This document provides information on various methods of contraception and family planning. It discusses the objectives of family planning, which include avoiding unwanted births and regulating the timing and number of pregnancies. It then describes different contraceptive methods like barrier methods (condoms, diaphragms, cervical caps), hormonal methods (birth control pills, injections, implants), emergency contraception, and natural family planning methods. For each method, it explains how it works, typical failure rates, advantages and disadvantages. It emphasizes the importance of contraception and responsible family planning.

1. FAMILY PLANNING & METHODS
OF CONTRACEPTION
By: Bhavisha Patel,
C.M Patel C.O.N.

2. INTRODUCTION
Family Planning as a way
of thinking & living that
is adopted voluntarily,
upon the basis of
knowledge, attitudes &
responsible decision by
individuals & couples, in
order to promote the
health & welfare of the
family group & thus
contribute effectively to
the social development
of a country.

3. OBJECTIVES:
 To avoid unwanted births.
 To bring about wanted births.
 To regulate the interval between the
pregnancies.
 To control the time at which births occur in
relation to the ages of the parent.
 To determine the number of children in the
family.

4. SCOPE OF FAMILY PLANNING
 Timing of births-.
 Spacing of births-
 Limited number of births-
 Care of infertile couples-
 Sex education-
 Preparation of parent hood-
 Other services-

5. SMALL FAMILY NORMS

6. In India, the peoples should
adopt small family norm to
stabilize the countries
population at the level of 1533
million by the 2050 AD. To
achieve the target the current
emphasis on three themes:
-“Son or Daughter- Two will
do”;
-“Second child after 3 years” &
-“Universal immunization”.
This will help to achieve the
NRR=1 by 2010.

7. CONTRACEPTIVE METHODS
Contraceptive methods
are, by definition,
preventive methods to
help women avoid
unwanted pregnancies.
They include all the
temporary & permanent
measures to prevent
pregnancy resulting
from coitus.

8. TYPES OF CONTRACEPTION

9. BARRIER METHOD
 Barrier methods should be part of the method
mix in all family planning/reproductive health
clinics.
 These methods prevent sperm deposition in
the vagina or prevent sperm penetration
through the cervical canal .
 The objective is achieved by mechanical
devices or by chemical means, which
produce sperm immobilization, or by
combined means.

10. PHYSICAL METHOD
 CONDOM.
 FEMALE CONDOM.
 DIAPHRAGM.
 CERVICAL CAP
 VAGINAL SPONGE

11. CONDOM(MALE & FEMALE)
Condoms are a barrier method of contraception.
Condom prevents the deposition of semen in
the vagina. There are male condoms and
female condoms.
A male condom is a thin latex (a type of rubber)
sheath that is worn on the penis.
A female condom is a polyurethane sheath with
a flexible ring at either end.

12. How Does It Work?
 The condom works by keeping
semen (the fluid that contains
sperm) from entering the
vagina. The male condom is
placed on a guy's penis when
it becomes erect. It is unrolled
all the way to the base of the
penis while holding the tip of
the condom to leave some
extra rubber. This creates a
space for semen after
ejaculation and makes it less
likely that the condom will
break.

13. Cont…
 The female condom
is inserted into the
vagina using the
closed-end ring. The
other ring creates the
open end of the
condom. The sheath
then lines the walls of
the vagina creating a
barrier between the
sperm and the cervix.

14. FAILURE RATE
Failure rate for
Males
condom
2-3 per 100
women-year
to 14 per 100
women-year
Failure rates for
female condom
During the first
year use vary
from 5 per 100
women-year to
about 21 in
typical users.

15. ADVANTAGES
MALE CONDOM
 Cheaper
 No side effects
 Easy to carry, simple
to use and disposable
 Protection against STI
 Protection against
PID
 where the coital act is
infrequent and regular
 Reduce the chance of
infertility & Ectopic
pregnancy
FEMALE CONDOM
 No side effects
 Protection against STI
 Protection against
PID
 No need for
spermicide, pre-
lubricated

16. DISADVANTAGES
MALE CONDOM
 Accidentally break or
slip off
 Inadequate sexual
pleasure
 Single use
 Failure rate due to
improper use
FEMALE CONDOM
 Costly
 Less acceptance
 Single use
 Failure rate due to
improper use
 Inadequate sexual
pleasure

17. DIAPHRAGM
The diaphragm is a dome-shaped bowl made of
thin, flexible rubber that sits over the cervix.
Diaphragm is a vaginal barrier it is also
known as ‘Dutch cap’. It ranges in diameter
from 5-10 cm (2-4inches) & it has a flexible
ring made up of spring or metal.

