Family planning programme

family planning program
Definition
important of family planning
Human right principles guide family planning services
type of family planning
Combined Oral Contraceptives.
Progestin-Only Pills
Emergency Contraceptive Pills
Progestin-Only Injectable
Monthly Injectable
Combined Patch
Combined Vaginal Ring
Progesterone-Releasing Vaginal Ring
Copper-Bearing Intrauterine Device
Levonorgestrel Intrauterine Device
Female Sterilization
Vasectomy
Male Condoms
Female Condoms
Cervical Caps
Lactational Amenorrhea Method

1. Family planning programme Prepared by Hawraz Faris Saadi BSc. in Nursing 1

2. Background Definition : Educational, comprehensive medical or social activities which enable individuals, to determine freely the number and spacing of their children and to select the means by which this may be achieved. Family planning may involve consideration of the number of children a woman wishes to have, including the choice to have no children, as well as the age at which she wishes to have them.  2

3. Background Cont. The term “ family planning ” is often used as a synonym for “ birth control .” Family planning, however, does not only involve contraception . Family planning also takes into account planning your child’s birth for specific times and planning for a child when you have challenges conceiving one. 3

4. Important of family planning It is  define woman’s ability to decide if and when to have children. Family planning services include counseling , education , access to contraception , and access to safe abortion . The positive effects of family planning are evident in a reduction in the worldwide fertility rate from 3.7 to 2.4 since 1980. 4

5. Important of family planning Cont. Voluntary family planning reduces the number of unintended pregnancies , as well as maternal and newborn deaths . When a woman has the ability to make choices about contraception, her children are much more likely to be healthier, better nourished. 5

6. Human rights principles guide family planning services Non-discrimination Availability of contraceptive information and services Accessible information and services Acceptable information and services Quality Informed decision-making Privacy and confidentiality Participation Accountability 6

7. Types of Contraceptive Combined Oral Contraceptives. Progestin-Only Pills Emergency Contraceptive Pills Progestin-Only Injectable Monthly Injectable Combined Patch Combined Vaginal Ring Progesterone-Releasing Vaginal Ring 7

8. Types of Contraceptive Cont. Copper-Bearing Intrauterine Device Levonorgestrel Intrauterine Device Female Sterilization Vasectomy Male Condoms Female Condoms Cervical Caps Lactational Amenorrhea Method 8

9. Combined Oral Contraceptives . Pills that contain low doses of 2 hormones a progestin and an estrogen like the natural hormones progesterone and estrogen in a woman’s body . Work primarily by preventing the release of eggs from the ovaries (ovulation). Effectiveness depends on the user : Risk of pregnancy is greatest when a woman starts a new pill pack 3 or more days late, or misses 3 or more pills near the beginning or end of a pill pack. 9

10. Combined Oral Contraceptives Cont. Advantage: Are controlled by the woman. Can be stopped at any time without a provider’s help. Do not interfere with sex. Are easy to use. Easy to obtain, for example, in drug shops or pharmacies. 10

11. Progestin-Only Pills Pills that contain very low doses of a progestin like the natural hormone progesterone in a woman’s body . Do not contain estrogen, and so can be used throughout breastfeeding and by women who cannot use methods with estrogen. Work primarily by: Thickening cervical mucus (this blocks sperm from meeting an egg) Disrupting the menstrual cycle, including preventing the release of eggs from the ovaries (ovulation ). 11

12. Progestin-Only Pills Cont. Advantage: Can be used while breastfeeding. Can be stopped at any time without a provider’s help. Do not interfere with sex. Are controlled by the woman. 12

13. Emergency Contraceptive Pills Emergency contraceptive pills (ECPs) help a woman avoid pregnancy after she has sex without contraception . ECPs help to prevent pregnancy when taken up to 5 days after unprotected sex. 13

