
lining.
STERILIZATION
• Procedure performed on a man or a
woman permanently sterilizes
• Female = Tubal Ligation
• Male = Vasectomy
TUBAL LIGATION
• Surgical procedure performed on a woman
• Fallopian tubes are cut, tied, cauterized, prevents eggs from
reaching sperm
• Failure rates vary by procedure, from 0.8%-3.7%
• May experience heavier periods
Surgical sterilization which
permanently prevents the
transport of the egg to the uterus
by means of sealing the fallopian
tubes is called tubal ligation,
commonly called "having one's
tubes tied." This operation can be
performed laparoscopically or in
conjunction with a Cesarean
section, after the baby is
delivered. Tubal ligation is
considered permanent, but
surgical reversal
can be performed in some cases
LAPAROSCOPY-’BAND-AID’
STERILIZATION
VASECTOMY
• Male sterilization procedure
• Ligation of Vas Deferens tube
• No-scalpel technique available
• Faster and easier recovery than a tubal
ligation
• Failure rate = 0.1%, more effective than
female sterilization
During a vasectomy (“cutting the vas”) a urologist cuts
and ligates (ties off) the ductus deferens. Sperm are still
produced but cannot exit the body. Sperm eventually
deteriorate and are phagocytized. A man is sterile, but
because testosterone is still produced he retains his sex
drive and secondary sex characteristics.
METHODS BASED ON
INFORMATION
• Withdrawal
• Natural Family Planning
• Fertility Awareness Method
• Abstinence
WITHDRAWAL
• Removal of penis from the vagina before ejaculation occurs
• NOT a sufficient method of birth control by itself
• Effectiveness rate is 80% (very unpredictable in teens, wide variation)
• 1 of 5 women practicing withdrawal become pregnant
• Very difficult for a male to ‘control’
Natural Family Planning &
Fertility Awareness Method
EXCELLENT REFERENCE SEE:
www.plannedparenthood.org/bc Hatcher,
Robert, MD
Contraceptive Technology ,17ed. (2001)
https://www.who.int/en/news-room/fact-
sheets/detail/sexually-
transmitted-infections-(stis)

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Lesson plan on family planning and contraception

  • 1.
  • 2. Estimated Annual Cases of STD’s (source: WHO) • More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide. • Each year, there are estimated 357 million new infections with 1 of 4 STIs: chlamydia (131 million), gonorrhoea (78 million), syphilis (5.6 million) and trichomoniasis (143 million). • 15.3 million in U.S.
  • 3. Estimated Annual Cases of STDs, U.S. (American Social Health Association, Dec 1998, “STD’s: How many at What Cost?”) • Human Papilloma Virus 5,500,000 • Tichomoniasis 5,000,000 • Chlamydia 3,000,000 • Herpes 1,000,000 • Gonorrhea 650,000 • Hepatitis B 77,000 • Syphilis 70,000 • HIV 20,000 • total 15,317,000
  • 4. CONCEPT OF FAMILY PLANNING
  • 5. GOALS OF FAMILY PLANNING OPERATIONAL GOAL • Prevent voluntary acceptance of small family norms. • To motivate peoples. • To ensure the easy availability of contraceptive. • To arrange medical & surgical services. DEMOGRAPHIC GOAL • To population control. • To reduce infant mortality rate. • To reduce maternal mortality rate. • Universal immunization. • Prevention of communicable disease.
  • 6. SCOPE OF FAMILY PLANNING (ACC. TO WHO) • Proper spacing between birth. • Limited no. of birth. • Diagnosis of reproductive tract disease. • Pregnancy test. • Provided services to unmarried mothers. • Preparing for first birth. • Sex education. • Genetic counselling. • Marital guidance. • Adoption service.
  • 8. Types of Birth Control • Hormonal • Barrier • IUD • Methods based on information • Permanent sterilization R
  • 9.
