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Health & Medicine Education

Chapter Fourteen Managing Your Fertility

Birth Control vs. Contraception ,[object Object],[object Object]

Selecting Your Contraception Method ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Current Birth Control Methods 95% Female condom 99% Male condom with spermicide 97% Male condom 94% Diaphragm with spermicide 94% Spermicide 91% Cervical cap 91-99% Periodic abstinence 96% Withdrawal 15% No method Theoretical Effectiveness Method

Current Birth Control Methods (cont’d) 99%+ Contraceptive Patch 99%+ Combined pill 99%+ Minipill 99%+ Depo-Provera (3 month) 99%+ Lunelle (1 month) 99%+ Contraceptive Ring 99%+ Vasectomy 99%+ Tubal ligation 99%+ / 98% IUD, copper / progestin Theoretical Effectiveness Method

Vaginal Spermicide Spermicide- chemical capable of killing sperm.

Condoms ,[object Object],[object Object],[object Object],[object Object]

Birth Control Pills- Contain synthetic hormones; do not provide protection against STD’s

Cervical Cap Small, thimble-shaped device that fits over the entire cervix; 1/3 full of spermicide

Emergency Contraception ,[object Object],[object Object],[object Object],[object Object]

Sterilization generally considered an irreversible procedure ,[object Object],[object Object]

Abortion – Termination of a Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Abortion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pregnancy (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Signs of Pregnancy [Probable signs] ,[object Object],[object Object],[object Object],[object Object]

Childbirth ,[object Object],[object Object],[object Object]

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Contraception Contraception is defined as the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs or surgical procedures. The preventive methods to help women avoid unwanted pregnancies are called contraceptive methods. Need for contraception • To avoid unwanted pregnancies. • To regulate the timing of pregnancy. • To regulate the interval between pregnancy. Ideal Contraceptive • Safe • Effective • Acceptable • Reversible • Inexpensive • Long lasting • Requires little or no medical supervision Contraceptive methods Spacing methods Natural Barrier IUDs Emergency contraception Terminal methods Male fertilisation Female fertilisation Natural Methods Coitus inteyrruptus / withdrawal Rhythm Method Lactational Amenorrhoea Barrier Methods Mechanical Male : Condom Female : Condom, Diaphragm, Cervical cap Chemical Creams - Deleen Jelly – Koromex, Volpar paste Foam tablets – Aerosol foams, Chlorimin T or Contab Combination Combined use of Chemical and Mechanical methods. Male condom • Most commonly known and used contraceptive. • Better known in India as NIRODH. Female condom Femidom Diaphragm Spermicides Spermicides are surface active agents which attach themselves to spermatozoa and kill them. Available in various forms like Intrauterine Contraceptive Devices Cu T200 T shaped device Polyethylene frame. 215 mm2 surface area of Cu wire. Contains 124 mg of copper Cu is lost at the rate of 50 µg/day. Polyethylene monofilament tied at vertical stem. Cu is radio opaque so additionally barium is incorporated in the device. Supplied in a sterilised sealed packet. Lifetime 4 years. Cu T 380A 380 mm square surface area of copper wire. Replacement 10 years. Multiload Cu 250 60-100 ug/day Replacement 3 years Multiload - 375 Mode of action Biochemical and histological changes in endometrium. Increased tubal motility. Endometrial inflammatory response. Prevents implantation. Contraindication for insertion of IUCD Presence of pelvic infection Genital tract bleeding (undiagnosed) Suspected pregnancy Uterine fibroid Severe dysmenorrhoea Ectopic pregnancy history Caesarean section Cu allergy Time of insertion Interval 2-3 days after menstrual phase. During lactational amenorrhoea. Postabortal Done immediately following termination of pregnancy. Postpartum After 6 weeks of delivery. Postplacental delivery Post delivery of placenta. Method of Insertion Preliminary steps: History taking and examination Patient is informed and consent is obtained. Insertion is done in OPD aseptic conditions. Placement of device in inserter. Steps of operation The patient is asked to remain empty bladder. The patient is placed in lithotomy position. Local antiseptic cleaning is done. Posterior vaginal speculum is introduced. Anterior lip of cervix is grasped with Allis tissue forcep. The device is placed in the inserter and introduced through cervical

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