14. Emergency Contraceptive Pills Cont. ECPs are sometimes called “morning after” pills or postcoital contraceptives . Work by preventing or delaying the release of eggs from the ovaries (ovulation ). They do not work if a woman is already pregnant. 14

15. Emergency Contraceptive Pills Cont. Advantage: Can be used as needed. Offer a second chance at preventing unwanted pregnancy. Enable a woman to avoid pregnancy if sex was forced or she was prevented from using contraception Are controlled by the woman Reduce the need for abortion in the case of contraceptive errors or if contraception is not used. 15

16. Progestin-Only Injectable The injectable contraceptives depot medroxyprogesterone acetate (DMPA ) and norethisterone enanthate (NET-EN) each contain a progestin like the natural hormone progesterone in a woman’s body . Do not contain estrogen, and so can be used throughout breastfeeding, starting 6 weeks after giving birth, and by women who cannot use methods with estrogen . 16

17. Progestin-Only Injectable Cont. 17

18. Progestin-Only Injectable Cont. 18

19. Progestin-Only Injectable Cont. Given by injection into the muscle (intramuscular injection) or, with a new formulation of DMPA, just under the skin (subcutaneous injection ). The hormone is then released slowly into the bloodstream 19

20. Monthly Injectable Monthly injectable contains 2 hormones—a progestin and an estrogen like the natural hormones progesterone and estrogen in a woman’s body .( Combined oral contraceptives also contain these 2 types of hormones). Also called combined injectable contraceptives, CIC s, the injection. 20

21. Monthly Injectable 21

22. Monthly Injectable Cont. Work primarily by preventing the release of eggs from the ovaries(ovulation). Effectiveness depends on returning on time: Risk of pregnancy is greatest when a woman is late for an injection or misses an injection. 22

23. Monthly Injectable Cont. As commonly used, about 3 pregnancies per 100 women using monthly injectable over the first year . When women have injections on time, less than 1 pregnancy per 100 women using monthly injectable over the first year 23

24. Monthly Injectable Cont. Some Women Like Monthly Injectable because of : Do not require daily action Are private: No one else can tell that a woman is using contraception Can be stopped at any time Are good for spacing births 24

25. Combined Patch A small, thin, square of flexible plastic worn on the body . Continuously releases 2 hormones a progestin and an estrogen The woman puts on a new patch every week for 3 weeks, then no patch for the fourth week. During this fourth week the woman will have monthly bleeding. 25

26. Combined Patch 26

27. Combined Patch Cont. Works primarily by preventing the release of eggs from the ovaries Effectiveness depends on the user: Risk of pregnancy is greatest when a woman is late to change the patch . 27

28. Combined Patch Cont. As commonly used, about 7 pregnancies per 100 women using the combined patch over the first year . When no mistakes are made with use of the patch, less than 1 pregnancy per 100 women using a patch over the first year. Pregnancy rates may be slightly higher among women weighing 90 kg or more . 28

29. Combined Vaginal Ring A flexible ring that a woman places in her vagina Continuously releases 2 hormones a progestin and an estrogen. She leaves the ring in place for 3 weeks, then removes it for the fourth week . During this fourth week the woman will have monthly bleeding. 29

30. Combined Vaginal Ring 30

31. Combined Vaginal Ring Cont. Works primarily by preventing the release of eggs from the ovaries. Effectiveness depends on the user: Risk of pregnancy is greatest when a woman is late to start a new ring. 31

32. Combined Vaginal Ring Cont. As commonly used, about 7 pregnancies per 100 women using the combined vaginal ring over the first year . When no mistakes are made with use of the combined vaginal ring, less than 1 pregnancy per 100 women using the combined vaginal ring over the first year. 32

33. Progesterone- Releasing Vaginal Ring A smooth, soft, flexible silicone ring placed in the vagina to prolong lactational amenorrhea. Continuously releases natural progesterone hormone like that in a woman’s body from inside the ring. The hormone passes through the wall of the vagina directly into the bloodstream. This ring does not contain estrogen. 33

