Family planning methods CHN..pptx

It includes family planning methods used. It's types and the different method.
Family planning includes various methods:

Contraceptives: Pills, patches, injections, and implants.
Barrier methods: Condoms, diaphragms, and cervical caps.
Intrauterine devices (IUDs): Small devices inserted into the uterus.
Sterilization: Permanent methods like tubal ligation or vasectomy.
Natural methods: Tracking menstrual cycles and fertility awareness.
It's crucial to consult with a healthcare professional to choose the most suitable method based on individual health and preferences.
Family: it refers to two or more individuals who depend on one other for emotional , physical and financial support.
Family planning : family planning is the way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitude and responsible decisions by individuals and couple in order to promote health and welfare of family groups and thus contribute effectively to the social development of a country. [WHO,1971].
Purpose: WHO use the range of methods of fertility regulation to help individuals or couples to attain certain objectives:
To avoid unwanted births
To bring out wanted births
produce a change in the number of children born
Regulate the intervals between pregnancies
Help to prevent STDs/ HIV/ AIDS.
To improve the health of the mother and child.
To plan and assure that all the resources are available [time , social ,financial and environment].
Introduction:
C ontraceptive methods are, by definition preventive methods to help women avoid unwanted pregnancies. They include all temporary and permanent methods to prevent pregnancy resulting from coitus or intercourse. The contraceptive methods may be broadly grouped into two classes: spacing methods and terminal methods.
Criteria for ideal contraceptive: It should be safe for you means free from any kind of side effects
It should be reliable
It should be easy to administer and convenient
It should be cost effective
It should be culturally feasible and acceptable. spacing methods:Also known as temporary methods. It help in prevention of pregnancy as long as they are used. These methods can help in bringing and spacing of pregnancy, preventing unwanted children.
It includes hormonal & non hormonal
Non hormonal - natural and barrier methods
Natural - These methods contraception prevent pregnancy without the use of chemical or physical agent[man-made devices].
It includes:
Total sexual abstinence
Periodic abstinence
Temperature method
Coitus interrupts
Lactation amenorrhea method(LAM)
Barrier methods are those which prevents sperm meeting with ovum.
, Types of barrier methods:Physical methods
Condom
Diaphragm
Cervical cap
Vaginal sponge
Chemical method
Foam tablets
Creams, gels
suppositories
Intrauterine device
Lippes loop
Copper-T
Hormonal contraceptives provides the best means of ensuring spacing between one child to
another: oral pills & inj.
Terminal methods: vasectomy & tubectomy

1. Family planning methods Palak Mahajan 201182053 B.Sc. nursing 4 th yr Community health nursing

2. What is family? What is family planning? Why family planning is important? What are family planning methods? Enlist them.

3. Family : it refers to two or more individuals who depend on one other for emotional , physical and financial support. Family planning : family planning is the way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitude and responsible decisions by individuals and couple in order to promote health and welfare of family groups and thus contribute effectively to the social development of a country. [WHO,1971].

4. Why family planning is important? India is the one of the most populated country in the world with the population of 1.428 billion [ Uttar Pradesh is the most populated state]. From the last century population of India is increasing with an alarming rate [high birth rates with declining death rates leads to [ population explosion ] causing serious consequences related to quality of human life [ hunger, unemployment , high living cost, lost living standards, law and order problems and increased crime rate]

5. Purpose WHO use the range of methods of fertility regulation to help individuals or couples to attain certain objectives: To avoid unwanted births To bring out wanted births produce a change in the number of children born Regulate the intervals between pregnancies Help to prevent STDs/ HIV/ AIDS. To improve the health of the mother and child. To plan and assure that all the resources are available [time , social ,financial and environment].

6. Family planning methods: Introduction: Contraceptive methods are, by definition preventive methods to help women avoid unwanted pregnancies. They include all temporary and permanent methods to prevent pregnancy resulting from coitus or intercourse. The contraceptive methods may be broadly grouped into two classes: spacing methods and terminal methods.

7. Criteria for ideal contraceptive It should be safe for you means free from any kind of side effects It should be reliable It should be easy to administer and convenient It should be cost effective It should be culturally feasible and acceptable

8. Spacing methods Also known as temporary methods. It help in prevention of pregnancy as long as they are used. These methods can help in bringing and spacing of pregnancy, preventing unwanted children.

