family planning, CPR, NPP, Methods of family planning

2. INTRODUCTION
 An expert committee (1971) of the WHO
defined family planning as :
“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
the country”.

3.  Family planning refers to practices that keep
individuals or couples to attain certain
objectives
a) To avoid unwanted births
b) To bring about wanted births
c) To regulate the intervals between
pregnancies
d) To control the time at which births occur in
relation to the ages of the parent
e) To determine the number of children in the
family

4. Couple Protection Rate
(CPR)
 It is an indicator of the prevalence of
contraceptive practice in the community.
 It is defined as per cent of eligible couples
effectively protected against child birth by
one or the other approved methods of family
planning.
 CPR is a dominant factor in the reproduction
rate.
 However about 54 per cent eligible couples
are still unprotected against conception.

5. National Population Policy -
2000
 Population policy refers to policies
intended to decrease the birth rate or
growth rate.
 In April 1976 India formed its 1st
‘National Population Policy’.
 The policy was modified in 1977.
 The NPP approved by the parliament in
1983 and set the goals of achieving a
Net Productive Rate (NRR) of one by
the year 2000.

6.  NPP 2000 reaffirms the commitment of
Government towards target free
approach in administrating family
planning services.
 Gives Choice to the people to avail the
productive health care services.

7. Contraceptive Methods (Fertility
Regulating Methods)
 Preventive methods to help women avoid
unwanted pregnancies. They include all
temporary & permanent measures to prevent
pregnancy resulting from coitus.
 There can never be an ideal contraceptive- that
is safe , effective, acceptable, inexpensive,
reversible, simple to administer, independent of
coitus, long lasting, requiring little or no medical
supervision.
 “Conventional contraceptives” is those methods
that require action at the time of sexual
intercourse eg: condoms, spermcides etc

8. i. Spacing methods
1) Barrier methods
a) Physical methods
b) Chemical methods
c) Combined methods
2) Intra-uterine devices
3) Hormonal methods
4) Post conceptional methods
5) Miscellaneous
ii. Terminal methods
1) Male sterilization
2) Female sterilization

9. 1) Barrier methods
 Suitable for men & women
 To prevent live sperm from meeting the
ovum
 Absence of side effects associated with the
pill & IUD
 It is only effective if they are used
consistently and carefully

10. A. PHYSICAL METHODS
1) Condom
2) Diaphragm
3) Vaginal sponge
MODE OF USE
 It is fitted before intercourse. The air must
be expelled from the teat end to create
space for ejaculate
 It should be held carefully while withdrawing
penis from vagina
 New one should be used for each sexual act

11.  ADVANTAGES :a) easily available, b) safe &
inexpensive, c) easy to use, d)no side
effects, e) light , compact & disposable.
 DISADVANTAGES : a) it may slip off or tear
during coitus due to incorrect use and b)
interferes with sex sensation.

12. DIAPHRAGM

13. VAGINAL SPONGE

14. B) CHEMICAL METHODS
 Used in 1960s,before IUD and oral
contraceptives
 4 categories :
a) Foams : tablets , aerosols
b) Creams ; jellies & pastes
c) Suppositories : manual insertion
d) Soluble films: C-film inserted manually
MODE OF ACTION
Spermicides Surface active agents which
attach themselves to spermatozoa, inhibit
oxygen uptake &kill sperms

15.  DISADVANTAGES
 There is very high failure rate.
 Application should be almost immediately
before intercourse & repeated before each
sexual act.
 All regions of vagina where sperms can to be
deposited should be smeared with chemical.
 Mild burning of irritation, systematic toxicity are
adverse effects.
 They cause messiness.
 They may cause systematic toxicity.
 Inflammatory or carcinogenic action on vaginal
skin or cervix can also occur.

16. 2) INTRA UTERINE CONTRACEPTIVE
DEVICE –IUCD/IUD
 2 basic types : non medical and medical
 Made up of polyethene and polymers
,release ions or hormones
 First generation : non medical or inert IUDs
 Second generation : copper IUDs
 Third generation : hormone releasing IUDs
 Most effective reversible contraceptive
methods , longer continuation rates

17.  ADVANTAGES
 Easy for use
 Less expensive
 Reversible by removal
 No side effects
 CONTRAINDICATIONS
 Suspected pregnancy
 Pelvic inflammatory diseases
 Vaginal bleeding of undiagnosed aetiology
 Cancer of cervix/adnexa/pelvic tumours
 Previous ectopic pregnancy
 Anaemia
 Previous history of PID
 Purulent cervical discharge
 Distortion of uterine cavity due to congenital malformations
of fibroids
 Unmotivated person

18. 3) HORMONAL CONTRACEPTIVES
When properly used they are the most effective
spacing methods of contraception.
Types : 1. oral pills
a) Combined pills
b) Progestogen only pill (POP)
c) Post-coital contraception
d) Once a month (long-acting) pill
e) Male pill
2.Depot formulations

19. 4) Post- conceptional methods
a) Menstrual regulation : menstrual regulation
differs from abortion in 3 aspects.
1) The lack of certainty
2) The lack of legal restrictions
3) The increased safety of the early procedure
b) Menstrual induction: based on disturbing the
normal progesterone prostaglandin balance.
c) Abortion : the termination of pregnancy
before the foetus becomes viable. This has
been fixed administratively at 28 weeks,
when the foetus weighs approximately
1000gram.

20. 5) MISCELLANEOUS
a) Abstinence
b) Coitus interrupts
c) Rhythm method ( calendar method)
d) Basel Body Temperature Method
e) Villings method ( cervical mucus method )

21. ii. Terminal methods
1) Male sterilization (vasectomy): both the ends
of the vas differents of men are folded and tied.
So that the sperms from the testis can not
move out. During the intercourse a fluid free
from spermatozoa is ejaculated. It does not
stop sperm production
2) Female sterilization (tubectomy): the fallopian
tubes are tied twice and cut between the knots.
Its done by opening the abdominal wall. Thus
the movements of the ovum from fallopian tube
to the uterus is prevented and the sperm
cannot reach the ovum

22. VASECTOMY

23. TUBECTOMY