34. Progesterone- Releasing Vaginal Ring 34

35. Progesterone- Releasing Vaginal Ring Cont. Use of the ring starts 4 to 9 weeks after giving birth . Each ring is kept in place for 90 days. The woman can then replace it with a new ring immediately . Up to 4 rings can be used, one after another, with no breaks . Works by preventing release of an egg from the ovaries. 35

36. Progesterone- Releasing Vaginal Ring Cont. Safe and effective option for a woman : Who has a baby at least 4 weeks old Who is breastfeeding her baby at least 4 times per day and plans to continue breastfeeding Whose monthly bleeding has not returned 36

37. Progesterone- Releasing Vaginal Ring Cont. One or 2 pregnancies per 100 women using the progesterone releasing vaginal ring for a year . Return of fertility after use is stopped: No delay 37

38. Implants Small plastic rods, each about the size of a matchstick, that release a progestin like the natural hormone progesterone in a woman’s body . A specifically trained provider performs a minor surgical procedure to place one or 2 rods under the skin on the inside of a woman’s upper arm . 38

39. Implants 39

40. Implants Cont. Do not contain estrogen, and so can be used throughout breastfeeding and by women who cannot use methods with estrogen . 2 rods containing levonorgestrel, highly effective for 5 years 1 rod containing etonogestrel, labeled for up to 3 years of use. 40

41. Implants Cont. Work primarily by: Preventing the release of eggs from the ovaries (ovulation) Thickening cervical mucus (this blocks sperm from reaching an egg ). Far less than 1 pregnancy per 100 women using implants over the first year. 41

42. Implants Cont. Some Women Like Implants because of: Do not require the user to do anything once they are inserted. Prevent pregnancy very effectively. Are both long-lasting and reversible. Do not interfere with sex. 42

43. Copper-Bearing Intrauterine Device The copper-bearing intrauterine device (IUD) is a small, flexible plastic frame with copper sleeves or wire around it. A specifically trained health care provider inserts it into a woman’s uterus through her vagina and cervix . 43

44. Copper-Bearing Intrauterine Device 44

45. Copper-Bearing Intrauterine Device Cont. Almost all types of IUDs have one or two strings, or threads, tied to them . The strings hang through the cervix into the vagina . Works by causing a chemical change that damages sperm and egg before they can meet. 45

46. Copper-Bearing Intrauterine Device Cont. Less than 1 pregnancy per 100 women using an IUD over the first year. A small risk of pregnancy remains beyond the first year of use and continues as long as the woman is using the IUD . Return of fertility after IUD is removed: No delay 46

47. Copper-Bearing Intrauterine Device Cont. Some Women Like the IUD because of: Prevents pregnancy very effectively and long-lasting. Does not require the user to do anything once the IUD is inserted. Is private usually no one else can tell a woman is using. contraception (sometimes a partner may feel the strings during sex ). Has no further costs for supplies after the IUD is inserted. 47

48. Levonorgestrel Intrauterine Device The levonorgestrel intrauterine device (LNG-IUD) is a T-shaped plastic device that steadily releases a small amount of levonorgestrel each day. A specifically trained health care provider inserts it into a woman’s uterus through her vagina and cervix . Works by preventing sperm from fertilizing an egg. 48

49. Levonorgestrel Intrauterine Device 49

50. Levonorgestrel Intrauterine Device Cont. Less than 1 pregnancy per 100 women using an LNG-IUD over the first year. A small risk of pregnancy remains beyond the first year of use and continues as long as the woman is using the LNG-IUD . Return of fertility after LNG-IUD is removed: No delay 50

51. Levonorgestrel Intrauterine Device Cont. Some Women Like the LNG-IUD because of: Prevents pregnancy very effectively Makes bleeding lighter and can prevent monthly bleeding for many months (amenorrhea) Is long-lasting 51