9. a. Natural methods These methods contraception prevent pregnancy without the use of chemical or physical agent[man-made devices]. It includes: Total sexual abstinence Periodic abstinence Temperature method Coitus interrupts Lactation amenorrhea method( LAM ) 1. Non-hormonal contraceptive

10. Total abstinence: A practice of brahmacharya. Failure rate is nil if followed properly. Periodic abstinence: also known as rhythm or calendar method or safe period . Temperature method: prediction of basal body temperature ( BBT ) at the time of ovulation.(temp. 0.5 C). This method is not practiced with high level of illiteracy. Coitus interruptus: also called withdrawal method. This requires the male to withdraw his penis from the vagina immediately before the ejaculation of semen. Lactation amenorrhea method [LAM]: the women is amenorrheol while breastfeeding in first 6 months postpartum until first spotting or menses begins

11. b. Barrier methods Barrier methods are those which prevents sperm meeting with ovum. Types of barrier methods:

12. i ) Physical barriers Male Condom ( nirodh ): The male condom is a latex or synthetic rubber sheath that is placed on the erect penis before vaginal penetration to trap the sperm during ejaculation.
It can prevent STIs and can be bought over the counter without any fitting needed.
Male condoms have an ideal fail rate of 2% and a typical fail rate of 15% due to a break in the sheath’s integrity or spilling.
After sexual intercourse, the condom is removed to be disposed. available free of cost in both urban or ruler family welfare centers. In 1982, condom with spermicide ( nonoxynol ) was introduced. Types : 1) dry nirodh 2) deluxe nirodh 3)super deluxe nirodh

13. Female condom These are also latex rubber sheaths that are specially designed for females and prelubricated with spermicide.
It has an inner ring that covers the cervix and an outer, open ring that is placed against the vaginal opening.
These are disposable and require no prescription.
The fail rate of female condoms is 12% to 22%.

14. 2. Diaphragm The diaphragm is you used to buy women in her vagina to form a barrier in front of the cervix. Diaphragm is dome like shaped and is a shallow cap. It is made of soft synthetic rubber or plastic with a stiff but flexible rim around the edge(rests b/w posterior fornix and symphysis pubis). Before insertion spermicide should br applied. It is also known as DUTCH CAP. Diaphragm is available in different sizes ranging from 5 to 10 cm It is headed imposition partly because of the tension created by the spring and partly because of the muscle tone of vagina. It is very important to observe the vagina muscle tone otherwise the diaphragm may not remain in position (slip)

15. Points to remember as a nurse Before insertion, spermicide is applied. After insertion the woman must check that her cervix is covered. Diaphragm can be inserted every evening as a matter of routine. It is inserted by hand or using introducer. It must be placed for atleast 6 hrs after the last intercourse. On removal, it should be washed with mild soap, dried and inspected for any damage. If alterations in weight (3 kgs ), postpartum, one must buy new one. * CERVICAL CAP is another device as functional as diaphragm.

16. 3. Vaginal sponge It is a small polyutherane foam sponge, diffused with spermicide. Sponge is shaped in a way that it can be filled on the cervix and loop on its outer surface which can be to pull out the sponge after use should be inserted before coitus. It provides protection for 24 hours and should remain in place for atleast 6 hrs after intercourse. Sperms are trapped on the sponge and are destroyed.

17. ii) Chemical methods Chemical barriers are usually spermicidal (killing ) or spermistatic (stopping) These are designed to keep the vaginal ph near 4.0 (while ovulating). As sperm best thrive at alkaline ph of 8.5 to 9.0. These are less expensive and needs no prescription. It also provides protection from some STDs and AIDS to some extent. These are quite effective when used with nirodh or diaphragm (but alone have high failure rates.

18. iii) Intrauterine devices (IUDs) IUDs are the devices which are placed in the womb. These are of many types: lippes loop and copper-T are most commonly used in India. 1.Lippes Loop: the loop is a small double-S shaped device made up of polythene and inert plastic material being produced in India. It is attached to one of the two ends in a fine plastic filament which extends through the cervix to the vagina where the loop is inserted into the uterine cavity by s plunger. It remains in uterine cavity for years and does not interfere with sex life. In case the couple want an extra child, the loop can be removed and conception can take place.

19. Points to remember: Loops should not be used in women who had Suspected pregnancy Pelvic infection History of bleeding Suspicion of malignancy Erosion of cervix *IUDs danger signs {PAINS} P: period of late pregnancy suspected abnormal spotting or bleeding A: abdominal pain or pain with intercourse I: infection (abnormal vaginal discharge) N: not feeling well, fevers, chills S: stringing lost, shorter or longer.

20. 2. COPPER-T It is the most effective contraceptive. It is T- shaped object made of plastic but is wrapped with fine copper which enhances its contraceptive effect. In this, white thread with two strands is attached to the copper-t, to check that it is in place. Types : non-hormonal ( cu containing IUDs). Hormonal (progestin-releasing IUD)

21. Points to remember CU-T should not be used in following : Abnormality of uterus or other reproductive organ Allergy to copper Anemia Bleeding between periods Blood clotting disorder diabetes treated with insulin Heart disorder Heavy menstrual flow suspected pregnancy Pelvic infection Recent abortion or miscarriage Severe menstrual cramps SIDE EFFECTS with CU-T Bleeding Painful periods Painful intercourse Erosion of uterus Infection Pregnancy outside the uterus Allergic reactions Expulsion Backache, pain in legs Vaginal discharge

22. 2. Hormonal methods Hormonal contraceptives provides the best means of ensuring spacing between one child to another.

