Family Planning.pptx

This document provides an overview of family planning methods. It defines family planning and the need for population control .The document describes various types of family planning methods, such as temporary methods (barrier, intra uterine, hormonal, post-conceptional, and natural methods)
and permanent methods (vasectomy and tubectomy). For each method, it explains the advantages and disadvantages. The document also provides some practice questions to improve the knowledge and for better understanding.

1. 6/15/2024 1 FAMILY PLANNING Ms. Jyoti Chand MSc Nursing Community Health Nursing

2. Introduction The rate of growth of population increased after industrial revolution. It was 500 million in 1650, one billion in 1800 and touched to 6 billion in 1999. It is expected to reach 8 billion in 2025 . The main reasons of population explosion are advances in medicines, increase in birth rate, decrease in death rate, improved obstetrical services, invention of antibiotics and other life saving drugs and progress in sanitation and hygiene condition.

3. Need for population control India is a country of vast population, if we see the trends of population growth by decades then the population of India is increasing rapidly. Some demographer projects that if the population of India is not control then it would become the first country with large population after china by 2050. earlier in the last century, the rate of increase population was about 10 million per year but it is now increasing at 100 million per year. Population control refers to the practice of artificially altering the rate of growth of a human population.

4. Family: It refers two or more individuals who depends on one other for emotional , physical and financial support.

5. Family Planning: “ Family planning is a way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitude 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”.

6. Family planning methods T o have gap between children To limit the size of family Temporary / spacing methods Permanent methods

7. Temporary family planning methods Barrier methods : a) Physical method b) Chemical Method Intra uterine devices Hormonal methods Post- conceptional methods Natural methods

8. Permanent family planning methods Vasectomy Tubectomy

9. Temporary family planning methods: Barrier method a)Physical Method

10. Condom Condom is the most widely known and used barrier device by the males around the world. In India, it is better known by its trade name NIRODH , a Sanskrit word, meaning prevention. A new condom should be used for each sexual act. Condom prevents the semen from being deposited in vagina.

11. ADVANTAGES they are easily available safe and inexpensive easy to use; do not require medical supervision no side effects light, compact and disposable, and provides protection not only against pregnancy but also against STD .

12. DISADVANTAGES It may slip off or tear during coitus due to incorrect use, and Interferes with sexual sensation locally about which some complain while others get used to it. The main limitation of condoms is that many men do not use them regularly or carefully, even when the risk of unwanted pregnancy or sexually transmitted disease is high.

13. Female condom The female condom is a pouch made of polyurethane, which lines the vagina. An internal ring in the close end of the pouch covers the cervix and an external ring remains outside the vagina.

14. Advantages Protect against sexually transmitted diseases and PID Disadvantages It is expensive

15. Diaphragm It was invented by a German physician in 1882. Also known as "Dutch cap“. the diaphragm is a shallow cup made of synthetic rubber or plastic material. It ranges in diameter from 5-10 cm (2-4 inches). The diaphragm is inserted, before sexual intercourse and must remain in place for not less than 6 hours after sexual intercourse. A spermicidal jelly is always used along with the diaphragm.

16. ADVANTAGES:- Cheap Can be used repeatedly for a long time Disadvantages Requires help of a doctor or paramedical person to measure the size required. Risk of vaginal irritation and urinary tract infection are there. Not suitable for women with uterine prolapsed.

17. Vaginal sponge It has been commercially marketed in USA under the trade name is marketed TODAY for the purpose of preventive contraception. The sponge is shaped in a way that it can be filled on to the cervix and has a loop on its outer surface which can be to pull out the sponge after use. It Should be inserted before the coitus. Provides protection for 24 hours. It should remain be there for at least 6 hours after coitus. Sperms are trapped on in the sponge and are destroyed. It is a small polyurethane foam sponge measuring 5cmx26cm, saturated with the spermicide, nonoxynol -9 .

18. Chemical methods Foams:- Foam tablets Creams, jelly and pastes Suppositories

19. Merits:- They are Simply, safe and easy They offer contraception just when needed. Do not require medical assistance. Demerits – They have a high failure rate they may cause mild burning or local allergic reaction and urinary tract infection

20. Intra Uterine Devices These are the devices which are placed in the uterine cavity. Three different types of IUD'S generations are: First Generation IUD’S Second Generation IUD’S Third Generation IUD'S

21. First Generation IUDs These devices were made of polyethylene and are non-medicated. These are available in different sizes and shapes such as coils, spirals, loops. The lippes loop is the most popular and commonly used devices under the first generation. Lippes loop:- It is made of polyethylene and contains barium sulphate which makes it possible to be located when required by x-ray. The loop is double 'S' shaped and has an attached made of Fine Nylon Threads.

22. Second Generation IUDs These are also made of polyethylene but copper is added into these. The copper enhances the contraceptive effect. Variety of copper devices are: Copper-7 and copper t-200 Variants of T devices: TCU: 220C and TCU: 380A Multi load devices: ML-CU: 250, ML:375 Nova T: TCU-380 The number included the surface area (in sq. mm) of the copper on the device.