52. Levonorgestrel Intrauterine Device Cont. Some Women Like the LNG-IUD because of: Is private—usually no one else can tell a woman is using contraception (sometimes a partner may feel the strings during sex) Has no further costs for supplies after the IUD is inserted Does not require the user to do anything once the IUD is inserted 52

53. Female Sterilization Permanent surgical contraception for women who will not want more children. Works because the fallopian tubes are blocked or cut. Eggs released from the ovaries cannot move down the tubes , and so they do not meet sperm. 53

54. Female Sterilization 54

55. Female Sterilization Cont. Less than 1 pregnancy per 100 women over the first year after having the sterilization procedure. small risk of pregnancy remains beyond the first year after the procedure and until the woman reaches menopause . Effectiveness varies slightly depending on how the tubes are blocked, but pregnancy rates are low with all techniques. 55

56. Female Sterilization Cont. Some Women Like Female Sterilization because of: Has no side effects. No need to warry about getting pregnant or about contraception again Nothing to do or remember after the procedure 56

57. Vasectomy Permanent contraception for men who will not want more children . Through a puncture or small incision in the scrotum, the provider locates each of the 2 tubes that carries sperm to the penis (vas deferens) and cuts or blocks them by cutting and tying them closed or by applying heat or electricity (cautery). 57

58. Vasectomy 58

59. Vasectomy Cont. Among the partners of men who have vasectomies, far less than 1 in every 100 will become pregnant in the first year of use of the method. Sometimes men can have their semen examined at 3 months after the procedure to see if it still contains sperm. If no sperm is found, 1 woman in every 1,000 of these men’s partners will become pregnant in the first year. 59

60. Male Condoms Sheaths, or coverings, that fit over a man’s erect penis . Most are made of thin latex rubber. Work by forming a barrier that keeps sperm out of the vagina, preventing pregnancy . Also keep infections in semen, on the penis, or in the vagina from infecting the other partner. 60

61. Male Condoms 61

62. Male Condoms Cont. Risk of pregnancy or sexually transmitted infection (STI) is greatest when condoms are not used with every act of sex . Very few pregnancies or infections occur due to incorrect use, slips, or breaks . As commonly used, about 13 pregnancies per 100 women whose partners use male condoms over the first year . 62

63. Female Condoms Sheaths, or linings, that fit loosely inside a woman’s vagina, made of thin, transparent, soft film. Have flexible rings at both ends One ring at the closed end helps to insert the condom The ring at the open end holds part of the condom outside the vagina 63

64. Female Condoms 64

65. Female Condoms Cont. Female condoms are made of various materials, such as latex, polyurethane , and nitrile . Work by forming a barrier that keeps sperm out of the vagina, preventing pregnancy. Also helps to keep infections in semen, on the penis, or in the vagina from infecting the other partner. 65

66. Female Condoms Cont. Risk of pregnancy or sexually transmitted infection (STI) is greatest when female condoms are not used with every act of sex. Few pregnancies or infections occur due to incorrect use, slips, or breaks. As commonly used, about 21 pregnancies per 100 women using female condoms over the first year. 66

67. Spermicides and Diaphragms Sperm-killing substances inserted deep in the vagina, near the cervix, before sex. Nonoxynol-9 is most widely used. Others include benzalkonium chloride, chlorhexidine, menfegol , octoxynol-9 , and sodium docusate. 67

68. Spermicides and Diaphragms 68

69. Spermicides and Diaphragms cont. Risk of pregnancy is greatest when spermicides are not used with every act of sex . One of the least effective family planning methods . As commonly used, about 21 pregnancies per 100 women using spermicides over the first year. 69

70. Cervical Caps A soft, deep, latex or plastic rubber cup that snugly covers the cervix. Comes in different sizes; requires fitting by a specifically trained provider . One of the least effective methods, as commonly used . As commonly used, about 32 pregnancies per 100 women using the cervical cap with spermicide over the first year. 70

71. Cervical Caps 71

72. 72