18. How Does It Work?
The diaphragm keeps sperm from entering the
uterus by blocking the cervix. For added
protection, spermicide is put into the bowl of the
diaphragm and along its edges before inserting
the diaphragm high into the vagina so it covers
the cervix.

19. It should remain in vagina for not
less than six hours after coitus.
The diaphragm must be checked
periodically to inspect the
condition of rubber and that the
size is not changed.

20. FAILURE RATE
 With spermicide vary between 6 to 12/100
women-year.
( In the case of a diaphragm, the two most
important things to be sure of are that it fits
correctly and that is used every time a couple
has sexual intercourse.)

21. ADVANTAGE & DISADVANTAGE
 Almost total absence of risks
and medical contraindication
 Easy to care
 Long lasting & cost effective
 No protection against STI
 Spermicide may irritate the
vagina & surrounding skin
 Strong odors or vaginal
discharge may appear if the
diaphragm is left in too long
 The rubber or latex in the
diaphragm may cause an
allergic reaction
 Toxic shock syndrome (TSS)
is a rare complication if the
diaphragm is left in too long.

22. CERVICAL CAP
A cervical cap is a small, thimble-shaped cup
made of silicone, latex, or rubber that fits over
the cervix (the part of the uterus that opens
into the upper part of the vagina). It is
considered one of the barrier methods of birth
control because it provides a physical barrier
between a male's sperm and a female's egg.

23. How Does a Cervical Cap Work?
 The cervical cap
keeps sperm from
entering the uterus by
covering the cervix.
For added protection,
spermicide is put into
the cap before
inserting the cap
snugly over the
cervix.

24. FAILURE RATE
 With spermicide vary between 16 to 24/100
women-year.

25. ADVANTAGE &
DISADVANTAGE
 Effective mean of
contraception
 May dislodge
 Spermicide may
irritate the vagina &
surrounding skin
 Not recommended for
most young women

26. VAGINAL SPONGE
Another barrier device employed for hundred of
years is the sponge soaked in vinegar oil or
olive oil, but it is only has been commercially
marketed in USA under the trade name
TODAY for the sole purpose of preventing
conception. It is a small polyurethane foam
sponge measuring 5cm X 2.5cm, saturated
with the spermicide, nonoxynol-9.

27.  The sponge is shaped in a way that it can be
fitted on to the cervix and has a loop on its
outer surface which can be used to pull out
the sponge after use.
 It should be inserted before coitus.
 It provides protection for 24 hours. It should
remain for at least 6 hours after coitus.
Sperms are trapped in the sponge and
destroyed by spermicide.
 This method is less effective than diaphragm
but it is convenient to use and can be inserted
about 18 hors before the coitus.
 Its better than not to use any method.

28. HOW DOSE IT WORK
Sponge absorbing the sperms & preventing them
from entering into vagina.

29. FAILURE RATE
The failure rate in porous woman is
between 20-40 per 100 women-
years and in nulli porous women
about 9-20 per 100 women-years.

30. ADVANTAGE &
DISADVANTAGE
Same as other means of
contraception. But less effective
than Diaphragm & Cervical cap.

31. CHEMICAL METHOD
SPERMICIDES
Spermicide come in several
different forms: cream, gel,
foam, film, and suppositories.
Most spermicide contain
nonoxynol-9, a chemical that
kills sperm. Spermicide can be
used alone but are more
effective when used with
another method of birth control,
such as a condom or
diaphragm.

32. How Does It Work?
Spermicide immobilize and kill the sperm before
they are able to swim into the uterus. To be
effective, the spermicide must be placed
deep in the vagina, close to the cervix.
Creams, gels, and foams are squirted into the
vagina using an applicator. Other types of
spermicide include vaginal contraceptive film
(VCF), a thin sheet placed in the back of
vagina by hand, and vaginal suppositories.

33. FAILURE RATE
 Over the course of 1 year, about 29 out of
100 typical couples who rely on spermicide
alone to prevent pregnancy will have an
accidental pregnancy.
(Spermicide are most effective when used in
combination with another form of birth
control.)

34. ADVANTAGE &
DISADVANTAGE
 Effective with other
mean of
contraception
 Failure rate high
 Least effect with time
 Irritability
 No protection against
STI

35. CONTRACEPTION IN
ADOLESCENCE
Adolescence is the period between the puberty
& the end of physiological maturation, which
occurs between the ages 15-19 years. One of
the toughest decisions that a lot of teens face
is whether to have sex. If people decide to
have sex, it means they must also take
responsibility to protect themselves from
unplanned pregnancy and sexually
transmitted diseases (STDs).