23. 1.Oral pills 1. Combined pills: These pills are composed of two hormones i.e. synthetic oestrogen and progesterone in very small doses. It’s action is to inhibit ovulation of ovum by blocking the secretion of gonadotropin from pituitary gland. It is of two types: MALA-D and MALA-N. MALA-N is free in government settings under free distribution scheme (FWP) and MALA-D under social marketing programs with the very minimal cost. Where MALA-D thickens the cervical secretion and prevent sperm from entering and MALA-N stops or prevent the ovulation. It contain 28 tablets in total, 21 white contraceptive pills and 7 brown Iron pills. One pill is taken daily beginning from the 5 th day of the onset of menstruation. If the pill is missed, take 2 pills( one in morning and other in afternoon) the next day. Advised to carry an extra pack. Pills can be prescribed by doctor or any trained nurse with the help of checklist.

24. Progesterone only pill This pill is also known as mini pill . It contain only progestron and it thickens the cervical mucus cavity. It can be taken throughout the menstrual cycle . It is not used widely because of high failure rate. Once-A-Month pill It is modified combined pill. It contains long lasting estrogen and short acting progestron. These pills are not in use because experimental results revealed high pregnancy rate and irregularity in the menstrual cycle.

25. Points to remember Side Effects Of Oral Pills: Nausea Tender breasts Abdominal pain Weight gain Irregular bleeding WARNING SIGNS ( ACHES) A: abdominal pain severe C: chest pain severe, cough, shortness of breath [ means blood clot] H:headaches severe, dizziness, weakness [ may mean hypertension or impending shock] E: eye problem blurry vision, speech problem [may mean stroke] S: severe pain in legs, calf or thighs [may mean blood clot] Pills should not be given in case women is pregnant , has had jaundice, cancer or a nursing mother

26. Emergency contraceptive pills ECPS or E-pills ECPs are used to prevent pregnancy for and unprotected sexual intercourse. If taken within 72 hours ECPs are safe for all women. It comes in a pack of 2. The first should be taken as soon as possible but certainly before 72 hours. the second pill should be taken 24 hours after the first pill is taken.

27. Non-steroidal weekly oral pills Central drug research institute Lucknow has developed a pill named “CENTCHRAMAN” This is a weekly pill that is to be taken orally. This fill is also known by the brand name “ Saheli”

28. Post coital pills This pills should be taken within 48 hours of unsafe coitus. This pills should be taken in case of emergency only like rape, failure of contraceptive and unsafe sexual intercourse.

29. 2. depot formulations These are long acting hormonal contraceptive containing only synthetic progesterone. These are available in three forms: Injectable e.g. DMPA [Depo-provera](depot medroxy progesterone acetate) and NET Oen Subdermal implants e.g. norplant and Norplant R-2 Vaginal ring

30. post conceptual methods These methods are used after the misses period and pregnancy may or may not have occurred. This method is used in regulating and inducing the menstruation and termination of pregnancy or aborting the fetus. These methods are: Menstrual regulation Dilatation and curettage Suction evacuation Abortion .

31. Terminal methods These methods are used in cases where both the partners agree not to have any more children or whether the health of one or both of them makes further pregnancies undesirable. Generally two methods are employed which are: Female sterilization or tubectomy Male sterilization or vasectomy

32. Male sterilization/ vasectomy This implies what is known as vasectomy. In this operation, vas deferens on each side is divided and ligated. This prevents the passage of spermatozoa into the seminal vesicles and so conception does not take place after intercourse. Points to teach patient after surgery: To ensure normal healing of wound and success of vasectomy patient should told that he is not sterile immediately and need at least 30 ejaculations before seminal examination is negative To use contraceptives until aspermia. Avoid taking bath for atleast 24 hrs. To wear T- bandage or scrotal support for 15 days. To avoid cycling or heavy lifting Recently ‘ NO SCAPEL VASECTOMY’ is accepted and used.

33. Female sterilization/ tubectomy This implies bilateral tubal ligation or salpingectomy. This can be done during the operation of cesarean section, or on the second or third postpartum day if the patient had vaginal delivery, or as an elective procedure in a non-pregnant woman. In women, tubal ligation is performed by occluding the fallopian tubes through cutting, cauterizing, or blocking to inhibit the passage of the both the sperm and the ova.
After menstruation and before ovulation, the procedure is done through a small incision under the woman’s umbilicus passage of the both the sperm and the ova. A laparoscope is used to visualize the surgery, and the patient is under local anesthesia.
The woman may return to her sexual activities after 2 to 3 days of the operation.
The effectiveness of this method is at 99.5%.

34. Points to remember : Educate that menstrual cycle would still occur, and make sure that coitus before ligation is protected to avoid ectopic pregnancy before the procedure is done, the position regarding future pregnancies must be adequately explained to the husband and his wife because the operation is, as a rule, irreversible great thought must be given to the problem before operation is performed.
The consent from both husband and wife must be obtained.

35. Thank you