  • 10. Hormonal Methods • Oral Contraceptives (Birth Control Pill) • Injections (Depo-Provera) • Implants (Norplant I & II)
  • 11. Birth Control Pills• Pills can be taken to prevent pregnancy • Pills are safe and effective when taken properly • Pills are over 99% effective • Women must have a pap smear to get a prescription for birth control pills • Pills DO NOT prevent STD’s
  • 12. How does the pill work? • Stops ovulation • Thins uterine lining • Thickens cervical mucus
  • 13. Positive Benefits of Birth Control Pills  Prevents pregnancy  Eases menstrual cramps  Shortens period  Regulates period Decreases incidence of ovarian cysts Prevents ovarian and uterine cancer Decreases acne • • • Breast tenderness Nausea Increase in headaches • • • Moodiness Weight change Spotting Side-effects
  • 14. Taking the Pill • Once a day at the same time everyday • Use condoms for first month • Use condoms when on antibiotics • Use condoms for 1 week if you miss a pill or take one late • The pill offers no protection from STD’s
  • 15. Depo-Provera • Birth control shot given once every three months to prevent pregnancy • 99.7% effective preventing pregnancy • No daily pills to remember
  • 16. How does the shot work? • The same way as the Pill! • Stops ovulation • Stops menstrual cycles!! • Thickens cervical mucus
  • 17. SIDE EFFECTS • Extremely irregular menstrual bleeding and spotting for 3-6 months! • NO PERIOD  after 3-6 months • Weight change • Breast tenderness • Mood change *NOT EVERY WOMAN HAS SIDE-EFFECTS!
  • 19. IMPLANTS • Implants are placed in the body filled with hormone that prevents pregnancy • Physically inserted in simple 15 minute outpatient procedure • Plastic capsules the size of paper matchsticks inserted under the skin in the arm • 99.95% effectiveness rate
  • 20. Norplant I vs. Norplant II • Six capsules • Five years • Two capsules • Three years The pill works in several ways to prevent pregnancy. The pill suppresses ovulation so that an egg is not released from the ovaries, and changes the cervical mucus, causing it to become thicker and making it more difficult for sperm to swim into the womb. The pill also does not allow the lining of the womb to develop enough to receive and nurture a fertilized egg. This method of birth control offers no protection against sexually- transmitted diseases.
  • 22. Norplant Considerations • Should be considered long term birth control • Requires no upkeep  • Extremely effective in pregnancy prevention > 99%
  • 23. Emergency contraception pills can reduce the chance of a pregnancy by 75% if taken within 72 hours of unprotected sex! Emergency Contraception
  • 24. Emergency Contraception (ECP) • Must be taken within 72 hours of the act of unprotected intercourse or failure of contraception method • Must receive ECP from a physician • 75 – 84% effective in reducing pregnancy
  • 25. ECP • Floods the ovaries with high amount of hormone and prevents ovulation • Alters the environment of the uterus, making it disruptive to the egg and sperm • Two sets of pills taken exactly 12 hours apart
  • 26. BARRIER METHODS • Spermicides • Male Condom • Female Condom • Diaphragm • Cervical Cap
  • 27. BARRIER METHOD • Prevents pregnancy blocks the egg and sperm from meeting • Barrier methods have higher failure rates than hormonal methods due to design and human error
  • 28. SPERMICIDES• Chemicals kill sperm in the vagina • Different forms: -Jelly -Foam -Film -Suppository • Some work instantly, others require pre-insertion • Only 76% effective (used alone), should be used in combination with another method i.e., condoms
  • 29. MALE CONDOM • Most common and effective barrier method when used properly • Latex and Polyurethane should only be used in the prevention of pregnancy and spread of STD’s (including HIV)
  • 30. MALE CONDOM • Perfect effectiveness rate = 97% • Typical effectiveness rate = 88% • Latex and polyurethane condoms are available • Combining condoms with spermicides raises effectiveness levels to 99%
  • 31. FEMALE CONDOM • Made as an alternative to male condoms • Polyurethane • Physically inserted in the vagina • Perfect rate = 95% • Typical rate = 79% • Woman can use female condom if partner refuses
  • 32. Reality  : The Female Condom The female condom is a lubricated polyurethane sheath, similar in appearance to a male condom. It is inserted into the vagina. The closed end covers the cervix. Like the male condom, it is intended for one-time use and then discarded.
  • 33. Vaginal Ring (NuvaRing) • 95-99% Effective A new ring is inserted into the vagina each month • Does not require a "fitting" by a health care provider, does not require spermicide, can make periods more regular and less painful, no pill to take daily, ability to become pregnant returns quickly when use is stopped. NuvaRing is a flexible plastic (ethylene-vinyl acetate copolymer) ring that releases a low dose of a progestin and an estrogen over 3 weeks.
