- There are many options for birth control, each with their own advantages and disadvantages. Abstinence is the only 100% effective way to prevent pregnancy and STDs. - Birth control methods can be barrier methods like condoms, hormonal methods like pills, patches or injections, long-acting reversible methods like IUDs, or permanent sterilization procedures. - When choosing a method, factors to consider include effectiveness, safety, ease of use, cost, acceptance and ability to use for an extended period. No single method is best for everyone so it is important to discuss options with a medical provider.

1. KONTRASEPSI
dr. Dona Wirniaty,MKed(OG),SpOG

2. ● No single method of birth control is the “best”
one. Each has its own advantages and
disadvantages.
● Abstinence is the only 100% effective way to
prevent pregnancy and STD’s
usaha-usaha untuk
mencegah terjadinya
kehamilan.

3. Syarat Pemilihan Kontrasepsi
a. Aman atau tidak berbahaya
b. Dapat diandalkan
c. Sederhana
d. Murah
e. Dapat diterima oleh orang banyak
f. Pemakaian jangka lama (continution rate tinggi).

4. ● Sederhana :
● - Dengan alat (barrier
contraception)
● -Tanpa alat ( coitus interuptus,
metode kalender, metode
amenorea laktasi)
● Hormonal:
● - Pil
● - Suntik
● - Dermal patch
● - Implan
● Alat kontrasepsi dalam rahim
(AKDR)
● Mantap / sterilisasi
● - Ligasi tuba
● - Vasektomi
● METODE
KONTRASEP
SI

5. Barrier contraception : Condom
●Methods that physically or chemically
block sperm from reaching an egg AND
provide a BARRIER between direct skin to
skin contact
●Act as a physical block between you
and your sexual partner
●Great for STD protection!

6. MALE CONDOMS

7. Male Condom, Cont.

8. Female Condom

9. KONTRASEPSI HORMONAL
●Meningkatkan produksi lendir serviks 
lebih tebal
●Mencegah ovulasi  dengan menghambat
produksi gonadotropin
●progestational agent supresi sekresi LH
●estrogenic agent  supresi sekresi FSH

10. Kontrasepsi Oral
●Pil KB kombinasi
● Estrogen dan progesteron
●Dikonsumsi pada waktu yang sama setiap
hari ( sekali sehari selama 3 minggu,
tanpa pil/plasebo pada minggu
keempat menstruasi )

11. Mini pil (Progestin only)

12. Mini pil (Progestin only)
● Because of the low dose, the minipill must be taken
every day at the same time of day. The change in the
cervical mucus requires 2–4 hours to take effect,
and, most importantly, the impermeability diminishes
22 hours after administration, and by 24 hours sperm
penetration is essentially unimpaired

13. Absolute Contraindications to the Use of
Oral Contraception
● Thrombophlebitis, thromboembolic disorders (including a close family
history, parent or sibling, suggestive of an inherited susceptibility for
venous thrombosis), cerebral vascular disease, coronary occlusion, or a past
history of these conditions, or conditions predisposing to these problems.
● Markedly impaired liver function. Steroid hormones are contraindicated in
patients with hepatitis until liver function tests return to normal.
● Known or suspected breast cancer.
● Undiagnosed abnormal vaginal bleeding.
● Known or suspected pregnancy.
● Smokers over the age of 35.
● Severe hypercholesterolemia or hypertriglyceridemia.
● Elevated blood pressure.

14. Relative Contraindications Requiring Clinical
Judgment and Informed Consent
● Migraine headaches.
● Hypertension.
● Uterine leiomyoma.
● Gestational diabetes.
● Diabetes mellitus.
● Elective surgery.
● Seizure disorders.
● Obstructive jaundice in
pregnancy.
● Sickle cell disease or sickle C
disease.
● Gallbladder disease.
● Mitral valve prolapse.
● Systemic lupus erythematosus.
● Hyperlipidemia.
● Smoking.
● Hepatic disease

17. 3 major factors that affect continuation:
● The experience of side effects, such as breakthrough
bleeding and amenorrhea, and perceived experience of
problems, such as headaches, nausea, breast tenderness,
and weight gain.
● Fears and concerns regarding cancer, cardiovascular
disease, and the impact of oral contraception on future
fertility.
● Nonmedical issues, such as inadequate instructions on
pill taking, complicated pill packaging, and difficulties
arising from the patient package insert

18. What to do?
● Explain how oral contraception works.
● Review briefly the risks and benefits of oral contraception, but be careful
to put the risks in proper perspective, and to emphasize the safety and
noncontraceptive benefits of low-dose oral contraceptives.
● Show and demonstrate to the patient the package of pills she will use.
● Explain how to take the pills:
● When to start.
● The importance of developing a daily routine to avoid missing pills.
● What to do if pills are missed (identify a backup method).
● Review the side effects that can affect continuation: amenorrhea,
breakthrough bleeding, headaches, weight gain, nausea, etc., and what
to do if one or more occurs.

19. ● Explain the warning signs of potential problems: abdominal or chest
pain, trouble breathing, severe headaches, visual problems, leg pain or
swelling.
● Ask the patient to be sure to call if another clinician prescribes other
medications.
● Ask the patient to repeat critical information to make sure she
understands what has been said. Ask if the patient has any questions.
● Schedule a return appointment in 1–2 months to review
understanding and address fears and concerns; a visit at 3 months is
too late because most questions and side effects occur early.482
Inconsistent use of oral contraceptives is more common in women who
are new starters.480
● Make sure a line of communication is open to clinician or office
personnel. Ask the patient to call for any problem or concern before
she stops taking the oral contraceptives

20. Dermal Patch
●the lower abdomen, buttocks, or upper
body
●Melepaskan hormone progestin dan
estrogen
●Dipakai selama 3 minggu dengan
menggantinya setiap seminggu sekal
●Minggu keempat tidak digunakan 
menstruasi

22. Vaginal Ring
●Melepaskan hormone progestin dan
estrogen
●Ring dimasukkan ke vagina dan
diletakkan di daerah serviks
●Digunakan selama 3 minggu 
dilepaskan pada minggu ke 4 
menstruasi

24. Injeksi Hormonal
●Setiap bulan/ 3 bulan
●hormone progestin
(ex:Medroxyprogesteron acetat)
●Diinjeksikan pada daerah bokong
atau lengan

25. Kontrasepsi emergensi
●“morning after pill”
●progestogen dengan dosis tinggi
●Levonorgestrel in a dose of 0.75 mg given twice, 12
hours apart
●75 to 89 % effective dalam mencegah
kehamilan
●Dapat digunakan paling lama 3-5 hari setelah
berhubungan seksual tanpa pengaman
●Efektivitas berkurang setelah 24 jam

26. AKDR
●Dimasukkan kedalam rongga uterus
●Copper IUD: Can stay for up to 10 years
● Interferes with sperm, fertilization, and
prevents implantation
●Hormonal IUD: Can stay for up to 5 years
● It releases a small amount of hormone each
day to keep you from getting pregnant.

28. Ligasi Tuba