36. Cont…
 In the United States, the teenage pregnancy
rate is higher than in many other countries.
Approximately 1 million teens become
pregnant every year and most didn't plan on
becoming pregnant. In addition to preventing
unplanned pregnancies, people who have sex
must protect themselves from STDs.

37. Different methods of birth control
for Adolescence
 Birth Control Patch
 Birth Control Pill
 Birth Control Ring
 Birth Control Shot
 Cervical Cap
 Condom
 Diaphragm
 Emergency Contraception (Morning-After Pill)
 Implantable Contraception
 IUD
 Fertility Awareness
 Spermicide
 Withdrawal

39. RECOMMENDATION FOR
ADOLESCENCE
As sexual need is one of the physiological need
as per “Maslow’s Hierarchy need”, it is
recommended to have safe sexual practice
with the available various contraceptives.
(Only Condom & Hormonal contraception
recommended for adolescence group.)

40. 51
58
64
37
45
53
41
48
56
0
10
20
30
40
50
60
70
Urban Rural Total
NFHS-1
NFHS-2
NFHS-3
ACCEPTANCE OF CONTRACEPTIVE
METHODS AS PER NFHS 05-06

41. TOTAL NUMBER OF FAMILY
PLANNING ACCEPTORS BY 2006-07
 Sterilization -4.51 million
 Vasectomy -0.11 million
 Tubectomy - 4.40 million
 IUD insertion - 5.95 million
 Condom users - 26.21 million
 Oral pill users - 9.52 million

42. TARGET POPULATION
 Total eligible couples = 193 million as on
31.03.2008
 Un-sterilized couples (Target group for spacing
method)=119 million
 Un-sterilized couples (Target group for
sterilization)= 49 million
 Couples sterilized= 74 million

43. Hormonal Methods
 Oral Contraceptives
(Birth Control Pill)
 Injections (Depo-Provera)
 Implants (Norplant I & II)

44. 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

45. How does the pill work?
 Stops ovulation
 Thins uterine lining
 Thickens cervical mucus

46. 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

47. Side-effects
 Breast tenderness
 Nausea
 Increase in
headaches
 Moodiness
 Weight change
 Spotting

48. 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

49. Depo-Provera
 Birth control shot given once every three months
to prevent pregnancy
 99.7% effective preventing pregnancy
 No daily pills to remember

50. How does the shot work?
 Stops ovulation
 Stops menstrual cycles!!
 Thickens cervical mucus

51. 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!

52. 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

53. Norplant I vs. Norplant II
 Six capsules
 Five years
 Two capsules
 Three years

54. Norplant Implant

55. Norplant Considerations
 Should be considered long term birth control
 Requires no upkeep 
 Extremely effective in pregnancy prevention >
99%

56. Emergency ContraceptionEmergency Contraception
 Emergency contraception pills can reduce the
chance of a pregnancy by 75% if taken
within 72 hours of unprotected sex!

57. 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
 California pharmacies can prescribe without
a doctor! (1/1/02)

58. 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

59. Natural family planning method.
 Withdrawal
 Natural Family Planning
 Fertility Awareness Method
 Abstinence

60. 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’

61. Natural Family Planning & Fertility
Awareness Method
 Women take a class on the menstrual cycle to
calculate more fertile times
 Requires special equipment and cannot be self-
taught
 NFP abstains from sex during the calculated
fertile time
 FAM uses barrier methods during fertile time
 Perfect effectiveness rate = 91%
 Typical effectiveness rate = 75%
 No 100% safe day-irregular periods

62. Abstinence
 Only 100% method of birth control
 Abstinence is when partners do not engage in
sexual intercourse
 Communication between partners is
important for those practicing abstinence to
be successful

63. Reasons for abstaining
 Moral or religious values
 Personal beliefs
 Medical reasons
 Not feeling ready for a emotional, intimate
relationship
 Future plans

64. SOMETHING TO THINK ABOUT…
Couples who use no birth control have a 85%
chance of a pregnancy within the first year.
Will you be one of the 512,000 of the teens that
gave birth in 2000?

65. CONCLUSION
The objective of the nation is to stabilize the
population, around 1533 million by 2050 so as to
achieve NRR= 1.
So a greater emphasis is placed on Family
planning & method of contraception, which will
help to achieve the target of National population
policy.

66. 66 Contraceptive Updates
Seminar, October 2005