  • 34. DIAPRAGHM • Perfect Effectiveness Rate = 94% • Typical Effectiveness Rate = 80% • Latex barrier placed inside vagina during intercourse • Fitted by physician • Spermicidal jelly before insertion • Inserted up to 18 hours before intercourse and can be left in for a total of 24 hours
  • 35. DIAPHRAGM The diaphragm is a flexible rubber cup that is filled with spermicide and self-inserted over the cervix prior to intercourse. The device is left in place several hours after intercourse. The diaphragm is a prescribed device fitted by a health care professional and is more expensive than other barrier methods, such as condoms
  • 36. CERVICAL CAP • Latex barrier inserted in vagina before intercourse • “Caps” around cervix with suction • Fill with spermicidal jelly prior to use • Can be left in body for up to a total of 48 hours • Must be left in place six hours after sexual intercourse • Perfect effectiveness rate = 91% • Typical effectiveness rate = 80%
  • 37. Cervical Cap The cervical cap is a flexible rubber cup-like device that is filled with spermicide and self- inserted over the cervix prior to intercourse. The device is left in place several hours after intercourse. The cap is a prescribed device fitted by a health care professional and can be more expensive than other barrier methods, such as condoms.
  • 38. Sponge The sponge is inserted by the woman into the vagina and covers the cervix blocking sperm from entering the cervix. The sponge also contains a spermicide that kills sperm. It is available without a prescription
  • 39. INTRAUTERINE DEVICES (IUD) • T-shaped object placed in the uterus to prevent pregnancy • Must be on period during insertion • A Natural childbirth required to use IUD • Extremely effective without using hormones > 97 % • Must be in monogamous relationship The intrauterine device (IUD) shown uses copper as the active contraceptive, others use progesterone in a plastic device. IUDs are very effective at preventing pregnancy (less than 2% chance per year for the progesterone IUD, less than 1% chance per year for the copper IUD). IUDs come with increased risk of ectopic pregnancy and perforation of the uterus and do not protect against sexually transmitted disease. IUDs are prescribed and placed by health care providers.
  • 40. Copper T vs.. Progestasert • 10 years • 99.2 % effective • Copper on IUD acts as spermicide, IUD blocks egg from implanting • Must check string before sex and after shedding of uterine lining. • 1 year • 98% effective • T shaped plastic that releases hormones over a one year time frame • Thickens mucus, blocking egg • Check string before sex & after shedding of uterine lining.
  • 41. STERILIZATION • Procedure performed on a man or a woman permanently sterilizes • Female = Tubal Ligation • Male = Vasectomy
  • 42. TUBAL LIGATION • Surgical procedure performed on a woman • Fallopian tubes are cut, tied, cauterized, prevents eggs from reaching sperm • Failure rates vary by procedure, from 0.8%-3.7% • May experience heavier periods Surgical sterilization which permanently prevents the transport of the egg to the uterus by means of sealing the fallopian tubes is called tubal ligation, commonly called "having one's tubes tied." This operation can be performed laparoscopically or in conjunction with a Cesarean section, after the baby is delivered. Tubal ligation is considered permanent, but surgical reversal can be performed in some cases
  • 44. VASECTOMY • Male sterilization procedure • Ligation of Vas Deferens tube • No-scalpel technique available • Faster and easier recovery than a tubal ligation • Failure rate = 0.1%, more effective than female sterilization
  • 45. During a vasectomy (“cutting the vas”) a urologist cuts and ligates (ties off) the ductus deferens. Sperm are still produced but cannot exit the body. Sperm eventually deteriorate and are phagocytized. A man is sterile, but because testosterone is still produced he retains his sex drive and secondary sex characteristics.
  • 46. METHODS BASED ON INFORMATION • Withdrawal • Natural Family Planning • Fertility Awareness Method • Abstinence
  • 47. WITHDRAWAL • Removal of penis from the vagina before ejaculation occurs • NOT a sufficient method of birth control by itself • Effectiveness rate is 80% (very unpredictable in teens, wide variation) • 1 of 5 women practicing withdrawal become pregnant • Very difficult for a male to ‘control’
  • 48. Natural Family Planning & Fertility Awareness Method
  • 49.
  • 50.
  • 51. EXCELLENT REFERENCE SEE: www.plannedparenthood.org/bc Hatcher, Robert, MD Contraceptive Technology ,17ed. (2001) https://www.who.int/en/news-room/fact- sheets/detail/sexually- transmitted-infections-(stis)