23. Cu T 220 C Cu T 380 A

24. Multiload device NOVA T

25. Third Generation IUDs These contains hormones which is released slowly in the uterus. The hormone affects the lining of the uterus and cervical mucus. It may affects the sperm. There are two types of hormone IUD’S: 1. Progestasert 2. Levonogestrel device( Mirena ) {LNG-20}

26. Mirena

27. Lifespan Cu T 380 A 10 years Multiload devices 5 years Mirena 5-7 years Progestasert 1 years

28. Merits- Can be used for longer period Can be easily removed when couple wants to have child Do not interfere with coitus Inexpensive Very effective and failure rate if less. Do not require hospitalization DEMERITS Bleeding, pain, perforation of uterus, expulsion.

29. Timing for insertion During mensuration or within 10 day of the beginning of a mensuration period. Within 24 hours of delivery(Post-partum) A convenient time for loop insertion is 6-8 weeks after the delivery

30. Hormonal contraceptive methods Oral pills Combined pill Progesterone only pill(POP) Post coital pill Once a month pill Depot formulation Injectables Subcutaneous implant

31. Combined pills Progesterone+ estrogen The pill is given orally for 21 consecutive days beginning on the 5 th day of the menstrual cycle, followed by a break of 7 days during which menstruation occur. The pill should be taken everyday at a fixed time.

32. Types of pills Mala N Mala D

33. Levonorgesterol - 0.15 mg Ethinyl estradiol - 0.03mg Mala D in a Package of 28 pills (21 OCP & 7 brown color 60 mg ferrous fumarate tablets ) Mala N contains 21 tablets Mala N is supplied free of cost through all PHCs And urban family welfare centers.

34. Progesterone only pill Minipill or micropill It contains only progesterone .

35. Post coital contraception Post coital ( morning pill) contraception is recommended within 72 hours of an unprotected intercourse. Eg - levonorgesterol 0.75 mg 1 tablet of 0.75 mg within 72 hours of unprotected sex and the 2 nd tablet after 12 hours of 1 st dose.

36. Weekly pill/ Non-steroidal/ Non hormonal Central drug research institute lucknow developed a pill :- Centchroman / SAHELI This pill should be taken once a week.

37. Injectable contraceptives Progesterone only injectables DMPA ( depot medroxy progesterone acetate) DMPA SC

38. DMPA / ANTARA Good to use among multiparae women >35 years IM injection of 150 mg every 3 month Duration- given at 1 st 5 days of menstrual cycle Mode of action- stop ovulation and thickens the cervical mucus

39. DMPA sc Subcutaneous injection of 104 mg at 3 month intervals

40. Subdermal implants Also known as Norplant It consist of 6 Silastic capsules containing 35 mg of levonorgesterol . These capsules or rodes are implanted beneath the skin of the forearm. Effective contraception is provided for 5 years .

41. Natural methods Abstinence Coitus interrupts Basal body temperature:- there is slight increase in body temperature during the fertile period How does it work ? It is based on identifying the woman's fertile days and avoiding intercourse during the fertile days to prevent pregnancy.

42. Terminal methods Vasectomy Tubectomy

43. Vasectomy It is the simple, safe, effective, cheap, convienient permanent and quick surgical method of family planning for men who decide that they do not want any more children. The passage of the sperm along with the vas deference is blocked , so that the sperm that is ejaculated does not contain sperm. The patient is not sterile immediately after the operation, at least 30 ejaculations may be necessary. During this Immediate period another method of contraception must be used .

44. Tubectomy This is also known as ‘ voluntary surgical contraception’ and ‘ Tubal ligation’ and ' Minilap ’ It is a simple, cheap, safe and permanent method of contraception for women, it consist of blocking both the fallopian tubes .

45. Instructions after surgery Rest for 2-3 days and avoid strenuous work for one week. Keep the wound clean and dry Not to have intercourse for at least one week or until pain gone.

46. Q. Identify the Contraceptive device shown in the image and which Spermicidal used in this Contraceptive ?

47. Q) Which of the following method of contraception can prevent STI? Oral pills CuT Condom Dutch cap

48. Q) Multiload device refers to? 1 st generation IUCD 2 nd generation IUCD 3 rd generation IUCD Oral contraceptives

49. Q ) All of the following are physical barrier methods used for birth spacing except- Diaphragm Vaginal sponge Cu T Nirodh

50. Q. A woman using diaphragm for contraception should be instructed to leave it in place for at least how long after intercourse? 6 hours 12 hours I hour 28 hours

51. Q) DMPA is an injectable contraceptive given every: 2week 2year 2 month 3 month

52. Q. Identify the Contraceptive device shown in the image : a) Cu T b) cu T 200 A c)Cu T 380 A d)cu T 220 B

53. Q. Contraceptive oral pills help in birth control by : Killing of Ova Preventing Ovulation Killing of sperms Forming barrier between sperms and Ova